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Ong-Artborirak P, Seangpraw K, Boonyathee S, Auttama N, Winaiprasert P. Health literacy, self-efficacy, self-care behaviors, and glycemic control among older adults with type 2 diabetes mellitus: a cross-sectional study in Thai communities. BMC Geriatr 2023; 23:297. [PMID: 37193967 DOI: 10.1186/s12877-023-04010-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2022] [Accepted: 04/28/2023] [Indexed: 05/18/2023] Open
Abstract
BACKGROUND Properly understanding the health information of people with type 2 diabetes mellitus (T2DM) is the basis for better risk factor management, which also positively affects their quality of life. The aim of this study was to investigate diabetes health literacy (HL), self-efficacy, and self-care behaviors associated with glycemic control among older adults with T2DM in northern Thai communities. METHODS A cross-sectional study was conducted among 414 older adults over the age of 60 diagnosed with T2DM. The study was conducted in Phayao Province from January to May 2022. Simple random sampling of the patient list for the Java Health Center Information System program was used. Questionnaires were used to collect data on diabetes HL, self-efficacy, and self-care behaviors. Blood samples were tested for estimated glomerular filtration rate (eGFR) and glycemic controls, such as fasting blood sugar (FBS) and glycated hemoglobin (HbA1c). RESULTS The mean age of participants was 67.1 years. FBS (mean ± SD = 108.5 ± 29.5 mg/dL) and HbA1c (mean ± SD = 6.6 ± 1.2%) levels were found to be abnormal in 50.5% (≥ 126 mg/dL) and 17.4% (≥ 6.5%) of the subjects, respectively. There was a strong correlation between HL and self-efficacy (r = 0.78), HL and self-care behaviors (r = 0.76), and self-efficacy and self-care behaviors (r = 0.84). The eGFR was significantly correlated with diabetes HL (r = 0.23), self-efficacy (r = 0.14), self-care behaviors (r = 0.16), and HbA1c (r = -0.16) scores. Linear regression after adjusting for sex, age, education, DM duration, smoking, and drinking alcohol showed that FBS level was inversely associated with diabetes HL (Beta = -0.21, R2 = 11.0%), self-efficacy (Beta = -0.43, R2 = 22.2%), and self-care behavior (Beta = -0.35, R2 = 17.8%), whereas HbA1C level was negatively associated with diabetes HL (Beta = -0.52, R2 = 23.8%), self-efficacy (Beta = -0.39, R2 = 19.1%), and self-care behavior (Beta = -0.42, R2 = 20.7%). CONCLUSION Diabetes HL was related to self-efficacy and self-care behaviors in elderly T2DM patients and was shown to influence their health, including glycemic control. These findings suggest that implementing HL programs to build competence in self-efficacy expectations is important for contributing to improvements in diabetes preventive care behaviors and HbA1c control.
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Affiliation(s)
| | | | | | - Nisarat Auttama
- School of Public Health, University of Phayao, Phayao, Thailand
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Salinas Martínez AM, Juárez Montes AG, Ramírez Morado Y, Cordero Franco HF, Guzmán de la Garza FJ, Hernández Oyervides LC, Núñez Rocha GM. Idealistic, realistic, and unrealistic expectations of pharmacological treatment in persons with type 2 diabetes in primary care. Front Public Health 2023; 11:1058828. [PMID: 36817935 PMCID: PMC9931755 DOI: 10.3389/fpubh.2023.1058828] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Accepted: 01/11/2023] [Indexed: 02/05/2023] Open
Abstract
Introduction Information on treatment expectations in diabetes is scarce for Mexican and Latino populations. We determined idealistic, realistic, and unrealistic expectations for metformin, insulin, and glyburide in primary care. We also explored the association between sociodemographic attributes, time since diagnosis, and expectations. Methods This was a cross-sectional study conducted during 2020-2022 in governmental primary care centers. We consecutively included persons with type 2 diabetes aged 30-70 years under pharmacological medication (n = 907). Questions were developed using information relevant to expectation constructs. Data were collected by interview. We used descriptive statistics, a test of the difference between two proportions, and multivariate ordinal logistic regression. Results A high percentage of participants would like to have fewer daily pills/injections or the option of temporarily stopping their medication. Realistic expectations ranged from 47% to 70%, and unrealistic expectations from 31 to 65%. More insulin users wished they could take a temporary break (p < 0.05) or would like to be able to change the route of administration (p < 0.001) than metformin users. More persons with diabetes on insulin expected realistic expectations compared to those on metformin or glyburide (p ≤ 0.01). Being able to interrupt medication upon reaching the glucose goal was higher in combined therapy users (p < 0.001). Conclusion Time since diagnosis, place of residence, sex, and diabetes education were factors associated to expectations. Management of expectations must be reinforced in primary care persons with type 2 diabetes undergoing pharmacological medication.
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Affiliation(s)
- Ana María Salinas Martínez
- Universidad Autónoma de Nuevo León, Facultad de Salud Pública y Nutrición, Monterrey, Mexico,Epidemiologic and Health Services Research Unit/CIBIN, Mexican Institute of Social Security, Monterrey, Mexico,*Correspondence: Ana María Salinas Martínez ✉ ; ✉
| | | | - Yesenia Ramírez Morado
- Family Medicine Clinic and General Hospital of Subzone No. 12, Mexican Institute of Social Security, Linares, Mexico
| | | | - Francisco Javier Guzmán de la Garza
- Epidemiologic and Health Services Research Unit/CIBIN, Mexican Institute of Social Security, Monterrey, Mexico,Universidad Autónoma de Nuevo León, Facultad de Medicina, Monterrey, Mexico
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Chu SF, Wang HH. Outcome Expectations and Older Adults with Knee Osteoarthritis: Their Exercise Outcome Expectations in Relation to Perceived Health, Self-Efficacy, and Fear of Falling. Healthcare (Basel) 2022; 11:57. [PMID: 36611517 PMCID: PMC9819286 DOI: 10.3390/healthcare11010057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2022] [Revised: 12/20/2022] [Accepted: 12/22/2022] [Indexed: 12/28/2022] Open
Abstract
Outcome expectations are a determinant of exercise engagement and adherence. However, the factors that influence outcome expectations for exercise remain poorly understood for people with knee osteoarthritis. In this paper, a cross-sectional study was conducted by recruiting 211 older adults from three clinics in Southern Taiwan. This study explored older adults with knee osteoarthritis exercise outcome expectations and perceived health, self- efficacy, and fear of falling. The older adults completed the Outcome Expectations for Exercise Scale (OEES), the pain and physical function subscales of Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), the Perceived Health Status Scale, the Self-Efficacy for Exercise scale (SEE- C), the Activities-Specific Balance Confidence Scale (ABC), the Geriatric Depression Scale (GDS). Multiple logistic regression models were used to determine associations between outcome expectations for exercise and physical and psychosocial outcomes in the knee OA population. Among the participants of the cross-sectional study, the mean age was 72.04 (SD = 5.53) years, and 71.6% were female. Higher outcome expectations for exercise were associated with higher physical function (OR = 0.98; 95% CI [0.96−1.99]; p = 0.007), better perceived health (OR = 1.30; 95% CI [1.12−1.51]; p < 0.001), greater self-efficacy (OR =1.03; 95% CI [1.01−1.04]; p = 0.006), and less fear of falling (OR = 3.33; 95% CI [1.21−9.19]; p = 0.020). Thus, the results indicated that outcome expectations for exercise among the participants were significantly associated with physical function, perceived health, self-efficacy, and fear of falling. These findings suggest the importance of personal factors in the design of interventions to promote exercise behavior changes among elderly patients with Knee Osteoarthritis.
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Affiliation(s)
- Su-Feng Chu
- Department of Nursing, Meiho University, Pingtung 912009, Taiwan
- College of Nursing, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
| | - Hsiu-Hung Wang
- College of Nursing, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
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Lightfoot CJ, Wilkinson TJ, Hadjiconstantinou M, Graham-Brown M, Barratt J, Brough C, Burton JO, Hainsworth J, Johnson V, Martinez M, Nixon AC, Pursey V, Schreder S, Vadaszy N, Wilde L, Willingham F, Young HML, Yates T, Davies MJ, Smith AC. The Codevelopment of "My Kidneys & Me": A Digital Self-management Program for People With Chronic Kidney Disease. J Med Internet Res 2022; 24:e39657. [PMID: 36374538 PMCID: PMC9706383 DOI: 10.2196/39657] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Revised: 08/05/2022] [Accepted: 08/11/2022] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Health care self-management is important for people living with nondialysis chronic kidney disease (CKD). However, the few available resources are of variable quality. OBJECTIVE This work describes the systematic codevelopment of "My Kidneys & Me" (MK&M), a theory-driven and evidence-based digital self-management resource for people with nondialysis CKD, guided by an established process used for the successful development of the diabetes education program MyDESMOND (Diabetes Education and Self-Management for Ongoing and Newly Diagnosed, DESMOND). METHODS A multidisciplinary steering group comprising kidney health care professionals and researchers and specialists in the development of complex interventions and digital health provided expertise in the clinical and psychosocial aspects of CKD, self-management, digital health, and behavior change. A patient and public involvement group helped identify the needs and priorities of MK&M and co-design the resource. MK&M was developed in 2 sequential phases. Phase 1 involved the codevelopment process of the MK&M resource (content and materials), using Intervention Mapping (IM) as a framework. The first 4 IM steps guided the development process: needs assessment was conducted to describe the context of the intervention; intervention outcomes, performance objectives, and behavioral determinants were identified; theory- and evidence-based change methods and practical strategies to deliver change methods were selected; and program components were developed and refined. Phase 2 involved the adoption and adaptation of the existing MyDESMOND digital platform to suit the MK&M resource. RESULTS The needs assessment identified that individuals with CKD have multiple differing needs and that delivering a self-management program digitally would enable accessible, tailored, and interactive information and support. The intended outcomes of MK&M were to improve and maintain effective self-management behaviors, including physical activity and lifestyle, improve knowledge, promote self-care skills, increase self-efficacy, and enhance well-being. This was achieved through the provision of content and materials designed to increase CKD knowledge and patient activation, reduce health risks, manage symptoms, and improve physical function. Theories and behavior change techniques selected include Self-Management Framework, Capability, Opportunity, Motivation Behavior model components of Behaviour Change Wheel and taxonomy of behavior change techniques, Health Action Process Approach Model, Common Sense Model, and Social Cognitive Theory. The program components developed comprised educational and behavior change sessions, health trackers (eg, monitoring blood pressure, symptoms, and exercise), goal-setting features, and forums for social support. The MyDESMOND digital platform represented an ideal existing platform to host MK&M; thus, the MyDESMOND interface and features were adopted and adapted for MK&M. CONCLUSIONS Applying the IM framework enabled the systematic application of theory, empirical evidence, and practical perspectives in the codevelopment of MK&M content and materials. Adopting and adapting a preexisting platform provided a cost- and time-efficient approach for developing our digital intervention. In the next stage of work, the efficacy of MK&M in increasing patient activation will be tested in a randomized controlled trial.
