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Suhaimi AF, Makki SM, Tan KA, Silim UA, Ibrahim N. Translation and Validation of the Malay Version of the WHO-5 Well-Being Index: Reliability and Validity Evidence from a Sample of Type 2 Diabetes Mellitus Patients. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19074415. [PMID: 35410094 PMCID: PMC8998902 DOI: 10.3390/ijerph19074415] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/26/2021] [Revised: 03/10/2022] [Accepted: 03/23/2022] [Indexed: 02/01/2023]
Abstract
The translation and validation process of the WHO-5 Well-Being Index (WHO-5) into Malay is still not yet available. This study is the first psychometric evaluation of the Malay version of the WHO-5 in a sample of 127 primary care patients with type 2 diabetes mellitus. We evaluated the internal consistency and 5-week test–retest reliability of the WHO-5 Malay, and three aspects of its validity—first, the factorial validity in relation to the factor structure of the WHO-5 Malay; second, the concurrent validity in relation to depression and diabetes-related distress; and third, the convergent validity in relation to diabetes management self-efficacy and diabetes self-care behaviors. This study had two phases. Phase 1 involved the translation of the WHO-5 into Malay language following established procedures, whereas Phase 2 involved the validation of the WHO-5 Malay. Excellent internal consistency and 5-week test–retest reliability estimates were obtained. The factorial validity of the WHO-5 was found to be unidimensional. As for concurrent validity, the WHO-5 Malay was found to be negatively correlated with depression and diabetes-related distress. The WHO-5 was found to be correlated with diabetes management self-efficacy and diabetes self-care behaviors, thereby establishing convergent validity. The WHO-5 Malay has reliable and valid psychometric properties and represents a promising tool that informs healthcare providers in making effective and holistic diabetes management.
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Affiliation(s)
- Aida Farhana Suhaimi
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang 43400, Malaysia;
- Department of Psychiatry and Mental Health, Hospital Putrajaya, Ministry of Health, Putrajaya 62250, Malaysia
- Correspondence: (A.F.S.); (K.-A.T.)
| | | | - Kit-Aun Tan
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang 43400, Malaysia;
- Correspondence: (A.F.S.); (K.-A.T.)
| | - Umi Adzlin Silim
- Department of Psychiatry and Mental Health, Hospital Serdang, Ministry of Health, Kajang 43000, Malaysia;
| | - Normala Ibrahim
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang 43400, Malaysia;
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Relationship of Self Efficacy in Medication Understanding with Quality of Life among Elderly with Type 2 Diabetes Mellitus on Polypharmacy in Malaysia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19053031. [PMID: 35270724 PMCID: PMC8910663 DOI: 10.3390/ijerph19053031] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 02/24/2022] [Accepted: 03/01/2022] [Indexed: 02/01/2023]
Abstract
Self-efficacy (SE) has been shown to be positively correlated with quality of life (QOL) among patients with type 2 diabetes mellitus (T2DM). Medication understanding (MU) on the other hand, leads to good adherence that indirectly improves QOL. Measuring self-efficacy in medication understanding is useful to ascertain patient’s confidence in medication adherence. However, there is a lack of studies on the relationship between self-efficacy in medication understanding with QOL. This study aimed to determine the relationship between self-efficacy in medication understanding and QOL, and the factors associated with QOL in elderly with T2DM on polypharmacy. A cross-sectional study was conducted on these populations at primary care specialist clinic. Malay version of MU in SE questionnaire (MUSE) was used. Higher scores showed a better understanding. A revised Version Diabetic Quality of Life-13 (RVDQOL-13) questionnaire was used with lower scores indicating higher QOL. A total of 321 patients participated, with the majority being male (58.3%), Malay (84.7%), a predominant age group of 60−69 (75.7%) with mean age (±SD) of 66.7 (±0.286) years old. The median (IQR) of MUSE was high—30 (4)—while the RVDQOL-13 was low—19 (8)—which demonstrated high QOL. Inverse correlation was found between MUSE and QOL (r −0.14, p < 0.01). Multiple linear regression analysis demonstrated that MUSE score (β −0.282; 95% CI: (−5.438, −2.581); p < 0.001), low-income group (β −0.144; 95% CI: (−3.118, −0.534); p = 0.006) and duration of medications ≥240 days (β −0.282; 95% CI: (−5.438, −2.581); p < 0.001) were associated with better QOL, while medications ≥10 (β 0.109; 95% CI: 0.214, 4.462; p = 0.031) and those with pills and insulin (β 0.193; 95% CI: 1.206, 3.747; p < 0.001) were associated with poor QOL. In conclusion, higher MUSE is associated with better QOL. Findings suggest emphasizing self-efficacy in medication understanding in the management of elderly with T2DM on polypharmacy to improve QOL.
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Al Hashmi I. Gestational diabetes and determinants of adherence to healthy behaviors. Minerva Obstet Gynecol 2021; 74:146-154. [PMID: 33876902 DOI: 10.23736/s2724-606x.21.04754-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Previous studies on (GDM) focused on finding new strategies to decrease the incidence of its complications; however, there is insufficient evidence that investigate the influencing factors of adherence to healthy behaviors. This study examined the influencing factors of adherence to healthy behaviors among pregnant women with gestational diabetes (GDM). METHODS Descriptive cross-sectional design was used among pregnant women with gestational diabetes. The study participants completed study instruments twice (pre-test & post-test), with a four-weeks gap. The measurement scales included summary of diabetes self-care activities measure (SDSCA), diabetes management self-efficacy scales (DMSES) and open-ended questions to assess barriers and motivators of adherence. The analytical tool was multiple linear regression. RESULTS The results from multiple regression indicated that 20.0 % of the total variation in the adherence to healthy behaviors was explained by women's perceived self-efficacy and the overall relationship was significant [F (1, 88) = 23.60, p < .000]. From the demographic variables, only, the gestational age at delivery was found to be a significant predictor of adherence to healthy behaviors (t= -3.1, p< .05), adjusted Rsquare=15.6. Physical limitation and time constraints (40%) were the most reported barriers for adherence. Participants' concern of GDM-related complications (94.4%) and family moral support (52.2%) were the main identified motivators for adherence. CONCLUSIONS The importance of assessing determinants, barriers and motivators of adherence to healthy behaviors should be considered before planning any antenatal health promotion interventions designed for women with GDM. The study findings have implications for research, practice, policy advisors and public health. For practice, maternal nurses should consider the identified barriers in this study in any health education intervention and provide solutions and resources to the pregnant women to overcome these barriers. Policy advisors need to take into considerations providing pregnant women with flexible working hours that could encourage them maintaining healthy lifestyle behaviors during the pregnancy period. Researchers interested in GDM should examine in the upcoming studies different self-efficacy enhancing strategies among pregnant women with GDM.
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Affiliation(s)
- Iman Al Hashmi
- Maternal and Child Health Department, College of Nursing, Sultan Qaboos University, Muscat, Oman -
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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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Oluma A, Abadiga M, Mosisa G, Fekadu G, Turi E. Perceived Self-Efficacy and Associated Factors Among Adult Patients with Type 2 Diabetes Mellitus at Public Hospitals of Western Ethiopia, 2020. Patient Prefer Adherence 2020; 14:1689-1698. [PMID: 33061312 PMCID: PMC7522517 DOI: 10.2147/ppa.s275887] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Accepted: 09/03/2020] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Diabetes Mellitus is a chronic disease and can be self-managed using five treatment approaches, including education, medical nutrition therapy, physical exercise, pharmacological intervention, and blood sugar monitoring. Improvement of patient compliance and self-efficacy are critical points that impact the self-care behavior in patients with type two diabetes mellitus in order to limit the morbidity and promote glycemic control. Therefore, the present study successfully assesses the effect of perceived self-efficacy and associated factors among patients with diabetes mellitus at public hospitals of western Ethiopia. METHODS The cross-sectional study design was employed on a sample of 423 diabetic patients. A systematic random sampling method was employed. An interviewer-administered structured questionnaire was used. The data entered into Epi data version 3.1 and exported into Statistical Package for the Social Sciences window version 24 for analysis. All variables significant at p <0.25 in bivariate were entered into multivariate analysis. The multivariable logistic regressions were used to determine factors associated with perceived self-efficacy by considering adjusted odds ratio at CI 95% and the significance level was set at p <0.05. RESULTS Out of 423 participants sampled, 398 participated in the study giving a response rate of 94.1%. The level of perceived good self-efficacy among diabetes patients was 52.5%. Being married (AOR=1.611, 95% CI = 1.003, 2.587), home blood glucose test (AOR=3.359, 95% CI = 1.912,5.903), doing exercise (AOR=11.412, 95% CI = 2.488,52.346), having good appetite (AOR=2.587, 95% CI = 1.454,4.606), having special diet (AOR=4.902, 95% CI= 1.202, 19.992), and good self-care behavior (AOR=10.320, 95% CI= 5.657, 18.824) were significantly associated with good self-efficacy. CONCLUSION The level of perceived self-efficacy was high. Home blood glucose tests, good self-care behavior, married, doing exercise, good appetite, having a special diet were significantly associated with high perceived self-efficacy. The national policymaker focused on patients' behavioral change to develop perceived self-efficacy for confidently managing the disease.