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Affiliation(s)
- Courtney J Lightfoot
- Leicester Kidney Lifestyle Team, Department of Health Sciences, University of Leicester, Leicester, United Kingdom
- Leicester Biomedical Research Centre, Leicester, United Kingdom
| | - Thomas J Wilkinson
- Leicester Kidney Lifestyle Team, Department of Health Sciences, University of Leicester, Leicester, United Kingdom
- National Institute for Health Research Applied Research Collaboration East Midlands, Leicester Diabetes Centre, Leicester, United Kingdom
| | | | - Matthew Graham-Brown
- Department of Cardiovascular Sciences, University of Leicester, Leicester, United Kingdom
- Department of Renal Medicine, University Hospitals of Leicester NHS Trust, Leicester, United Kingdom
| | - Jonathan Barratt
- Department of Cardiovascular Sciences, University of Leicester, Leicester, United Kingdom
- Department of Renal Medicine, University Hospitals of Leicester NHS Trust, Leicester, United Kingdom
| | - Christopher Brough
- Leicester Diabetes Centre, University Hospitals of Leicester NHS Trust, Leicester, United Kingdom
| | - James O Burton
- Department of Cardiovascular Sciences, University of Leicester, Leicester, United Kingdom
- Department of Renal Medicine, University Hospitals of Leicester NHS Trust, Leicester, United Kingdom
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, United Kingdom
| | - Jenny Hainsworth
- Department of Medical Psychology, Leicestershire Partnership NHS Trust, Leicester, United Kingdom
- University Hospitals of Leicester NHS Trust, Leicester, United Kingdom
| | - Vicki Johnson
- Leicester Diabetes Centre, University Hospitals of Leicester NHS Trust, Leicester, United Kingdom
| | - Maria Martinez
- Renal and Transplant Unit, University Hospitals of Leicester NHS Trust, Leicester, United Kingdom
| | - Andrew C Nixon
- Department of Renal Medicine, Lancashire Teaching Hospitals NHS Foundation Trust, Preston, United Kingdom
- Division of Cardiovascular Sciences, University of Manchester, Manchester, United Kingdom
| | - Victoria Pursey
- Department of Renal Medicine, York Teaching Hospital NHS Foundation Trust, York, United Kingdom
| | - Sally Schreder
- Leicester Diabetes Centre, University Hospitals of Leicester NHS Trust, Leicester, United Kingdom
| | - Noemi Vadaszy
- Leicester Kidney Lifestyle Team, Department of Health Sciences, University of Leicester, Leicester, United Kingdom
| | - Lucina Wilde
- Leicester Kidney Lifestyle Team, Department of Health Sciences, University of Leicester, Leicester, United Kingdom
| | - Fiona Willingham
- Nutrition and Dietetics Team, School of Sport and Health Sciences, University of Central Lancashire, Preston, United Kingdom
- Nutrition and Dietetic Department, East Lancashire Hospitals NHS Trust, Blackburn, United Kingdom
| | - Hannah M L Young
- Diabetes Research Centre, University of Leicester, Leicester, United Kingdom
- Leicester Diabetes Centre, University Hospitals of Leicester NHS Trust, Leicester, United Kingdom
| | - Thomas Yates
- Leicester Biomedical Research Centre, Leicester, United Kingdom
- Diabetes Research Centre, College of Life Sciences, University of Leicester, Leicester, United Kingdom
| | - Melanie J Davies
- Leicester Biomedical Research Centre, Leicester, United Kingdom
- Diabetes Research Centre, University of Leicester, Leicester, United Kingdom
| | - Alice C Smith
- Leicester Kidney Lifestyle Team, Department of Health Sciences, University of Leicester, Leicester, United Kingdom
- Leicester Biomedical Research Centre, Leicester, United Kingdom
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Development and evaluation of a new questionnaire to assess social cognitive factors of self-management in patients with type 2 diabetes: a psychometric study. J Diabetes Metab Disord 2022; 21:483-492. [PMID: 35673441 PMCID: PMC9167319 DOI: 10.1007/s40200-022-00999-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Accepted: 01/30/2022] [Indexed: 10/19/2022]
Abstract
Background Self-care behaviors are essential to control blood sugar and to prevent mortality and complications of diabetes. The evidence suggests that social cognitive factors play a crucial role in adopting self-care behaviors. This study aimed to develop and examine the psychometric properties of the Diabetes Self-Management Questionnaire based on the social cognitive theory (DSMQ-SCT). Methods The present methodological cross-sectional study investigated 460 patients with T2DM referred to the Isfahan Endocrine and Metabolism Research Centre, Isfahan, Iran using the convenience sampling method. We assessed the reliability (internal consistency), content validity, convergent validity and construct validity. Construct validity was evaluated using exploratory factor analysis (calibration sample = 230) and confirmatory factor analysis (validation sample = 230). Results In the EFA with the varimax rotation, we extracted four factors that could explain 65.9% of the total variance of the DSMQ-SCT scale. The CFA exhibited a satisfactory fit level for the four-factor structure extracted from the EFA with the following measures. CFI: .971, IFI: .971, NFI: .942, TLI: .966, RMSEA: .046).Internal consistency was good (Cronbach's alpha coefficient for the whole scale: 0.88; the subscales: 0.85 to 0.92). The convergent validity showed significant negative correlations between DSMQ-SCT subscales and HbA1c. Conclusion DSMQ-SCT is a valid and reliable instrument to assess social cognitive factors associated with self-management behaviors in patients with T2DM. Therefore, this instrument can be used in both future research and clinical practices.
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Deng B, Chen Y, Meng Y, Zhang Y, Tan X, Zhou X, Zhang M. A self-efficacy-enhancing intervention for Chinese patients after total hip arthroplasty: study protocol for a randomized controlled trial with 6-month follow-up. J Orthop Surg Res 2022; 17:1. [PMID: 34983553 PMCID: PMC8725334 DOI: 10.1186/s13018-021-02689-8] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2021] [Accepted: 08/23/2021] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Total hip arthroplasty (THA) is a common and effective surgical method for advanced hip arthritis. Rehabilitation exercises are important to improve joint function after THA and are usually conducted in a home-based program. Poor patient adherence limits improvements in pain and function, affecting quality of life. The increasing use of THA in the aging Chinese population underscores the need to develop strategies that maximize functional outcomes. The purpose of this pilot study is to develop and assess the feasibility of a self-efficacy-enhancing intervention (SEEI) to improve exercise adherence in patients undergoing THA. METHODS This single-blinded, parallel, randomized control trial will recruit 150 patients after THA and randomly assign them to an intervention or control group using computer-generated block randomization. The control group will receive usual care using evidence-based guidelines. The intervention group will receive the 6-month SEEI comprising personalized exercise guidance and self-efficacy education delivered using one face-to-face education session and four telephone consultations, supplemented by written materials. Participants are encouraged to build confidence in their own abilities, set rehabilitation goals, and self-monitor their physical exercise. RESULTS Assessments will be conducted at baseline and 1, 3, and 6 months postsurgery. The outcome indicators are exercise adherence, physical function, anxiety and depression, self-efficacy of rehabilitation, joint function, and quality of life. CONCLUSIONS This study will test a theory-based intervention program to improve self-efficacy in rehabilitation, which may significantly impact out-of-hospital rehabilitation. The results will provide evidence to inform the postoperative recovery of patients undergoing THA or similar procedures. TRIAL REGISTRATION Chinese Clinical Trials Registry, ChiCTR2000029422 , registered on 31 January 2020.
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Affiliation(s)
- Bo Deng
- Nursing Department, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, China
| | - Yumei Chen
- Nursing Department, Foshan Hospital of Traditional Chinese Medicine, Foshan, Guangdong, China
| | - Ya Meng
- School of Nursing, Sun Yat-sen University, 74, Zhongshan 2nd Rd, Guangzhou, 510080, Guangdong, China
| | - Yiheng Zhang
- School of Nursing, Sun Yat-sen University, 74, Zhongshan 2nd Rd, Guangzhou, 510080, Guangdong, China
| | - Xingxian Tan
- Department of Orthopedics, Foshan Hospital of Traditional Chinese Medicine, Foshan, Guangdong, China
| | - Xiaohong Zhou
- Department of Orthopedics, Foshan Hospital of Traditional Chinese Medicine, Foshan, Guangdong, China
| | - Meifen Zhang
- School of Nursing, Sun Yat-sen University, 74, Zhongshan 2nd Rd, Guangzhou, 510080, Guangdong, China.
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Gilcharan Singh HK, Chee WSS, Hamdy O, Mechanick JI, Lee VKM, Barua A, Mohd Ali SZ, Hussein Z. Eating self-efficacy changes in individuals with type 2 diabetes following a structured lifestyle intervention based on the transcultural Diabetes Nutrition Algorithm (tDNA): A secondary analysis of a randomized controlled trial. PLoS One 2020; 15:e0242487. [PMID: 33253259 PMCID: PMC7703935 DOI: 10.1371/journal.pone.0242487] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2019] [Accepted: 11/03/2020] [Indexed: 12/16/2022] Open
Abstract
OBJECTIVE Eating self-efficacy behavior is an important predictor of successful lifestyle intervention. This secondary analysis evaluated the changes in eating self-efficacy behavior in patients with type 2 diabetes (T2D) and overweight/obesity following structured lifestyle intervention based on the Malaysian customized transcultural Diabetes Nutrition Algorithm (tDNA). METHODS Patients with T2D and overweight/obesity (n = 230) were randomized either into the tDNA group which included a structured low-calorie meal plan using normal foods, incorporation of diabetes-specific meal replacements, and an exercise prescription or usual T2D care (UC) for 6 months. Patients in the tDNA group also received either counseling with motivational interviewing (tDNA-MI) or conventional counseling (tDNA-CC). The UC group received standard dietary and exercise advice using conventional counseling. Eating self-efficacy was assessed using a locally validated Weight Efficacy Lifestyle (WEL) questionnaire. All patients were followed up for additional 6 months' post-intervention. RESULTS There was a significant change in WEL scores with intervention over one-year [Group X Time effect: F = 51.4, df = (3.4, 318.7), p<0.001]. Compared to baseline, WEL scores improved in both the tDNA groups with significantly higher improvement in the tDNA-MI group compared to the tDNA-CC and UC groups at 6 months (tDNA-MI: 25.4±2.1 vs. tDNA-CC: 12.9±2.8 vs. UC: -6.9±1.9, p<0.001). At 12 months' follow-up, both the tDNA groups maintained improvement in the WEL scores, with significantly higher scores in the tDNA-MI group than tDNA-CC group, and the UC group had decreased WEL scores (tDNA-MI: 28.9±3.1 vs. tDNA-CC: 11.6±3.6 vs. UC: -13.2±2.1, p<0.001). Patients in the tDNA-MI group with greater weight loss and hemoglobin A1C reduction also had a higher eating self-efficacy, with a similar trend observed in comparative groups. CONCLUSION Eating self-efficacy improved in patients with T2D and overweight/obesity who maintained their weight loss and glycemic control following a structured lifestyle intervention based on the Malaysian customized tDNA and the improvement was further enhanced with motivational interviewing. CLINICAL TRIAL This randomized clinical trial was registered under National Medical Research Registry, Ministry of Health Malaysia with registration number: NMRR-14-1042-19455 and also under ClinicalTrials.gov with registration number: NCT03881540.