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Affiliation(s)
- Adugna Oluma
- School of Nursing and Midwifery, Institute of Health Sciences, Wollega University, Nekemte, Ethiopia
| | - Muktar Abadiga
- School of Nursing and Midwifery, Institute of Health Sciences, Wollega University, Nekemte, Ethiopia
| | - Getu Mosisa
- School of Nursing and Midwifery, Institute of Health Sciences, Wollega University, Nekemte, Ethiopia
| | - Ginenus Fekadu
- Department of Pharmacy, Institute of Health Sciences, Wollega University, Nekemte, Ethiopia
| | - Ebisa Turi
- Department of Public Health, Institute of Health Sciences, Wollega University, Nekemte, Ethiopia
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Allam MM, El-Zawawy HT, Ibrahim Ismail I, Ghazy RM. Cross-Cultural Reliability of an Arabic Version of the Self-Efficacy for Managing Chronic Disease 6-Item Scale in Arab Patients with Diabetes mellitus. Prim Care Diabetes 2020; 14:305-310. [PMID: 31786157 DOI: 10.1016/j.pcd.2019.11.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2019] [Revised: 10/15/2019] [Accepted: 11/02/2019] [Indexed: 12/12/2022]
Abstract
INTRODUCTION Arab nations have the second highest diabetes mellitus (DM) prevalence in the world. There is a growing interest in self-management programs that emphasize patient's central role in managing type 2 DM. AIM OF THE STUDY To validate an Arabic version of the Self-Efficacy for Managing Chronic Disease 6-Item Scale (SEM6S) among Arab type 2 DM patients and to explore factors associated with self-efficacy measured with the SEM6S. METHODS Cross-sectional study on 302 Arab patients with T2DM of three different nationalities (Egyptian, Saudi, Kuwaiti).The SEM6S was translated using forward-backward method, and its reliability was determined by calculating Cronbach's alpha. A regression model was used to examine variables associated with self-efficacy in Arab patients with T2DM. RESULTS Questionnaire was successfully translated without language or content-related problem. The mean age of participants was 47.71±14.7 years with equally represented sexes. The mean total score of the SEM6S was 5.99±1.86. The scale psychometric properties was reproducible (ICC=0.61-0.71) with good reliability (Cronbach's alpha=0.79). Statistically significant increase in self-efficacy was observed in patients <30 years, uncomplicated DM, DM with hypertension, and in patients who had physical activity > 60min per day. Also, a bimodal increase in self-efficacy was detected in patients with DM<5 years and 10.1-15 years. After regression analysis, physical activity was significantly positively correlated with self-efficacy (β=0.8, P=0.01), and duration of diabetes was significantly negatively correlated with self-efficacy (β = -0.23, P=0.03). CONCLUSION Arabic SEM6S is acceptable, reliable and repeatable metric for self-efficacy.
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Affiliation(s)
- Magdy Mohamed Allam
- Internal Medicine department, Alexandria University Student Hospital (AUSH), Egypt
| | | | | | - Ramy Mohamed Ghazy
- Tropical Health department, High Institute of Public Health, Alexandria University, Egypt
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Chen Z, Zhang C, Fan G. Interrelationship between Interpersonal Interaction Intensity and Health Self-Efficacy in People with Diabetes or Prediabetes on Online Diabetes Social Platforms: An In-Depth Survey in China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17155375. [PMID: 32722561 PMCID: PMC7432193 DOI: 10.3390/ijerph17155375] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Revised: 07/20/2020] [Accepted: 07/21/2020] [Indexed: 02/05/2023]
Abstract
Objective: The peer interaction-based online model has been influential in the recent development of diabetes management. This model "extends and innovates" the traditional mode of doctor-patient guidance, transforming it into a mode in which both doctor-patient guidance and patient-patient interaction coexist; this new mode has the added advantage of offering "extended continual intervention." This study contributes to research on extending diabetes management models by investigating how patients with diabetes or prediabetes interact in online health communities, focusing on the interrelationship between self-efficacy characteristics and online participation during patient-patient interactions. Methods: In this cross-sectional study, participants with diabetes of various severities completed an electronic questionnaire, which was formulated with a revised classical scale. The questionnaire was disseminated through diabetes online health communities. Its content covered the respondent's general condition, self-evaluation of their self-efficacy, and participation in online health communities, specifically with respect to factors such as the time spent in online information each day, the number of groups joined, and the extent of interaction in diabetes online health communities, etc. The main observation indicators were the participants' self-efficacy, their extent of online participation, and the characteristics of online health communities. Descriptive statistics, chi-square test, linear trend estimation, and ordinal logistic regression were used to explore the relationship between the three indicators. Results: The self-efficacy scores ( x ¯ ± s) were 51.9 ± 9.12, and 59.1% of interviewed participants had self-efficacy scores greater than the mean. Overall, most participants (96%) considered online diabetes social platforms to be helpful. Groups differed with respect to interaction mode, which indicated that people with high self-efficacy tend to employ various modes of interaction. Participants with high self-efficacy were also more likely to live in cities (p < 0.05) and be married (p < 0.05) and tended to spend more time paying attention to group information (p < 0.05), spend more time viewing group information (p < 0.05), and have a greater degree of interaction with group members (p < 0.05). Information sources for the different grades of participants was primarily obtained from social media. Conclusion: Among people with diabetes, the frequency and intensity of online interaction might positively affect self-efficacy and, by implication, diabetes self-management. Diabetics with high self-efficacy also tend to have positive online interaction and adopt different ways of interaction. In addition, the diabetes information sources of the respondents mainly come from social networks, most of the respondents think that online social networking sites have a positive impact on diabetes self-management, which shows that social network plays an important role in diabetes information source of diabetics. However, the design of online health communities has room for improvement, specifically with respect to the provision of information that patients require. As an interesting side note, among people with diabetes or prediabetes, those who lived in urban area and were married, those who paid more attention to group information, and those who actively participated in interactions tended to have relatively high self-efficacy. The results suggest that people with diabetes have higher-quality self-care when they engage in online health community interactions; such benefits cannot be obtained from treatment in a hospital. In general, enhanced self-efficacy in people with diabetes enables them to more readily acquire diabetes-related knowledge. Online interaction with diabetics, who has the same experience, can not only get more information, but also have a sense of identity and belonging, which enhances self-efficacy and further urges them to actively participate in online interaction. Therefore, online health communities are an important supplement to the clinical treatment of diabetes mellitus and clinicians can take advantage of the educational function of online diabetes groups in their provision of tailored diabetes interventions and take into account the factors that affect the self-efficacy of diabetics (including the frequency and intensity of online interaction, age, marital status, residential area, etc.), to provide tailored diabetes interventions for diabetics. Such a use of online diabetes groups can strengthen diabetes self-management.
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Abstract
Purpose:
The prevalence of diabetes and the personal and national burden from diabetes, a serious health issue around the globe, continues to increase. The purpose of this study was to identify factors influencing self-care among patients with type 2 diabetes.
Methods:
We conducted a cross-sectional descriptive survey of 118 outpatients with type 2 diabetes in national university hospital C in Korea. Data were collected from self-report questionnaires covering information on demographics, self-care, and self-efficacy. Additional data were collected from medical records including information on HbA1c, fasting blood glucose levels, and cholesterol levels. Collected data were analyzed using descriptive statistics, Pearson’s correlation coefficient, and multiple regression using SPSS/WIN version 22.0 software.
Results:
Factors affecting self-care were the following four: self-efficacy, HbA1c, occupation status, and smoking status. Higher engagement in self-care was associated with higher self-efficacy (β = .53, p < .001), lower HbA1c (β = -0.33, p < .001), unemployment (β = -0.20, p < .001), and non-smoking status (β = -0.15, p = .011). The regression model of self-care among the type 2 diabetes patients was statistically significant (F = 67.15, p < .001), and the explanatory power of the adjusted R2 was 69%.
Conclusion:
Type 2 diabetes patients with high self-efficacy and self-care scores showed good glycemic control. Therefore, this finding suggests that nursing interventions should be developed to enhance self-efficacy, which is the greatest influencing factor for self-care.
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Suhaimi AF, Ibrahim N, Tan KA, Silim UA, Moore G, Ryan B, Castle DJ. Effectiveness of a culturally adapted biopsychosocial intervention (POHON SIHAT) in improving self-efficacy in patients with diabetes attending primary healthcare clinics in Putrajaya, Malaysia: study protocol of a randomised controlled trial. BMJ Open 2020; 10:e033920. [PMID: 32066607 PMCID: PMC7044963 DOI: 10.1136/bmjopen-2019-033920] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION People with diabetes are often associated with multifaceted factors and comorbidities. Diabetes management frameworks need to integrate a biopsychosocial, patient-centred approach. Despite increasing efforts in promotion and diabetes education, interventions integrating both physical and mental health components are still lacking in Malaysia. The Optimal Health Programme (OHP) offers an innovative biopsychosocial framework to promote overall well-being and self-efficacy, going beyond education alone and has been identified as relevant within the primary care system. Following a comprehensive cultural adaptation process, Malaysia's first OHP was developed under the name 'Pohon Sihat' (OHP). The study aims to evaluate the effectiveness of the mental health-based self-management and wellness programme in improving self-efficacy and well-being in primary care patients with diabetes mellitus. METHODS AND ANALYSIS This biopsychosocial intervention randomised controlled trial will engage patients (n=156) diagnosed with type 2 diabetes mellitus (T2DM) from four primary healthcare clinics in Putrajaya. Participants will be randomised to either OHP plus treatment as usual. The 2-hour weekly sessions over five consecutive weeks, and 2-hour booster session post 3 months will be facilitated by trained mental health practitioners and diabetes educators. Primary outcomes will include self-efficacy measures, while secondary outcomes will include well-being, anxiety, depression, self-care behaviours and haemoglobin A1c glucose test. Outcome measures will be assessed at baseline, immediately postintervention, as well as at 3 months and 6 months postintervention. Where appropriate, intention-to-treat analyses will be performed. ETHICS AND DISSEMINATION This study has ethics approval from the Medical Research and Ethics Committee, Ministry of Health Malaysia (NMRR-17-3426-38212). Study findings will be shared with the Ministry of Health Malaysia and participating healthcare clinics. Outcomes will also be shared through publication, conference presentations and publication in a peer-reviewed journal. TRIAL REGISTRATION NUMBER NCT03601884.