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Affiliation(s)
- Harvinder Kaur Gilcharan Singh
- Division of Nutrition and Dietetics, School of Health Sciences, International Medical University, Kuala Lumpur, Malaysia
| | - Winnie Siew Swee Chee
- Division of Nutrition and Dietetics, School of Health Sciences, International Medical University, Kuala Lumpur, Malaysia
| | - Osama Hamdy
- Division of Endocrinology, Diabetes and Metabolism, Joslin Diabetes Center, Harvard Medical School, Boston, United States of America
| | - Jeffrey Ian Mechanick
- Division of Endocrinology, Diabetes and Bone Disease, Icahn School of Medicine at Mount Sinai, New York, United States of America
| | - Verna Kar Mun Lee
- Department of Family Medicine, School of Medicine, International Medical University, Kuala Lumpur, Malaysia
| | - Ankur Barua
- Department of Community Medicine, School of Medicine, International Medical University, Kuala Lumpur, Malaysia
| | - Siti Zubaidah Mohd Ali
- Department of Non-Communicable Diseases, Klinik Kesihatan Seremban, Negeri Sembilan, Malaysia
| | - Zanariah Hussein
- Department of Medicine, Hospital Putrajaya, Pusat Pentadbiran Kerajaan Persekutuan, Putrajaya, Malaysia
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Momenabadi V, Kaveh MH, Nakhaee N, Karimzadeh Shirazi K, Sedighi B, Tabatabaei SHR. Health Promoting Self-care Behaviors in Patients With Multiple Sclerosis in the Southeast of Iran: Developing a Model for Practice. Basic Clin Neurosci 2020; 11:687-699. [PMID: 33643561 PMCID: PMC7878060 DOI: 10.32598/bcn.11.5.1670.1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2019] [Revised: 01/25/2019] [Accepted: 09/15/2019] [Indexed: 11/20/2022] Open
Abstract
INTRODUCTION Promoting self-care practice, as a critical strategy for enhancing the quality of life in patients with Multiple Sclerosis (MS) is a challenging issue. This study aimed to propose a model of health-promoting self-care behaviors in MS patients. METHODS In this cross-sectional study, 200 patients with MS, who had referred to the Hospital for Special Diseases in Kerman City, Iran, were chosen. The main data collection instruments were the multiple sclerosis knowledge questionnaire, the Rosenberg self-esteem scale, multiple sclerosis self-efficacy scale, questionnaire of perceived barriers and benefits of self-care behaviors, social support, the health promotion lifestyle profile II, and resilience and sense of coherence scale. Data analysis was conducted in SPSS V. 22 and AMOS18 software. The Structural Equation Modeling (SEM) was also used for further analysis of data. RESULTS The model explained 82% of variance in Health-Promoting self-care Behavior (HPB). The results of the final model obtained from the SEM showed that self-efficacy (β=0.53, SE=0.04, P= 0.007), self-esteem (β=0.39, SE=0.04, P=0.005), social support (β=0.36, SE=0.04, P=0.009), sense of coherence (β=0.34, SE=0.07, P=0.006), resilience (β=0.33, SE=0.07, P=0.018), and perceived benefits (β=0.25, SE=0.05, P=0.009) had a positive and significant relationship with HPB. CONCLUSION The self-care empowerment model in patients with MS presented in this study can be used as a framework for designing health promotion interventions to improve the quality of life of patients with MS.
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Affiliation(s)
- Victoria Momenabadi
- Department of Health Education & Promotion, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohammad Hossein Kaveh
- Department of Health Education & Promotion, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Nouzar Nakhaee
- Neuroscience Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - Kambiz Karimzadeh Shirazi
- Department of Health Education and Promotion, School of Health and Nutrition Sciences, Yasuj University of Medical Sciences, Yasuj, Iran
| | - Behnaz Sedighi
- Neuroscience Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - Seyyed Hamid Reza Tabatabaei
- Department of Epidemiology, Research Center for Health Sciences, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran
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Richmond RS, Connolly M. A delineation of self-management and associated concepts. INTERNATIONAL JOURNAL OF HEALTHCARE MANAGEMENT 2020. [DOI: 10.1080/20479700.2020.1810963] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Adu MD, Malabu UH, Malau-Aduli AEO, Drovandi A, Malau-Aduli BS. Efficacy and Acceptability of My Care Hub Mobile App to Support Self-Management in Australians with Type 1 or Type 2 Diabetes. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E2573. [PMID: 32283659 PMCID: PMC7177976 DOI: 10.3390/ijerph17072573] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/21/2020] [Revised: 04/04/2020] [Accepted: 04/05/2020] [Indexed: 11/17/2022]
Abstract
The aim of this study was to evaluate the preliminary efficacy and user acceptance of My Care Hub (MCH) mobile app-developed to provide evidenced-based support and education on diabetes self-management (DSM). Using a mixed-methods design, the efficacy and acceptability of MCH were measured among people with type 1 or type 2 diabetes after three weeks of intervention. The primary outcome measure was level of involvement with DSM, while the mediating factors were skills and self-efficacy for DSM. Telephone interviews were conducted to elucidate information on perceptions of the app's impact on participants' DSM and interest in future use. Statistically significant improvements were observed between pre- and post-intervention measures: DSM activities (4.55 ± 1.14 vs. 5.35 ± 0.84; p = 0.001); skills (7.10 ± 1.99 vs. 7.90 ± 1.67; p = 0.04); and self-efficacy (7.33 ±1.83 vs. 8.07 ± 1.54; p = 0.03). Multivariate analysis showed that self-efficacy had the strongest, though not significant influence on DSM. Interview findings revealed that the app reinforced knowledge and provided motivation to participate in DSM activities. The study suggested a positive impact of MCH on DSM and acceptability by patients. To confirm these promising results, further large scale and long-term studies are required.
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Affiliation(s)
- Mary D. Adu
- College of Medicine and Dentistry, James Cook University, Townsville QLD 4811, Australia; (M.D.A.); (U.H.M.); (A.D.); (B.S.M.-A.)
| | - Usman H. Malabu
- College of Medicine and Dentistry, James Cook University, Townsville QLD 4811, Australia; (M.D.A.); (U.H.M.); (A.D.); (B.S.M.-A.)
| | - Aduli E. O. Malau-Aduli
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville QLD 4811, Australia
| | - Aaron Drovandi
- College of Medicine and Dentistry, James Cook University, Townsville QLD 4811, Australia; (M.D.A.); (U.H.M.); (A.D.); (B.S.M.-A.)
| | - Bunmi S. Malau-Aduli
- College of Medicine and Dentistry, James Cook University, Townsville QLD 4811, Australia; (M.D.A.); (U.H.M.); (A.D.); (B.S.M.-A.)
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Lin CY, Cheung MKT, Hung ATF, Poon PKK, Chan SCC, Chan CCH. Can a modified theory of planned behavior explain the effects of empowerment education for people with type 2 diabetes? Ther Adv Endocrinol Metab 2020; 11:2042018819897522. [PMID: 31934326 PMCID: PMC6945455 DOI: 10.1177/2042018819897522] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Accepted: 12/07/2019] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND The effectiveness of the Patient Empowerment Program (PEP) has been demonstrated in people with diabetes mellitus (DM); however, the underlying reasons for its effectiveness remain unclear. To improve effectiveness, we need to study the psychological mechanism(s) of PEP to understand why it is effective. This study hypothesized that the Theory of Planned Behavior (TPB), modified specifically for people with DM, could describe the mechanism explaining PEP effects. METHODS A longitudinal design was used. Patients with type 2 DM (n = 365; 151 males; mean age = 62.9 ± 9.6 years) received two education sessions (i.e. seminars delivered by registered nurses to provide disease-specific knowledge), and some (n = 210) further enrolled afterwards in five empowerment sessions (i.e. small-group interactive workshops conducted by social workers to practice action planning, problem solving, and experience sharing). Validated questionnaires were used to measure risk perception, health literacy, attitude, subjective norm, perceived behavioral control and behavioral intention on diabetes self-care behaviors, and four diabetes self-care behaviors (diet control, exercise, blood glucose monitoring, and foot care) at baseline. Three months later (i.e. at the end of PEP), all participants completed the behavioral intention and diabetes self-care behaviors measures again. Attitude, subjective norm, perceived behavioral control, behavioral intention, and diabetes self-care behaviors were assessed to represent the TPB constructs. Risk perception and health literacy elements relevant to people with DM were assessed and added to modify the TPB. RESULTS The behavioral intention was associated with three diabetes self-care behaviors: exercise, blood glucose monitoring, and foot care. The behavioral intention was found to be a significant mediator in the following relationships: empowerment session participation and exercise (β = 0.045, p = 0.04), and empowerment session participation and foot care (β = 0.099, p < 0.001). CONCLUSIONS The effects of enrollment of empowerment sessions in PEP on exercise and foot care were likely to be mediated through behavioral intention.
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Affiliation(s)
- Chung-Ying Lin
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | | | | | | | - Sam C. C. Chan
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Chetwyn C. H. Chan
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong SAR, China
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Wu MP, Wu SFV, Lee MC, Peng LN, Tsao LI, Lee WJ. Health-promotion interventions enhance and maintain self-efficacy for adults at cardiometabolic risk: A randomized controlled trial. Arch Gerontol Geriatr 2019; 82:61-66. [DOI: 10.1016/j.archger.2019.01.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2018] [Revised: 01/08/2019] [Accepted: 01/19/2019] [Indexed: 12/14/2022]
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Karl FM, Holle R, Schwettmann L, Peters A, Laxy M. Time preference, outcome expectancy, and self-management in patients with type 2 diabetes. Patient Prefer Adherence 2018; 12:1937-1945. [PMID: 30288034 PMCID: PMC6163016 DOI: 10.2147/ppa.s175045] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND Patient self-management is crucial to prevent complications and mortality in type 2 diabetes. From an economic perspective, time preference predicts short-sighted decision making and thus might help to explain non-adherence to self-anagement recommendations. However, recent studies on this association have shown mixed results. PURPOSE In this study, we tested whether the combination of time preference and outcome expectancy can improve the predictions of self-management behavior. PATIENTS AND METHODS Data from 665 patients with type 2 diabetes were obtained from the cross-sectional KORA (Cooperative Health Research in the Region of Augsburg) GEFU 4 study. Time preference and outcome expectancy were measured by one question each, which were answered on a 4-point Likert scale. Their association with six self-managing behaviors was tested in logistic and linear regression analyses. Likewise, we examined the association between self-management and the interaction of outcome expectancy and time preference. RESULTS A high time preference was associated with a significantly lower sum of self-management behaviors (β=-0.29, 95% CI [-0.54, -0.04]). Higher outcome expectancy was associated with a higher self-management score (β=0.21, 95% CI [-0.03, 0.45]). The interaction model showed that low time preference was only associated with better self-management when combined with a high outcome expectancy (β=0.05, 95% CI [-0.28, 0.39] vs β=0.27, 95% CI [-0.09, 0.63]). CONCLUSION Time preference and outcome expectancy are interrelated predictors of patient self-management and could be used to identify and to intervene on patients with a potentially poor self-management.