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Affiliation(s)
- Aida Farhana Suhaimi
- Department of Psychiatry and Mental Health, Hospital Putrajaya Malaysia, Selangor, Malaysia
- Department of Psychiatry, Universiti Putra Malaysia, Faculty of Medicine and Health Sciences, Serdang, Malaysia
| | - Normala Ibrahim
- Department of Psychiatry, Universiti Putra Malaysia, Faculty of Medicine and Health Sciences, Serdang, Malaysia
| | - Kit-Aun Tan
- Department of Psychiatry, Universiti Putra Malaysia, Faculty of Medicine and Health Sciences, Serdang, Malaysia
| | - Umi Adzlin Silim
- Department of Psychiatry and Mental Health, Hospital Kuala Lumpur, Kuala Lumpur, Wilayah Persekutuan, Malaysia
| | - Gaye Moore
- Centre for Palliative Care, St. Vincent's Hospital Melbourne, Melbourne, Victoria, Australia
| | - Brigid Ryan
- International Unit, St. Vincent's Hospital Melbourne, Melbourne, Victoria, Australia
| | - David J Castle
- Department of Psychiatry, St. Vincent's Mental Health, Melbourne, Victoria, Australia
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Melaku T, Chelkeba L, Mekonnen Z, Kumela K. Glycemic Control Among People Living with Diabetes and Human Immunodeficiency Virus in Ethiopia: Leveraging Clinical Care for the Looming Co-Epidemics. Diabetes Metab Syndr Obes 2020; 13:4379-4399. [PMID: 33235478 PMCID: PMC7680108 DOI: 10.2147/dmso.s266105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2020] [Accepted: 10/28/2020] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Antiretroviral therapy has decreased human immunodeficiency virus related mortality. However, the incidence of diabetes mellitus is increasing among people living with human immunodeficiency virus and adds complexity to the standards of care. OBJECTIVE The study was aimed to determine the glycemic control and delivery of clinical care among people living with diabetes and human immunodeficincy virus in Ethiopia. METHODS A comparative prospective cohort study was conducted among patients living with diabetes at follow-up clinics of Jimma Medical Center in two study arms. The first arm was people living with diabetes and human immunodeficiency virus. The second arm was human immunodeficiency virus negative patients living with diabetes. The expanded English version of the summary of diabetes self-care activities scale was used to measure self-care behaviors. In order to identify the predictors of glycemic control, multivariable Cox regression analysis was used. Statistical significance at p-value ≤0.05 was considered. RESULTS A total of 297 eligible participants were followed for one year, with a mean age of 44.35±12.55 years. Males accounted for 55.9%. After one year of follow-up, 61.9% of diabetes people living with human immunodeficiency virus, and 49% of human immunodeficiency virus-negative patients with diabetes poorly met blood glucose target (p=0.037). Female gender [AHR: 2.72; 95% CI (1.21-5.72)], age >31 years [AHR: 2.48; 95% CI (1.34-11.01)], increased waist circumference [AHR: 3.64; 95% CI (2.57-16.12)], overweight [AHR: 3.63; 95% CI (1.65-22.42)], chronic disease comorbidity [AHR: 2.02; 95% CI (1.44-2.84)], human immunodeficiency virus infection [AHR: 3.47; 95% CI (2.03-23.75)], living longer with diabetes (>5 years) [AHR: 3.67; 95% CI (3.26-4.14)] showed a higher risk of blood sugar control failure and were independent predictors of uncontrolled glycemia. Tuberculosis infection increased the risk of uncontrolled blood sugar among people living with diabetes and human immunodeficency virus[AHR:3.82;95% CI(2.86-5.84]. CONCLUSION Significant gaps were observed in achieving the recommended glycemic target and involvement of patients on self-care care behavior in the study area. The co-occurrence of tuberculosis, human immunodeficiency virus, and diabetes is triple trouble needing special attention in their management. It is high time to leverage the clinical care of the looming co-epidemics through chronic comprehensive care clinic.