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Affiliation(s)
- Florian M Karl
- Institute of Health Economics and Health Care Management, Helmholtz Zentrum München (GmbH), German Research Center for Environmental Health, Neuherberg, Germany,
- German Center for Diabetes Research (DZD), Neuherberg, Germany,
| | - Rolf Holle
- Institute of Health Economics and Health Care Management, Helmholtz Zentrum München (GmbH), German Research Center for Environmental Health, Neuherberg, Germany,
- German Center for Diabetes Research (DZD), Neuherberg, Germany,
| | - Lars Schwettmann
- Institute of Health Economics and Health Care Management, Helmholtz Zentrum München (GmbH), German Research Center for Environmental Health, Neuherberg, Germany,
| | - Annette Peters
- German Center for Diabetes Research (DZD), Neuherberg, Germany,
- Institute of Epidemiology II, Helmholtz Zentrum München (GmbH), German Research Center for Environmental Health, Neuherberg, Germany
| | - Michael Laxy
- Institute of Health Economics and Health Care Management, Helmholtz Zentrum München (GmbH), German Research Center for Environmental Health, Neuherberg, Germany,
- German Center for Diabetes Research (DZD), Neuherberg, Germany,
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Saad AMJ, Younes ZMH, Ahmed H, Brown JA, Al Owesie RM, Hassoun AAK. Self-efficacy, self-care and glycemic control in Saudi Arabian patients with type 2 diabetes mellitus: A cross-sectional survey. Diabetes Res Clin Pract 2018; 137:28-36. [PMID: 29278711 DOI: 10.1016/j.diabres.2017.12.014] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2017] [Revised: 11/20/2017] [Accepted: 12/18/2017] [Indexed: 10/18/2022]
Abstract
AIMS To determine the prevalence of diabetes self-care activities among type 2 diabetes patients and examine the association between socio-demographic and clinical parameters, diabetes self-care activities, and glycemic control among type 2 diabetes patients. METHODS A cross sectional study was conducted among patients with diabetes (n = 123) at the Sultan Bin Abdulaziz Humanitarian City (SBAHC). A regression model was used to examine the variables that predicted glycemic control. Moreover, a regression analysis examining the effect of each self-efficacy subscale on its respective diabetes self -management (DSM) behavior was carried out. RESULTS The most frequently reported DSM behaviors were foot care followed by medication taking self-management behavior. The least frequently reported DSM behaviors were exercise self-management behavior and blood sugar testing behavior. Self-efficacy was associated with higher levels of diet, exercise, blood sugar testing, and medication taking self-management behaviors. Diet self-management behaviors and oral hypoglycemic agents (OHA) use were significantly independent predictors of glycemic control HbA1c <7% (53 mmol/mol). CONCLUSIONS The findings can serve to help clinicians have a better understanding on the extent to which different self-efficacy parameters have an influence on self-management behaviors, which will in turn lead to better glycemic control and thus improved HbA1c levels.
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Affiliation(s)
- Ahmad M J Saad
- Dubai Diabetes Center, Dubai Health Authority, Block C, Al Hudaiba Awards Building, P.O. Box 215252, Dubai, United Arab Emirates.
| | - Zeina M H Younes
- Dubai Diabetes Center, Dubai Health Authority, Block C, Al Hudaiba Awards Building, P.O. Box 215252, Dubai, United Arab Emirates
| | - Hafez Ahmed
- Dubai Medical College, Al Muhaisanah 1, Al Mizhar, P.O. Box 20170, Dubai, United Arab Emirates
| | - Jason A Brown
- Sultan Bin AbdulAziz Humanitarian City, Bahban, Riyadh 13567, Saudi Arabia
| | - Rafat M Al Owesie
- Sultan Bin AbdulAziz Humanitarian City, Bahban, Riyadh 13567, Saudi Arabia
| | - Ahmed A K Hassoun
- Dubai Diabetes Center, Dubai Health Authority, Block C, Al Hudaiba Awards Building, P.O. Box 215252, Dubai, United Arab Emirates
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Cheung MKT, Chan SCC, Hung ATF, Leung AYM, Lee A, Chan FWK, Chung KL, Poon PKK, Chan CCH. A latent profile analysis on patient empowerment programme in a Hong Kong primary care setting. PATIENT EDUCATION AND COUNSELING 2017; 100:1890-1897. [PMID: 28599868 DOI: 10.1016/j.pec.2017.05.028] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/28/2016] [Revised: 04/29/2017] [Accepted: 05/21/2017] [Indexed: 06/07/2023]
Abstract
OBJECTIVE This study identified the profiles of subgroups of type 2 diabetic (T2DM) patients of the Patient Empowerment Programme (PEP) by different levels of benefits gained in diabetic self-management behaviors, self-efficacy, and health literacy. METHODS This study adopted a non-experimental repeated-measures design on T2DM patients who joined PEP, using structured questionnaires. Latent profile analysis (LPA) was used to identify patterns of participants' change on the outcome measures. RESULTS Findings of LPA revealed that participants who were older, unemployed, weaker in diabetic self-management, and having a higher self-perception in personal disease risk were more likely to join the empowerment sessions and gained more benefits from the program. Participants with lower impairment in energy function and lower autonomy in personal health care showed more improvement in the outcomes. CONCLUSION The study identified significant factors associated with patients' participation on and benefits gained from a service delivery model integrating health education and patient empowerment in a primary care setting. PRACTICE IMPLICATION Findings from this study shed light on strategies to improve the PEP design in order to meet the needs of individuals with different health-related profiles.
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Affiliation(s)
- Mike K T Cheung
- Centre on Research and Advocacy, The Hong Kong Society for Rehabilitation, Hong Kong, China
| | - Sam C C Chan
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, China
| | - Anchor T F Hung
- Centre on Research and Advocacy, The Hong Kong Society for Rehabilitation, Hong Kong, China.
| | - Angela Y M Leung
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong, China
| | - Albert Lee
- Centre for Health Education and Health Promotion, The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Frank W K Chan
- Hospital Authority Head Office, Hong Kong Hospital Authority, Hong Kong, China
| | - K L Chung
- Hospital Authority Head Office, Hong Kong Hospital Authority, Hong Kong, China
| | - Peter K K Poon
- Centre on Research and Advocacy, The Hong Kong Society for Rehabilitation, Hong Kong, China
| | - Chetwyn C H Chan
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, China
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Azar FE, Solhi M, Nejhaddadgar N, Amani F. The effect of intervention using the PRECEDE-PROCEED model based on quality of life in diabetic patients. Electron Physician 2017; 9:5024-5030. [PMID: 28979737 PMCID: PMC5614287 DOI: 10.19082/5024] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2016] [Accepted: 04/23/2017] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Poor quality of life is common among diabetic patients, and educational intervention is one of the most effective strategies to improve the quality of life for chronic patients. OBJECTIVES To determine the effect of an educational intervention based on PRECEDE-PROCEED in quality of life of diabetic patients, in 2016. METHODS In this quasi-experimental study, 86 patients referred to diabetic centers of Ardabil participated. We used the components PRECEDE-PROCEED model for planning, implementation and evaluation of the program. Data collection tools were Diabetes Quality of Life questionnaire (DQOL) and a researcher-made questionnaire. Eight training sessions were conducted for the intervention group for self-efficiency, self- management, attitude, knowledge, and enabling reinforcing factors. Quality of life was followed one and three months after intervention. Data were analyzed through SPSS 16 software using descriptive and analytical tests. RESULTS The mean age of patients was 55.88 (±12.1) years. The result showed that before intervention, no significant difference was observed among the mean scores of quality of life, self-management, knowledge, attitude, enabling and reinforcing factors, and self-efficiency in two groups. But one and three months after intervention a significant difference was observed (p<0.001). CONCLUSION Educational intervention with PRECEDE-PROCEED model improved the diabetic patient's quality of life.
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Affiliation(s)
- Farbod Ebadifard Azar
- Ph.D. Professor, Department of Health Services and Health Education, Faculty of Health, Iran University of Medical Sciences, Tehran, Iran
| | - Mahnaz Solhi
- Ph.D. Assistant Professor, Department of Health Services and Health Education, School of Health, Iran University of Medical Sciences, Tehran, Iran
| | - Nazila Nejhaddadgar
- Ph.D. Candidate in Health Education and Health Promotion, Department of Health Care Services and Health Education, School of Health, International Campus, Iran University of Medical Sciences, Tehran, Iran
| | - Firoz Amani
- Ph.D. Assistant Professor, Department of Epidemiology and Biostatistics, School of Public Health, Ardebil University of Medical Sciences. Ardebil, Iran
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Albargawi M, Snethen J, Al Gannass A, Kelber S. Relationship between person's health beliefs and diabetes self-care management regimen. JOURNAL OF VASCULAR NURSING 2017; 35:187-192. [PMID: 29153226 DOI: 10.1016/j.jvn.2017.07.002] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2017] [Revised: 06/30/2017] [Accepted: 07/06/2017] [Indexed: 11/28/2022]
Abstract
PURPOSE To examine the relationship between the health beliefs of Saudi adults with type 2 diabetes mellitus (T2DM) and their adherence to daily diabetes self-care management regimen. A secondary aim was to examine the health beliefs of adults with a diabetic foot ulcer (DFU) and participants without a DFU. METHOD Descriptive correlational design with a convenience sample of 30 participants. Participants were recruited for this pilot study from an outpatient clinic at King Abdulaziz Medical City in Riyadh. The participants completed self-reported questionnaires about their health beliefs, daily diabetes self-care management regimen, and demographic characteristics. Hierarchical multiple regression analysis was used to test the interaction effects. FINDINGS Participants who reported having a high internal health locus of control (IHLoC) and a high level of self-efficacy (SE) adhered well to their foot care regimen (P = .038). The more the participants believed that God controls their health, and the higher their SE, the greater the participant's adherence to their medication regimen (P = .035). The stronger the participant's belief that following their diabetes treatment regimen will lead to good outcomes, the greater the participant's adherence to their dietary regimen for those with a low IHLoC (P = .015). Participants with a high SE and reported that their doctor is able to help them control their diabetes were more likely to follow their dietary regimen (P = .048). Participants with a DFU reported having additional health conditions besides T2DM (P = .018) and had less than a college education (P = .015). Although participants with a DFU reported that they were responsible for their diabetes (P = .21), they stated that God manages their diabetes (P = .29), and the disease can be controlled based on luck (P = .10). CONCLUSIONS Participants' beliefs were found to influence their daily self-care management regimen. Further studies are needed using a larger sample.
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Affiliation(s)
- Moudi Albargawi
- Department of Nursing, College of Nursing, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin; Department of Nursing, College of Nursing, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.
| | - Julia Snethen
- Department of Nursing, College of Nursing, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin
| | - Abdulaziz Al Gannass
- National Guard Health Affairs, King Abdulaziz Medical City-Riyadh, Department of Surgery-Medical City, Podiatric Surgery Unit, Riyadh, Saudi Arabia
| | - Sheryl Kelber
- Department of Nursing, College of Nursing, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin
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Borhaninejad V, Iranpour A, Shati M, Tahami AN, Yousefzadeh G, Fadayevatan R. Predictors of Self-care among the Elderly with Diabetes Type 2: Using Social Cognitive Theory. Diabetes Metab Syndr 2017; 11:163-166. [PMID: 27594115 DOI: 10.1016/j.dsx.2016.08.017] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2016] [Accepted: 08/22/2016] [Indexed: 11/20/2022]
Abstract
INTRODUCTION Diabetes is one of the most common chronic diseases among the elderly and is also a very serious health problem. Adopting theory-based self-care behaviors is an effective means in managing such diseases. This study aimed to determine the predictors of diabetes self-care in the elderly in Kerman based on a social cognitive theory. MATERIAL AND METHODS In this cross-sectional study, 384 elderly diabetic patients who had referred to health screening centers in Kerman were chosen via cluster sampling. To collect information about self-care and its predictors, Toobert Glasgow's diabetes self-efficacy scale as well as a questionnaire was used which was based on social cognitive theory constructs. The validity and reliability of the questionnaire was confirmed. The data were analyzed using Pearson correlation and linear regression analysis in SPSS software 17. FINDINGS Among the subjects, 67.37% (252) had poor self-care ability; 29.14% (109) had average ability, and 3.40% (13) enjoyed a proper level of self- care ability. There was a significant relationship between the constructs of the social cognitive theory (knowledge, self- efficacy, social support, outcome expectations, outcome expectancy and self-regulation) and the self-care score. Furthermore, the mentioned constructs could predict 0.47% of the variance of the self-care behaviors. CONCLUSION self-care behaviors in this study were poor. Therefore, it is necessary to develop an educational intervention based on cognitive theory constructs with the goal of properly managing diabetes in the elderly patients.
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Affiliation(s)
- Vahidreza Borhaninejad
- Iranian Research Center on Aging, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Abedin Iranpour
- Modeling in Health Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Mohsen Shati
- Department of Aging, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Ahmad Naghibzadeh Tahami
- Physiology Research Center, Institute of Neuropharmacology, Kerman University of Medical Sciences, Kerman, Iran
| | - Gholamrezan Yousefzadeh
- Physiology Research Center, Institute of Neuropharmacology, Kerman University of Medical Sciences, Kerman, Iran
| | - Reza Fadayevatan
- Iranian Research Center on Aging, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.
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Kav S, Yilmaz AA, Bulut Y, Dogan N. Self-efficacy, depression and self-care activities of people with type 2 diabetes in Turkey. Collegian 2017; 24:27-35. [DOI: 10.1016/j.colegn.2015.09.005] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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A study of the psychological predictors controlling the risk factors of cardiovascular diseases. Res Cardiovasc Med 2017. [DOI: 10.5812/cardiovascmed.40309] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Wichit N, Mnatzaganian G, Courtney M, Schulz P, Johnson M. Randomized controlled trial of a family-oriented self-management program to improve self-efficacy, glycemic control and quality of life among Thai individuals with Type 2 diabetes. Diabetes Res Clin Pract 2017; 123:37-48. [PMID: 27918976 DOI: 10.1016/j.diabres.2016.11.013] [Citation(s) in RCA: 74] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2016] [Revised: 11/14/2016] [Accepted: 11/15/2016] [Indexed: 11/16/2022]
Abstract
AIMS We evaluated a theoretically-derived family-oriented intervention aimed to improve self-efficacy, self-management, glycemic control and quality of life in individuals living with Type 2 diabetes in Thailand. METHODS In a single-blinded randomized controlled trial, 140 volunteer individuals with Type 2 diabetes, recruited from a diabetes clinic in rural Thailand, were randomly allocated to intervention and control arms. Those in the intervention arm received routine care plus a family-oriented program that included education classes, group discussions, a home visit, and a telephone follow-up while the control arm only received routine care. Improvement in outcomes over time (baseline, Week 3, and Week 13 following intervention) was evaluated using Generalized Estimating Equations multivariable analyses. RESULTS Except for age, no between-group significant differences were observed in all other baseline characteristics. Diabetes self-efficacy, self-management, and quality of life improved in the intervention arm but no improvement was observed in the controls. In the risk-adjusted multivariable models, compared to the controls, the intervention arm had significantly better self-efficacy, self-management, outcome expectations, and diabetes knowledge (p<0.001, in each). Participation in the intervention increased the diabetes self-management score by 14.3 points (β=14.3, (95% CI 10.7-17.9), p<0.001). Self-management was better in leaner patients and in females. No between-group differences were seen in quality of life or glycemic control, however, in the risk-adjusted multivariable models, higher self-management scores were associated with significantly decreased HbA1c levels (p<0.001) and improved patient quality of life (p<0.05) (irrespective of group membership). CONCLUSIONS Our family-oriented program improved patients' self-efficacy and self-management, which in turn could decrease HbA1c levels.
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Affiliation(s)
- Nutchanath Wichit
- School of Nursing, Midwifery and Paramedicine, Faculty of Health Sciences, Australian Catholic University, Brisbane, Australia; Faculty of Nursing, Suratthani Rajabhat University, Suratthani, Thailand.
| | - George Mnatzaganian
- College of Science, Health and Engineering, La Trobe Rural Health School, La Trobe University, Victoria, Australia; Faculty of Health Sciences, Australian Catholic University, Sydney, Australia.
| | - Mary Courtney
- School of Nursing, Midwifery and Paramedicine, Faculty of Health Sciences, Australian Catholic University, Brisbane, Australia.
| | - Paula Schulz
- School of Nursing, Midwifery and Paramedicine, Faculty of Health Sciences, Australian Catholic University, Brisbane, Australia.
| | - Maree Johnson
- Faculty of Health Sciences, Australian Catholic University, Sydney, Australia; Ingham Institution of Applied Medical Research Liverpool, Sydney, Australia.
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Self-Efficacy, Depression, and Self-Care Activities in Adult Jordanians with Type 2 Diabetes: The Role of Illness Perception. Issues Ment Health Nurs 2016; 37:744-755. [PMID: 27484761 DOI: 10.1080/01612840.2016.1208692] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Diabetes mellitus is reaching epidemic levels worldwide. In a developing country like Jordan, type 2 diabetes mellitus (T2DM) has reached a prevalence rate of 17.1%. This cross-sectional study examined the relationship between self-care activities and: illness perception, depression, social support, religiosity and spiritual coping, and self-efficacy among patients with T2DM. A random sample of 220 patients with T2DM, who attended Jordan University Hospital in Jordan were enrolled. The data were collected through a structured interview and the medical files. The instruments consisted of a sociodemographic and clinical standardised questionnaires: Brief Illness Perception Questionnaire, Patients' Health Questionnaire-9; ENRICH Social Support Instrument; Religious and Spiritual Coping Subscale; Diabetes Management Self-Efficacy Scale; and Summary of Diabetes Self-Care Activities. Bivariate analysis investigated the relationship between variables. Structure Equation Modelling (SEM) was performed to test the proposed conceptual model. The study found that approximately 70% of the respondents suffered some form of depressive symptoms. The SEM showed a direct relationship between self-efficacy and self-care activities (β = 0.40; p < 0.001). Depression was indirectly related to self-care activities through self-efficacy (β = -0.20; p = 0.003); nevertheless, it was directly related to perception of: treatment control, consequences, and emotional representations. Overall, the sequence between illness perception and self-efficacy was mediated by depression. Strategies to promote self-efficacy and illness perception are vital in customising a diabetes health plan to meet Arabic cultural expectations.
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Self concepts, health locus of control and cognitive functioning associated with health-promoting lifestyles in schizophrenia. Compr Psychiatry 2016; 70:82-9. [PMID: 27624426 DOI: 10.1016/j.comppsych.2016.06.014] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2016] [Revised: 05/23/2016] [Accepted: 06/20/2016] [Indexed: 11/23/2022] Open
Abstract
PURPOSE The study aimed to investigate the relationship among self concepts, health locus of control, cognitive functioning and health-promoting lifestyles in patients diagnosed with schizophrenia. We examined health-promoting lifestyles through self-efficacy, self-esteem, health locus of control and neurocognitive factors. METHOD Fifty-six people with schizophrenia were enrolled in the study group. All subjects participated in the self-esteem (Rosenberg Self-Esteem Scale), self-efficacy (General Self-Efficacy Scale), health locus of control (The Multidimensional Health Locus of Control Scales), health-promoting lifestyles (Health Promotion Life-style Profile-II) and a series of neurocognitive measures. FINDINGS Stepwise regression analysis revealed that self-efficacy, internal health locus of control and attentional set-shifting accounted for 42% of the variance in total health-promoting lifestyles scores. Self-efficacy, self-esteem, internal and powerful others health locus of control and attentional set-shifting were significant predictors for domains of health-promoting lifestyles, respectively. CONCLUSION Study findings can help mental health professionals maintain and improve health-promoting behaviors through a better understanding of self-esteem, self-efficacy, health locus of control and neurocognitive functioning among people with schizophrenia.
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Wu SFV, Hsieh NC, Lin LJ, Tsai JM. Prediction of self-care behaviour on the basis of knowledge about chronic kidney disease using self-efficacy as a mediator. J Clin Nurs 2016; 25:2609-18. [PMID: 27364760 DOI: 10.1111/jocn.13305] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/13/2016] [Indexed: 12/18/2022]
Abstract
AIMS AND OBJECTIVES This study was to investigate: (1) the important factors in the self-care of chronic kidney disease (CKD) patients and (2) the mediating effects of self-efficacy on knowledge and self-care. BACKGROUND Chronic kidney disease has become a major global health issue and is one of the top 10 leading causes of death in Taiwan where the dialysis population ranks first in the world. The number of patients with poor self-care behaviours continues to rise despite ongoing health education. Knowledge and self-efficacy are important factors that influence self-care behaviour; however, very few articles have examined the relationships among them. DESIGN Cross-sectional and correlational design. METHODS Subject recruitment was conducted by purposive sampling in the renal outpatient clinics and dialysis centres of two teaching hospitals in northern Taiwan. A total of 247 patients with chronic kidney disease (stages 1-5) were enrolled. RESULTS (1) Knowledge was positively correlated with self-efficacy (r = 0·41, p < 0·01) and with self-care (r = 0·18, p < 0·01). Self-efficacy (r = 0·44, p < 0·01) as well as age (r = 0·15, p < 0·01) were positively correlated with self-care. (2) The relationship between knowledge and self-care was fully mediated by self-efficacy (z = 4·82, p < 0·001) and the effect was 50%. CONCLUSION The results showed that self-efficacy was a crucial mediator between knowledge and self-care. In addition to providing knowledge to chronic kidney disease patients, healthcare professionals should also offer strategies that can enhance self-efficacy to increase self-care behaviours in chronic kidney disease patients and implement effective disease management. RELEVANCE TO CLINICAL PRACTICE Incorporate self-efficacy strategies into the process of health education to improve knowledge and the effectiveness of self-care. The findings of this study provide evidence of effectiveness of the use of group activity through self-management and self-efficacy enhancement programmes and may influence the policy makers to consider adding or modifying the reimbursement criteria.
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Affiliation(s)
- Shu-Fang Vivienne Wu
- School of Nursing, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan.
| | - Nan-Chen Hsieh
- Department of Information Management, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
| | - Li-Ju Lin
- National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
| | - Juin-Ming Tsai
- Department of Long-TermCare, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
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ALAboudi IS, Hassali MA, Shafie AA, Saleem F. Self-efficacy, self-care behaviours and glycaemic control in type 2 diabetic patients in Riyadh, Saudi Arabia. J Public Health (Oxf) 2016. [DOI: 10.1007/s10389-016-0723-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Lee EH, Lee YW, Moon SH. A Structural Equation Model Linking Health Literacy to Self-efficacy, Self-care Activities, and Health-related Quality of Life in Patients with Type 2 Diabetes. Asian Nurs Res (Korean Soc Nurs Sci) 2016; 10:82-7. [PMID: 27021840 DOI: 10.1016/j.anr.2016.01.005] [Citation(s) in RCA: 77] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2015] [Revised: 01/08/2016] [Accepted: 01/11/2016] [Indexed: 11/26/2022] Open
Abstract
PURPOSE Health literacy has been attracting increasing attention because low health literacy is considered an important predictor of adverse health outcomes in many chronic conditions, including diabetes. However, it is unclear how health literacy is associated with health outcomes. The purpose of this study was to formulate a hypothetical structural equation model linking health literacy to self-efficacy, self-care activities, and health-related quality of life (HRQOL) in patients with type 2 diabetes. METHODS A cross-sectional survey design was employed, and 459 patients with type 2 diabetes were recruited from outpatient clinics in two university hospitals. The patients completed a pack of questionnaires. The hypothetical model was tested using structural equation modeling analysis. RESULTS The values of multiple fit indices indicated that the proposed model provided a good fit to the data. Health literacy exerted not only a direct effect on self-care activities, but also an indirect effect on self-care activities via self-efficacy. However, health literacy exerted only an indirect effect on HRQOL. This structural model was invariant across hemoglobin-A1c-controlled and hemoglobin-A1c-uncontrolled groups. Based on R(2) values, the final model accounted for 20.0% of the variance in self-efficacy, 61.0% of the variance in self-care activities, and 16.0% of the variance in HRQOL. CONCLUSIONS This study suggests that self-care activities are crucial to the link between health literacy and HRQOL. Both health literacy and self-efficacy need to be considered in clinical practice for enhancing self-care activities in patients with type 2 diabetes. This approach may ultimately improve HRQOL in these patients.