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Affiliation(s)
- Tsegaye Melaku
- Department of Clinical Pharmacy, School of Pharmacy, Institute of Health, Jimma University, Jimma, Ethiopia
- Correspondence: Tsegaye Melaku Jimma University, Jimma, EthiopiaTel +251 913765609 Email
| | - Legese Chelkeba
- Department of Clinical Pharmacy, School of Pharmacy, Institute of Health, Jimma University, Jimma, Ethiopia
| | - Zeleke Mekonnen
- School of Medical Laboratory Sciences, Institute of Health, Jimma University, Jimma, Ethiopia
| | - Kabaye Kumela
- Department of Clinical Pharmacy, School of Pharmacy, Institute of Health, Jimma University, Jimma, Ethiopia
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Knowles SR, Apputhurai P, O’Brien CL, Ski CF, Thompson DR, Castle DJ. Exploring the relationships between illness perceptions, self-efficacy, coping strategies, psychological distress and quality of life in a cohort of adults with diabetes mellitus. PSYCHOL HEALTH MED 2019; 25:214-228. [DOI: 10.1080/13548506.2019.1695865] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Affiliation(s)
- Simon R Knowles
- Department of Psychology, Faculty of Health, Arts and Design, Swinburne University, Melbourne, Australia
- Department of Psychiatry, The University of Melbourne, Melbourne, Australia
- Mental Health Service, St. Vincent’s Hospital, Melbourne, Australia
| | - Pragalathan Apputhurai
- Department of Psychology, Faculty of Health, Arts and Design, Swinburne University, Melbourne, Australia
| | - Casey L O’Brien
- Department of Psychiatry, The University of Melbourne, Melbourne, Australia
- Mental Health Service, St. Vincent’s Hospital, Melbourne, Australia
| | - Chantal F Ski
- Department of Psychiatry, The University of Melbourne, Melbourne, Australia
- School of Nursing and Midwifery, Queen’s University Belfast, Belfast, UK
| | - David R Thompson
- Department of Psychiatry, The University of Melbourne, Melbourne, Australia
- School of Nursing and Midwifery, Queen’s University Belfast, Belfast, UK
| | - David J Castle
- Department of Psychiatry, The University of Melbourne, Melbourne, Australia
- Mental Health Service, St. Vincent’s Hospital, Melbourne, Australia
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Aga F, Dunbar SB, Kebede T, Higgins MK, Gary R. Sociodemographic and clinical correlates of diabetes self-efficacy in adults with type 2 diabetes and comorbid heart failure. Res Nurs Health 2019; 43:79-89. [PMID: 31773764 DOI: 10.1002/nur.21999] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2019] [Accepted: 11/11/2019] [Indexed: 11/08/2022]
Abstract
Heart failure (HF) is a comorbidity that complicates type 2 diabetes mellitus (T2D) management and increases the chance of death. However, little is known concerning factors related to diabetes self-efficacy in comorbid HF. This secondary data analysis was aimed at describing sociodemographic and clinical correlates of diabetes self-efficacy in adults with T2D and comorbid HF. A correlational design was used to analyze cross-sectional baseline data from a randomized study of 180 participants that tested a 6-month integrated self-care intervention targeting adults with concomitant HF and T2D. Participants were enrolled from one of four large urban-tertiary hospitals in Atlanta, GA, during 2010-2013. Data were collected from medical records and self-report. We used stepwise multiple linear regressions to examine variables associated with diabetes self-efficacy. The participants' mean age was 58.1 ± 10.7 years and the majority were male (n = 118; 65.6%) and African American (n = 119; 66.1%). Good self-rated health and presence of implantable cardioverter-defibrillator (ICD) had significant positive relationships with diabetes self-efficacy, while taking both oral antiglycemic medication and insulin, history of depression, cardiac pacemaker, and taking digitalis were negatively related. These variables collectively explained 22.4% of the variation in diabetes self-efficacy. One study implication is that using self-rated health provides a quick, patient-centered assessment to evaluate patient health status. Further studies are warranted to ascertain the pathways linking ICD, pacemaker, and digitalis treatment with diabetes self-efficacy.