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Affiliation(s)
- Eun-Hyun Lee
- Graduate School of Public Health, Ajou University, Suwon, South Korea.
| | - Young Whee Lee
- Department of Nursing, Inha University, Incheon, South Korea
| | - Seung Hei Moon
- Department of Nursing, Graduate School, Inha University, Incheon, South Korea
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Reisi M, Mostafavi F, Javadzade H, Mahaki B, Tavassoli E, Sharifirad G. Impact of Health Literacy, Self-efficacy, and Outcome Expectations on Adherence to Self-care Behaviors in Iranians with Type 2 Diabetes. Oman Med J 2016; 31:52-9. [PMID: 26813680 PMCID: PMC4720937 DOI: 10.5001/omj.2016.10] [Citation(s) in RCA: 52] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2015] [Accepted: 09/09/2015] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVES Diabetic patients with higher health literacy (HL) may feel more confident in their ability to perform self-care behaviors and may have strong beliefs that diabetes-related behaviors will lead to specific outcomes. Our study aimed to document the relationships between HL, self-efficacy, outcome expectations, and diabetes self-care of patients with type 2 diabetes mellitus (T2DM) in Iran. METHODS We conducted a cross-sectional observational study of 187 patients with T2DM. Participants completed the Functional Communicative and Critical Health Literacy scale, the Summary of Diabetes Self-Care Activities, the Diabetes Management Self-Efficacy Scale, Outcome Expectations Questionnaire, and a demographic questionnaire. RESULTS Participants who received diabetes education (t = 5.79, p<0.001) and were married (F = 3.04, p<0.050) had better diabetes self-care behavior. There was a significant positive correlation between self-care behaviors and communicative HL (r = 0.455, p<0.010), critical HL (r = 0.297, p<0.010), self-efficacy (r = 0.512, p<0.010) and outcome expectations (r = 0.387, p<0.010). Diabetes education and marital status accounted for 16.9% of the variance in diabetes self-care. Self-efficacy, outcome expectations, communicative, and critical HL explained 28.0%, 1.5%, 3.7%, and 1.4% of the variance, respectively. CONCLUSIONS This study revealed that the potential impact of self-efficacy, outcome expectations, communicative, and critical HL should be considered in the education program for patients with diabetes. We found self-efficacy to be the most important predictor of diabetes self-care. Therefore, the use of self-efficacy theory when designing patient education interventions could enhance diabetes self-care. It is essential that health care providers assess patient's HL levels to tailor health-related information specific to a domain of HL. This would fully inform patients and promote empowerment rather than simple compliance.
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Affiliation(s)
- Mahnoush Reisi
- Department of Health Education and Health Promotion, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Firoozeh Mostafavi
- Department of Health Education and Health Promotion, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Homamodin Javadzade
- Department of Health Education and Health Promotion, Bushehr University of Medical Sciences, Bushehr, Iran
| | - Behzad Mahaki
- Department of Biostatistics and Epidemiology, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Elahe Tavassoli
- The Student’s Research Committee Department of Public Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Lu Y, Xu J, Zhao W, Han HR. Measuring Self-Care in Persons With Type 2 Diabetes: A Systematic Review. Eval Health Prof 2015; 39:131-84. [PMID: 26130465 DOI: 10.1177/0163278715588927] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This systematic review examines the characteristics and psychometric properties of the instruments used to assess self-care behaviors among persons with type 2 diabetes. Electronic databases were searched for relevant studies published in English within the past 20 years. Thirty different instruments were identified in 75 articles: 18 original instruments on type 2 diabetes mellitus self-care, 8 translated or revised version, and 4 not specific but relevant to diabetes. Twenty-one instruments were multidimensional and addressed multiple dimensions of self-care behavior. Nine were unidimensional: three focusing exclusively on medication taking, three on diet, one on physical activity, one on self-monitoring of blood glucose, and one on oral care. Most instruments (22 of 30) were developed during the last decade. Only 10 were repeated more than once. Nineteen of the 30 instruments reported both reliability and validity information but with varying degrees of rigor. In conclusion, most instruments used to measure self-care were relatively new and had been applied to only a limited number of studies with incomplete psychometric profiles. Rigorous psychometric testing, operational definition of self-care, and sufficient explanation of scoring need to be considered for further instrument development.
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Affiliation(s)
- Yan Lu
- School of Nursing, China Medical University, Shenyang City, Liaoning Province, People's Republic of China
| | - Jiayun Xu
- Department of Community-Public Health, Johns Hopkins University School of Nursing, Baltimore, MD, USA
| | - Weigang Zhao
- Endocrinology Department, Peking Union Medical College Hospital, Beijing, People's Republic of China
| | - Hae-Ra Han
- Department of Community-Public Health, Johns Hopkins University School of Nursing, Baltimore, MD, USA
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Choi JS, Kim BH, Chang SJ. Gender-Specific Factors Influencing Diabetes Self-Care Behaviors and Health-Related Quality of Life Among Older Adults With Type 2 Diabetes in South Korea. Res Gerontol Nurs 2015; 8:231-9. [PMID: 25893724 DOI: 10.3928/19404921-20150331-01] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2014] [Accepted: 01/15/2015] [Indexed: 11/20/2022]
Abstract
The purpose of the current study was to identify gender-specific factors influencing diabetes self-care behaviors and health-related quality of life among older adults with type 2 diabetes in South Korea. This is a secondary analysis using data from 278 older adults (77 women, 201 men) with type 2 diabetes. An independent t test and hierarchical multiple regression analyses were used to analyze the data. No significant mean differences in diabetes self-care behaviors and health-related quality of life were observed according to gender. Regarding predictors by gender, the number of diabetes-related complications was a unique predictor of diabetes self-care behaviors in older men, whereas duration of diabetes and barriers were unique predictors in older women. Depression was a significant common predictor of health-related quality of life in older men and women. Nurses should be aware of and consider gender specificity when developing intervention programs for promoting self-care behaviors and health-related quality of life.
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30
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McElfish PA, Hallgren E, Yamada S. Effect of US health policies on health care access for Marshallese migrants. Am J Public Health 2015; 105:637-43. [PMID: 25713965 DOI: 10.2105/ajph.2014.302452] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
The Republic of the Marshall Islands is a sovereign nation previously under the administrative control of the United States. Since 1986, the Compacts of Free Association (COFA) between the Republic of the Marshall Islands and the United States allows Marshall Islands citizens to freely enter, lawfully reside, and work in the United States, and provides the United States exclusive military control of the region. When the COFA was signed, COFA migrants were eligible for Medicaid and other safety net programs. However, these migrants were excluded from benefits as a consequence of the Personal Responsibility and Work Opportunity Reconciliation Act. Currently, COFA migrants have limited access to health care benefits in the United States, which perpetuates health inequalities.
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Affiliation(s)
- Pearl Anna McElfish
- Pearl Anna McElfish is a PhD candidate with the University of Arkansas for Medical Sciences Northwest, Fayetteville. Emily Hallgren is a sociology PhD student at University of Illinois at Chicago. Seiji Yamada is with the Department of Family Medicine and Community Health, John A. Burns School of Medicine, University of Hawaii, Honolulu
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31
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Towards a conceptual model of diabetes self-management among Chinese immigrants in the United States. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2014; 11:6727-42. [PMID: 24978878 PMCID: PMC4113840 DOI: 10.3390/ijerph110706727] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/17/2014] [Revised: 06/06/2014] [Accepted: 06/06/2014] [Indexed: 11/29/2022]
Abstract
Background: Chinese immigrants have been disproportionally affected by type 2 diabetes. This paper presents the state of science regarding the factors that may influence diabetes self-management among Chinese immigrants in the US and the potential health outcomes. Design: Using Walker and Avant’s techniques, a search of the literature was conducted from CINAHL, PubMed, OVID, and Web of Science. Findings: Factors most relevant to diabetes self-management were grouped under five categories: socio-demographic characteristics, behavioral and psychological characteristics, social support, linguistic barriers, and cultural characteristics. Potential outcomes derived from improved diabetes self-management include quality of life, glycosylated hemoglobin, and blood pressure and other cardiovascular risk factors. Discussion: A conceptual model was provided to guide future research. Based on the review of the literature, specific research topics that need to fill the gaps in the literature were provided, including family-focused interventions for Chinese immigrant patients with diabetes and the effectiveness of these interventions to improve family functioning.
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32
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Chen SR, Chien YP, Kang CM, Jeng C, Chang WY. Comparing self-efficacy and self-care behaviours between outpatients with comorbid schizophrenia and type 2 diabetes and outpatients with only type 2 diabetes. J Psychiatr Ment Health Nurs 2014; 21:414-22. [PMID: 23829198 DOI: 10.1111/jpm.12101] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/02/2013] [Indexed: 12/01/2022]
Abstract
People with schizophrenia show higher-than-normal rates of type 2 diabetes mellitus (T2DM); however, research on their understanding of diabetes self-efficacy and self-care behaviours is lacking. This study compared differences in scores of self-efficacy and self-care behaviours between outpatients with comorbid schizophrenia and T2DM and outpatients with T2DM alone. Data were collected using the Diabetes Management Self-Efficacy Scale and Summary of Diabetes Self-Care Activity questionnaire. In total, 105 outpatients with schizophrenia and T2DM and 106 outpatients with T2DM returned completed questionnaires. Results of this study revealed that outpatients with schizophrenia and T2DM had significantly lower total self-efficacy and self-care scores than outpatients with only T2DM. The stepwise regression analysis revealed that self-efficacy, the haemoglobin A1C level and current smoking were significant predictors of self-care behaviours in outpatients with comorbid schizophrenia and T2DM, which explained 33.20% of the variance. These findings help mental health professionals improve patient care through a better understanding of self-care behaviours among outpatients with comorbid schizophrenia and T2DM.
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Affiliation(s)
- S-R Chen
- School of Nursing, Taipei Medical University, Taipei, Taiwan
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33
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Kozica SL, Gibson-Helm ME, Teede HJ, Moran LJ. Assessing self-efficacy and self-help methods in women with and without Polycystic Ovary Syndrome. Behav Med 2014; 39:90-6. [PMID: 23930901 DOI: 10.1080/08964289.2012.720312] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Polycystic Ovary Syndrome (PCOS) is a common endocrine disorder in women strongly associated with obesity and psychological dysfunction. It is crucial to assess the contributions of psychological parameters to obesity and weight management. This survey based cross-sectional study assessed self-efficacy, health attitudes and beliefs, response to illness and adult health history in women with (n = 74) and without PCOS (n = 90). There were no significant differences in self-efficacy, health attitudes and beliefs between groups. Women with PCOS reported less engagement in self-help methods compared to women without (p = 0.003). Women with PCOS reported poorer overall (p < 0.001) and recent health history (p = 0.02), greater prevalence (p < 0.001) and impact of a chronic illness (p < 0.001). It is crucial that women recognize that PCOS is a chronic condition requiring on-going lifestyle management; to encourage active engagement in their management, enhance participation in screening for complications and uptake of lifestyle recommendations.