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Affiliation(s)
- Fekadu Aga
- Department of Nursing, School of Nursing and Midwifery, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Sandra B Dunbar
- Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, Georgia
| | - Tedla Kebede
- Diabetes and Endocrinology Unit, Department of Internal Medicine, Tikur Anbessa Specialized Hospital, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | | | - Rebecca Gary
- Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, Georgia
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Lim MT, Lim YMF, Teh XR, Lee YL, Ismail SA, Sivasampu S. Patient experience on self-management support among primary care patients with diabetes and hypertension. Int J Qual Health Care 2019; 31:37-43. [PMID: 30608582 PMCID: PMC6839370 DOI: 10.1093/intqhc/mzy252] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2018] [Revised: 10/20/2018] [Accepted: 12/14/2018] [Indexed: 12/22/2022] Open
Abstract
OBJECTIVE To determine the extent of self-management support (SMS) provided to primary care patients with type 2 diabetes (T2D) and hypertension and its associated factors. DESIGN Cross-sectional survey conducted between April and May 2017. SETTING Forty public clinics in Malaysia. PARTICIPANTS A total of 956 adult patients with T2D and/or hypertension were interviewed. MAIN OUTCOME MEASURES Patient experience on SMS was evaluated using a structured questionnaire of the short version Patient Assessment of Chronic Illness Care instrument, PACIC-M11. Linear regression analysis adjusting for complex survey design was used to determine the association of patient and clinic factors with PACIC-M11 scores. RESULTS The overall PACIC-M11 mean was 2.3(SD,0.8) out of maximum of 5. The subscales' mean scores were lowest for patient activation (2.1(SD,1.1)) and highest for delivery system design/decision support (2.9(SD,0.9)). Overall PACIC-M11 score was associated with age, educational level and ethnicity. Higher overall PACIC-M11 ratings was observed with increasing difference between actual and expected consultation duration [β = 0.01; 95% CI (0.001, 0.03)]. Better scores were also observed among patients who would recommend the clinic to friends and family [β = 0.19; 95% CI (0.03, 0.36)], when health providers were able to explain things in ways that were easy to understand [β = 0.34; 95% CI (0.10, 0.59)] and knew about patients' living conditions [β = 0.31; 95% CI (0.15, 0.47)]. CONCLUSIONS Our findings indicated patients received low levels of SMS. PACIC-M11 ratings were associated with age, ethnicity, educational level, difference between actual and expected consultation length, willingness to recommend the clinic and provider communication skills.
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Affiliation(s)
- Ming Tsuey Lim
- Healthcare Statistics Unit, National Clinical Research Centre, Ministry of Health, 3rd Floor, MMA House, 124 Jalan Pahang, Kuala Lumpur, Malaysia
| | - Yvonne Mei Fong Lim
- Healthcare Statistics Unit, National Clinical Research Centre, Ministry of Health, 3rd Floor, MMA House, 124 Jalan Pahang, Kuala Lumpur, Malaysia
| | - Xin Rou Teh
- Healthcare Statistics Unit, National Clinical Research Centre, Ministry of Health, 3rd Floor, MMA House, 124 Jalan Pahang, Kuala Lumpur, Malaysia
| | - Yi Lin Lee
- Clinical Research Ward, Ampang Hospital, Ministry of Health, Jalan Mewah Utara, Pandan Mewah, Ampang, Selangor, Malaysia
| | - Siti Aminah Ismail
- Healthcare Statistics Unit, National Clinical Research Centre, Ministry of Health, 3rd Floor, MMA House, 124 Jalan Pahang, Kuala Lumpur, Malaysia
| | - Sheamini Sivasampu
- Healthcare Statistics Unit, National Clinical Research Centre, Ministry of Health, 3rd Floor, MMA House, 124 Jalan Pahang, Kuala Lumpur, Malaysia
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Lael-Monfared E, Tehrani H, Moghaddam ZE, Ferns GA, Tatari M, Jafari A. Health literacy, knowledge and self-care behaviors to take care of diabetic foot in low-income individuals: Application of extended parallel process model. Diabetes Metab Syndr 2019; 13:1535-1541. [PMID: 31336518 DOI: 10.1016/j.dsx.2019.03.008] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2019] [Accepted: 03/05/2019] [Indexed: 02/03/2023]
Abstract
AIM This study has been conducted with the aim of determining the relationship between health literacy, knowledge and self-care behaviors to take care of the diabetic foot in low-income individuals, based on the extended parallel process model (EPPM). METHODS This cross-sectional study was conducted on 400 patients with type II diabetes referred to the Diabetes Clinic, using a random sampling method and using standard questionnaires. In this study, the constructs of knowledge, EPPM (perceived sensitivity, perceived severity, response efficacy, self-efficacy), and health literacy were significantly related to self-care behaviors (p < 0.05). RESULTS Based on the linear regression results, the constructs of knowledge, health literacy, and constructs of EPPM were able to account for 43% of the variance to perform diabetic foot self-care behaviors. The maximum impact was related to the constructs of health literacy and self-efficacy (p < 0.001). CONCLUSION Based on these results, levels of knowledge and health literacy of patients were very poor overall, and the self-care behaviors were not appropriate. On the other hand, considering the great impact of health literacy in performing self-care behaviors, it is suggested that educational courses be held in this regard and proper strategies are employed to enhance the health literacy of diabetic patients.