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Affiliation(s)
- Samantha L Kozica
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
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Hu D, Juarez DT, Yeboah M, Castillo TP. Interventions to increase medication adherence in African-American and Latino populations: a literature review. HAWAI'I JOURNAL OF MEDICINE & PUBLIC HEALTH : A JOURNAL OF ASIA PACIFIC MEDICINE & PUBLIC HEALTH 2014; 73:11-18. [PMID: 24470982 PMCID: PMC3901167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
The objective of this systematic review was to investigate the effectiveness of interventions to improve medication adherence in ethnic minority populations. A literature search from January 2000 to August 2012 was conducted through PubMed/Medline, Web of Science, The Cochrane Library, and Google Scholar. Search terms used included: medication (MeSH), adherence, medication adherence (MeSH), compliance (MeSH), persistence, race, ethnicity, ethnic groups (MeSH), minority, African-American, Hispanic, Latino, Asian, Pacific Islander, and intervention. Studies which did not have ≥75% of the sample population comprised of individuals of any one ethnic background were excluded, unless the authors performed sub-group analyses by race/ethnicity. Of the 36 studies identified, 20 studies showed significant post-intervention differences. Sample population sizes ranged from 10 to 520, with a median of 126.5. The studies in this review were conducted with patients of mainly African-American and Latino descent. No studies were identified which focused on Asians, Pacific Islanders, or Native Americans. Interventions demonstrating mixed results included motivational interviewing, reminder devices, community health worker (CHW) delivered interventions, and pharmacist-delivered interventions. Directly observed therapy (DOT) was a successful intervention in two studies. Interventions which did not involve human contact with patients were ineffective. In this literature review, studies varied significantly in their methods and design as well as the populations studied. There was a lack of congruence among studies in the way adherence was measured and reported. No single intervention has been seen to be universally successful, particularly for patients from ethnic minority backgrounds.
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Affiliation(s)
- Daniel Hu
- University of Hawai'i at Hilo; Hilo, HI (DH, DTJ)
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35
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Wu SFV, Liang SY, Lee MC, Yu NC, Kao MJ. The efficacy of a self-management programme for people with diabetes, after a special training programme for healthcare workers in Taiwan: a quasi-experimental design. J Clin Nurs 2013; 23:2515-23. [DOI: 10.1111/jocn.12440] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/08/2013] [Indexed: 11/26/2022]
Affiliation(s)
- Shu-Fang Vivienne Wu
- School of Nursing; National Taipei University of Nursing and Health Sciences; Taipei Taiwan
| | - Shu-Yuan Liang
- School of Nursing; National Taipei University of Nursing and Health Sciences; Taipei Taiwan
| | - Mei-Chen Lee
- School of Nursing; National Taipei University of Nursing and Health Sciences; Taipei Taiwan
| | - Neng-Chun Yu
- Neng-Chun Diabetes Clinic; Taipei Taiwan
- Taiwanese Association of Diabetes Educators; Taipei Taiwan
| | - Mu-Jung Kao
- Department of Physical Medicine and Rehabilitation; Taipei City Hospital; Taipei Taiwan
- Department of Physical Therapy and Assistive Technology; National Yang-Ming University; Taipei Taiwan
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36
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Cosansu G, Erdogan S. Influence of psychosocial factors on self-care behaviors and glycemic control in Turkish patients with type 2 diabetes mellitus. J Transcult Nurs 2013; 25:51-9. [PMID: 24084701 DOI: 10.1177/1043659613504112] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
PURPOSE The main purpose of this study was to investigate the direct and indirect effects of psychosocial factors on self-care behavior and glycemic control in Turkish patients with type 2 diabetes mellitus. METHOD The study used a cross-sectional questionnaire survey design (N = 350). Data were collected using the Summary of Diabetes Self-Care Activities Scale and the Multidimensional Diabetes Questionnaire. The relationship between the study variables was analyzed using Pearson's correlation coefficient and structural equation modeling. RESULTS Self-efficacy was associated with social support, outcome expectancies, perceived interference, educational level, and self-care and A1C. According to the structural equation model, self-efficacy was the predictor variable that influenced both self-care and glycemic control. CONCLUSIONS Self-efficacy in achieving desired health outcomes was found to play a central role in Turkish patients. Although interventions are planned and implemented to achieve and maintain self-management in individuals with diabetes, strengthening psychosocial factors, particularly self-efficacy, may contribute to adjustment to disease and good glycemic control in the long term.
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Affiliation(s)
- Gulhan Cosansu
- Istanbul University, Florence Nightingale Nursing Faculty, Public Health Nursing Department Istanbul, Turkey
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37
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Hayes RP, Curtis B, Ilag L, Nelson DR, Wong M, Funnell M. Expectations about insulin therapy, perceived insulin-delivery system social acceptability, and insulin treatment satisfaction contribute to decreases in insulin therapy self-efficacy in patients with type 2 diabetes after 36 weeks insulin therapy. J Diabetes 2013; 5:358-67. [PMID: 23489710 DOI: 10.1111/1753-0407.12037] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2012] [Revised: 02/08/2013] [Accepted: 02/27/2013] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Self-efficacy plays a critical role in diabetes self-care. Herein we explore factors contributing to decreased insulin therapy self-efficacy in insulin-naïve patients with type 2 diabetes mellitus (T2DM) initiating and managing insulin therapy over 36 weeks. METHODS The study was conducted within an international, randomized clinical trial comparing two insulin therapies administered by insulin pen in patients with T2DM inadequately controlled with oral antihyperglycemic medications. Patients completed the Self-Efficacy about Insulin Therapy Questionnaire (SEITQ) at baseline and endpoint. Patients also completed patient-reported measures assessing expectations about insulin therapy at baseline and perceptions about insulin therapy and insulin-delivery system (IDS) satisfaction at endpoint. Baseline and endpoint SEITQ scores were compared. Using prespecified criteria, patients were classified as having "decreased" or "no change/improved" insulin self-efficacy. Demographic, clinical, and patient-reported variables were entered into a logistic regression model with decreased insulin self-efficacy (yes or no) as the dependent variable. RESULTS Baseline and endpoint SEITQ data were available for 450 insulin-naïve T2DM patients (mean age 59 years; 53% female; 57% Caucasian; mean baseline HbA1c 9.4%; 80.0 mmol/mol). Insulin therapy self-efficacy improved from baseline to endpoint (74.0 vs 77.5; P<0.001). Logistic regression analysis indicated that lower IDS satisfaction (P<0.0001), lower IDS social acceptability (P=0.004), and more positive expectations of insulin therapy (P<0.0001) were associated with decreased insulin self-efficacy. CONCLUSIONS A candid discussion between clinicians and their insulin-naïve T2DM patients about the benefits and challenges of insulin therapy may prevent unrealistic expectations that could potentially undermine insulin self-efficacy.
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Affiliation(s)
- Risa P Hayes
- Global Health Outcomes, Eli Lilly and Company, Indianapolis, Indiana 46285, USA.
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38
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Wu SFV, Huang YC, Lee MC, Wang TJ, Tung HH, Wu MP. Self-efficacy, self-care behavior, anxiety, and depression in Taiwanese with type 2 diabetes: A cross-sectional survey. Nurs Health Sci 2013; 15:213-9. [PMID: 23301516 DOI: 10.1111/nhs.12022] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2012] [Revised: 10/24/2012] [Accepted: 10/29/2012] [Indexed: 11/29/2022]
Abstract
The relationships between self-efficacy, self-care behavior, anxiety, and depression for Taiwanese individuals with type 2 diabetes were determined in this study. Depression and anxiety are common symptoms that can contribute toward adverse medical outcomes. A descriptive, cross-sectional, correlational design was used. The sample comprised 201 patients with type 2 diabetes from diabetes outpatient clinics at three teaching hospitals in Taiwan. The results of this study revealed that people with diabetes who had received diabetes health education, regularly made clinical visits, underwent treatment, and did not smoke demonstrated a high self-efficacy score (P < 0.05). Self-efficacy among people with diabetes positively correlated with illness duration (P < 0.05), treatment (P < 0.01), and self-care behavior (P < 0.01). Self-efficacy among people with diabetes negatively correlated with anxiety and depression (P < 0.01). Self-efficacy can be a predictor of anxiety and depression (P < 0.01). This study revealed that enhancing self-efficacy levels might reduce anxiety and depression. Self-efficacy-enhancing programs should be held regularly in clinical practices. Conducting psychological research on diabetes drives policy and healthcare system change.
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Affiliation(s)
- Shu-Fang Vivienne Wu
- School of Nursing, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan.
| | - Yi-Ching Huang
- Department of Exercise and Health Science, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
| | - Mei-Chen Lee
- School of Nursing, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
| | - Tsae-Jyy Wang
- School of Nursing, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
| | - Heng-Hsin Tung
- School of Nursing, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
| | - Meng-Ping Wu
- Department of Nursing, Taipei City Hospital, Taipei, Taiwan
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Brouwer AM, Mosack KE. “I Am a Blood Sugar Checker”: Intervening Effects of Self-as-doer Identity on the Relationship between Self-efficacy and Diabetes Self-care Behaviors. SELF AND IDENTITY 2012. [DOI: 10.1080/15298868.2011.603901] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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40
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Hunt CW, Wilder B, Steele MM, Grant JS, Pryor ER, Moneyham L. Relationships among self-efficacy, social support, social problem solving, and self-management in a rural sample living with type 2 diabetes mellitus. Res Theory Nurs Pract 2012; 26:126-41. [PMID: 22908432 DOI: 10.1891/1541-6577.26.2.126] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Self-management behaviors are important for control of type 2 diabetes mellitus. Therefore, determining factors that promote effective self-management behaviors may be significant for improving the well-being of patients with type 2 diabetes mellitus. This study examined relationships among self-efficacy, social support, social problem solving, and diabetes self-management behaviors. Further, this study evaluated whether social support and social problem solving were mediators of the relationship between self-efficacy and diabetes self-management behaviors in those living with type 2 diabetes mellitus. Using a cross-sectional, descriptive correlational design, data from a convenience sample of 152 rural people living with type 2 diabetes mellitus were examined. Findings indicated that self-efficacy was a strong predictor of diabetes self-management. The effect of social support on diabetes self-management differed among men and women in the sample. Social support and social problem solving were significantly associated with diabetes self-management in men. Neither social support nor social problem solving were mediators of the relationship between self-efficacy and diabetes self-management in this sample. These findings suggest that nurses need to consider implementing interventions to improve patients' self-efficacy and potentially influence diabetes self-management.
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Affiliation(s)
- Caralise W Hunt
- Auburn University, School of Nursing, Auburn, AL 36849, USA.
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Wu MP, Wu SFV, Wang TC, Kao MJ, Yang WL. Effectiveness of a community-based health promotion program targeting people with hypertension and high cholesterol. Nurs Health Sci 2012; 14:173-81. [DOI: 10.1111/j.1442-2018.2011.00675.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Sharoni SKA, Wu SFV. Self-efficacy and self-care behavior of Malaysian patients with type 2 diabetes: a cross sectional survey. Nurs Health Sci 2012; 14:38-45. [PMID: 22288688 DOI: 10.1111/j.1442-2018.2011.00658.x] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
This study investigated the association between self-efficacy and self-care behavior to determine the degree of self-efficacy and to examine differences in self-efficacy according to patient variables, including state of health, of Malaysian patients with type 2 diabetes. The sample comprised 388 patients (respondents). We collected the data from December 2010 to February 2011. We found a significant positive relationship between self-efficacy and self-care behavior (r(s) = 0.481, P < 0.001). The degree of self-efficacy was moderately high (mean = 7.570). We found significant differences between self-efficacy and education level (Wilk's Lambda = 0.918, F[12, 1008] = 2.779, P < 0.05), duration of diabetes (Wilk's Lambda = 0.954, F[8, 736] = 2.264, P < 0.05), other chronic conditions (Wilk's Lambda = 0.967, F[4, 383] = 3.304, P < 0.05) and diabetic complications (Wilk's Lambda = 0.963, F[4, 383] = 3.653, P < 0.05). Self-efficacy can be used as a model to understand self-care behavior. Individualized nursing interventions based on self-efficacy theory should be utilized in high risk diabetic patients so as to assist and improve self-care behavior.
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Affiliation(s)
- Siti Khuzaimah Ahmad Sharoni
- Nursing Department, Faculty of Health Sciences, Universiti Teknologi MARA, Puncak Alam Campus, Puncak Alam, Selangor, Malaysia.
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Lee S, Chib A, Kim JN. Midwives' cell phone use and health knowledge in rural communities. JOURNAL OF HEALTH COMMUNICATION 2011; 16:1006-1023. [PMID: 21728781 DOI: 10.1080/10810730.2011.571344] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
This study developed and tested a theoretical model that explains the underlying process through which the use of cell phones can facilitate the capacity of community health care workers in developing regions. On the basis of a study conducted on 223 midwives in rural regions of Indonesia, the results showed that cell phone use was positively associated with midwives' access to institutional and peer information resources. Access to institutional resources was positively associated with midwives' health knowledge. Further, access to peer resources was associated with higher self-efficacy, which was positively associated with health knowledge. The study provides implications for technology intervention strategies targeted to community health workers in rural communities.
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Affiliation(s)
- Seungyoon Lee
- Department of Communication, Purdue University, West Lafayette, Indiana 47907, USA.
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Wu SFV, Liang SY, Wang TJ, Chen MH, Jian YM, Cheng KC. A self-management intervention to improve quality of life and psychosocial impact for people with type 2 diabetes. J Clin Nurs 2011; 20:2655-65. [DOI: 10.1111/j.1365-2702.2010.03694.x] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Oftedal B, Bru E, Karlsen B. Motivation for diet and exercise management among adults with type 2 diabetes. Scand J Caring Sci 2011; 25:735-44. [DOI: 10.1111/j.1471-6712.2011.00884.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Lun Gan JK, Brammer JD, Creedy DK. Effectiveness of educational interventions to promote oral hypoglycaemic adherence in adults with Type 2 diabetes: a systematic review. ACTA ACUST UNITED AC 2011. [DOI: 10.11124/jbisrir-2011-92] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Lun Gan JK, Brammer JD, Creedy DK. Effectiveness of educational interventions to promote oral hypoglycaemic adherence in adults with Type 2 diabetes: a systematic review. ACTA ACUST UNITED AC 2011; 9:269-312. [PMID: 27819951 DOI: 10.11124/01938924-201109090-00001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
EXECUTIVE SUMMARY Background As a chronic condition, the prevalence of Type 2 diabetes is increasing worldwide and adherence to oral medications, an essential component of self-management, has been shown to improve glycaemic control. However compliance with oral medication adherence remains poor. Educating people with Type 2 diabetes is an important strategy to enhance self-management ability, including medication-taking behaviour.Objectives The overall objective of the review was to determine the effectiveness of educational interventions to promote oral hypoglycaemic adherence in adults with Type 2 diabetes. INCLUSION CRITERIA Types of participants Studies involving adults over 18 years old with Type 2 diabetes, with or without co-morbidities, currently taking oral hypoglycaemic medication without insulin treatment, and with aglycated haemoglobin (HbA1c) > 7.0% prior to the intervention were considered. Aglycated haemoglobin (HbA1c) concentration of less than 7.0%, is important in order to delay or prevent diabetes-related complications. Participants could be from the primary, tertiary or acute care setting.Types of intervention The review focused on various forms of educational interventions delivered by healthcare professionals aimed at improving participants' knowledge.Types of outcomes The review evaluated outcomes measuring oral hypoglycaemic adherence including HbA1c, fasting blood glucose levels and other relevant indicators.Types of studies Studies that were randomized controlled trials (RCTs) or case-control studies were considered.Search strategy A three-stage search strategy was employed. Papers in English and between the years 1990-2009 were searched in the following databases: CINAHL, Medline, Mosby's Nursing Consult, PsycINFO, PubMed, ScienceDirect, Scopus, TRIP and Web of Science. Full text was retrieved when the titles and abstracts of studies fulfilled the inclusion criteria.Methodological quality Full papers were assessed for methodological quality independently by two reviewers using critical appraisal checklists from the Joanna Briggs Institute (JBI). A third reviewer was consulted whenever there were disagreements between the two reviewers.Data collection/extraction Details of each study included in the review were extracted using standardized data extraction forms developed by JBI. Extraction was conducted independently by two reviewers.Data synthesis Meta-analysis was not possible due to methodological and statistical heterogeneity of the included studies. Hence study findings are presented in narrative form.Results Seven studies included in the final review consisted of seven RCTs. Five studies concluded that the educational intervention was effective in promoting oral hypoglycaemic adherence compared to usual care. These included pharmacist-led interventions, individual diabetes education provided by nurses and diabetes group education based on a self-management approach. Similarities among these interventions were provision of information on oral hypoglycaemic medication and the need for regular education sessions. However, small samples in some studies limited generalization of results. CONCLUSIONS Implications for practice Increased knowledge of oral hypoglycaemic issues and reinforcement of the importance of medication adherence were useful in promoting adherence. Regular education sessions allow individuals to reinforce information and educators to identify barriers to medication adherence. Educational interventions focusing on self-management strategies appear more likely to achieve positive outcomes.Implications for research Further trials involving larger samples and populations with poor glycaemic control are needed. The effects of educational interventions, influence of additional take-home written material, the optimal interval length of follow-up and duration of education sessions, and specific processes of individual or group education which have been identified as effective need further exploration.
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Affiliation(s)
- Jessica Kai Lun Gan
- 1. Jessica Kai Lun Gan, Honours Student, Alice Lee Centre for Nursing Studies, National University Singapore, A collaborating centre of the Joanna Briggs Institute. 2. Jillian Diane Brammer, Assistant Professor, Alice Lee Centre for Nursing Studies, National University of Singapore, A collaborating centre of the Joanna Briggs Institute. 3. Debra K Creedy, Professor, Alice Lee Centre for Nursing Studies, National University of Singapore, A collaborating centre of the Joanna Briggs Institute
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Lin PL, Huang HL, Lu KY, Chen T, Lin WT, Lee CH, Hsu HM. Second-hand smoke exposure and the factors associated with avoidance behavior among the mothers of pre-school children: a school-based cross-sectional study. BMC Public Health 2010; 10:606. [PMID: 20942977 PMCID: PMC2972241 DOI: 10.1186/1471-2458-10-606] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2010] [Accepted: 10/14/2010] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Second-hand Smoke (SHS) exposure is a significant public health problem that may be responsible for serious health hazards for child. This study aimed to examine the exposure status of SHS and the factors associated with SHS avoidance behavior among the mothers of pre-school children. METHODS A cross-sectional study was used to obtain a sample of the mothers of pre-school children (n = 1,020) in 30 registered kindergartens in eastern Taiwan. Overall, 919 (a response rate of 90%) completed the questionnaires. Regression models were used to identify factors with respect to the avoidance behavior of SHS. RESULTS The prevalence of exposure to SHS was 70% and 50% for the mothers and their children, respectively. After adjusting for other variables, mothers who were current smokers (β = -0.260, p < 0.001), had spouses who smoked (β = -0.060, p < 0.05), SHS exposure (β = -0.138, p < 0.001), and/or children with exposure to SHS (β = -0.084, p < 0.05) were found to be less likely to avoid SHS, whereas mothers with a high knowledge score about SHS (β = 0.082, p < 0.01), positive attitudes (β = 0.274, p < 0.001) and a high self-efficacy level in regard to the avoidance of SHS (β = 0.397, p < 0.001) were observed to be more likely to avoid SHS. Regression analyses confirmed that the significantly factors associated with the avoidance behavior of SHS were self-efficacy, being a current smoker, and the attitude toward the avoidance of SHS to be that of 55.5% of the total variance explained (p < 0.001). CONCLUSIONS The high prevalence rate of exposure to SHS for mothers and their children suggests that a well-designed future intervention program should be implemented in regard to pre-school children's mothers in order to prevent these mothers and their children from SHS exposure hazards, more particularly, to strengthen the knowledge base, to enhance self-efficacy and to foster a more positive attitude toward the avoidance of SHS in the mothers.
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Affiliation(s)
- Pi-Li Lin
- Department of Public Health, Tzu Chi University, Hualien, 97004, Taiwan
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Ko GT, So WY, Tong PC, Le Coguiec F, Kerr D, Lyubomirsky G, Tamesis B, Wolthers T, Nan J, Chan J. From design to implementation--the Joint Asia Diabetes Evaluation (JADE) program: a descriptive report of an electronic web-based diabetes management program. BMC Med Inform Decis Mak 2010; 10:26. [PMID: 20465815 PMCID: PMC2876072 DOI: 10.1186/1472-6947-10-26] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2009] [Accepted: 05/13/2010] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND The Joint Asia Diabetes Evaluation (JADE) Program is a web-based program incorporating a comprehensive risk engine, care protocols, and clinical decision support to improve ambulatory diabetes care. METHODS The JADE Program uses information technology to facilitate healthcare professionals to create a diabetes registry and to deliver an evidence-based care and education protocol tailored to patients' risk profiles. With written informed consent from participating patients and care providers, all data are anonymized and stored in a databank to establish an Asian Diabetes Database for research and publication purpose. RESULTS The JADE electronic portal (e-portal: http://www.jade-adf.org) is implemented as a Java application using the Apache web server, the mySQL database and the Cocoon framework. The JADE e-portal comprises a risk engine which predicts 5-year probability of major clinical events based on parameters collected during an annual comprehensive assessment. Based on this risk stratification, the JADE e-portal recommends a care protocol tailored to these risk levels with decision support triggered by various risk factors. Apart from establishing a registry for quality assurance and data tracking, the JADE e-portal also displays trends of risk factor control at each visit to promote doctor-patient dialogues and to empower both parties to make informed decisions. CONCLUSIONS The JADE Program is a prototype using information technology to facilitate implementation of a comprehensive care model, as recommended by the International Diabetes Federation. It also enables health care teams to record, manage, track and analyze the clinical course and outcomes of people with diabetes.
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Affiliation(s)
- Gary T Ko
- Asia Diabetes Foundation, Flat 4B, Block B, Prince of Wales Hospital, Shatin, Hong Kong SAR, China
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong SAR, China
| | - Wing-Yee So
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong SAR, China
| | - Peter C Tong
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong SAR, China
| | | | - Debborah Kerr
- Merck Sharp & Dohme (MSD), a subsidiary of Merck & Co. Inc., USA
| | - Greg Lyubomirsky
- Merck Sharp & Dohme (MSD), a subsidiary of Merck & Co. Inc., USA
| | - Beaver Tamesis
- Merck Sharp & Dohme (MSD), a subsidiary of Merck & Co. Inc., USA
| | - Troels Wolthers
- Merck Sharp & Dohme (MSD), a subsidiary of Merck & Co. Inc., USA
| | - Jennifer Nan
- Asia Diabetes Foundation, Flat 4B, Block B, Prince of Wales Hospital, Shatin, Hong Kong SAR, China
| | - Juliana Chan
- Asia Diabetes Foundation, Flat 4B, Block B, Prince of Wales Hospital, Shatin, Hong Kong SAR, China
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong SAR, China
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Effectiveness of educational interventions to promote oral hypoglycaemic adherence in adults with Type 2 diabetes. JBI LIBRARY OF SYSTEMATIC REVIEWS 2010; 8:1-27. [PMID: 27820038 DOI: 10.11124/01938924-201008081-00001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
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