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Affiliation(s)
- Elaheh Lael-Monfared
- Ph.D Student in Health Education and Health Promotion, Student Research Committee, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Hadi Tehrani
- Health Education & Health Promotion, Social Determinants of Health Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
| | - Zahra Esmati Moghaddam
- Student Research Committee, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran.
| | - Gordon A Ferns
- Department of Medical Education Brighton and Sussex Medical School, Division of Medical Education, University of Brighton Falmer Campus, Brighton BN1 9PH, UK.
| | - Maryam Tatari
- School of Health, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran.
| | - Alireza Jafari
- Social Determinants of Health Research Center, Gonabad University of Medical Sciences, Gonabad, Iran; Social Determinants of Health Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
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Chew BH, Vos RC, Pouwer F, Rutten GEHM. The associations between diabetes distress and self-efficacy, medication adherence, self-care activities and disease control depend on the way diabetes distress is measured: Comparing the DDS-17, DDS-2 and the PAID-5. Diabetes Res Clin Pract 2018; 142:74-84. [PMID: 29802952 DOI: 10.1016/j.diabres.2018.05.021] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2017] [Revised: 02/09/2018] [Accepted: 05/09/2018] [Indexed: 02/08/2023]
Abstract
AIMS To examine whether diabetes distress (DD), when measured by three different instruments, was associated differently with self-efficacy, self-care activity, medication adherence and disease control in people with Type 2 diabetes mellitus. METHODS A cross-sectional study in three health clinics. DD was assessed with the 17-item Diabetes Distress Scale, the 2-item DDS-2 (DDS-2) and the 5-item Problem Areas in Diabetes Scale (PAID-5). Dependent variables included self-efficacy, self-care activities, medication adherence, HbA1c, systolic and diastolic blood pressure (SBP, DBP). Multiple linear and logistic regression were used in analyses. RESULTS In total 338 participants (56% women), with a mean age of 61 years and diabetes duration of 9.8 years, were included. DDS-2 was an independent determinant of SBP (β = 1.89, 95% CI 0.14, 3.64), DBP (β = 1.19, 95% CI 0.16, 2.21) and blood pressure target (OR = 2.09, 95% CI 1.12, 3.83). PAID-5 was an independent determinant of medication adherence (adjusted β = -0.05, 95% CI -0.08, -0.01) and self-care activities (OR = 0.50, 95% CI 0.26, 0.99). CONCLUSIONS Associations of DD with important aspects of diabetes care are substantially influenced by confounders and depend on the way DD is measured. Our findings call for a judicious use of different DD measures in clinical practice and research. The study is registered on ClinicalTrials.gov (NCT02730754).
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Affiliation(s)
- Boon-How Chew
- Department of Family Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400 Serdang, Selangor, Malaysia; University of Utrecht, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Huispost Str. 6.131, P.O. Box 85500, 3508 GA Utrecht, The Netherlands.
| | - Rimke C Vos
- University of Utrecht, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Huispost Str. 6.131, P.O. Box 85500, 3508 GA Utrecht, The Netherlands
| | - Frans Pouwer
- Department of Psychology, University of Southern Denmark, Odense, Denmark
| | - Guy E H M Rutten
- University of Utrecht, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Huispost Str. 6.131, P.O. Box 85500, 3508 GA Utrecht, The Netherlands
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Chew BH, Vos RC, Stellato RK, Ismail M, Rutten GEHM. The effectiveness of an emotion-focused educational programme in reducing diabetes distress in adults with Type 2 diabetes mellitus (VEMOFIT): a cluster randomized controlled trial. Diabet Med 2018; 35:750-759. [PMID: 29505098 DOI: 10.1111/dme.13615] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/28/2018] [Indexed: 02/05/2023]
Abstract
AIMS To evaluate the effectiveness of a brief, value-based emotion-focused educational programme (VEMOFIT) in Malay adults with Type 2 diabetes mellitus compared with a programme of active listening to participants' emotional experiences, social support and their opinion on the health clinic diabetes care services (attention control). METHODS Malay adults with severe diabetes distress [Diabetes Distress Scale (DDS-17) mean score ≥ 3] were included. VEMOFIT consisted of four biweekly group sessions, a booster session after 3 months and a follow-up 6 months post intervention. The attention control programme consisted of three sessions over the same period. Outcomes included diabetes distress, depressive symptoms, self-efficacy and disease control. Required total sample size was 165. RESULTS Participants (n = 124) were randomized to either VEMOFIT (n = 53) or the attention control programme (n = 71). Participants had a mean (sd) age of 55.7 (9.7) years, median diabetes duration of 7.0 (8.0) years and mean HbA1c level of 82 mmol/mol (9.7%). The mean DDS-17 level decreased significantly in both the VEMOFIT and the attention control programmes (3.4 to 2.9 vs. 3.1 to 2.7, respectively). The adjusted between-group DDS-17 difference was not significant [-0.01, 95% confidence interval (CI) -0.38, 0.35]. The proportion of individuals with severe diabetes distress decreased in both groups, from 89% to 47% vs. 69% to 39% (odds ratio 0.88; 95% CI 0.26, 2.90). Other outcomes did not differ between groups. CONCLUSIONS Both interventions decreased diabetes distress significantly. The theory-based VEMOFIT programme was not superior to the attention control programme. The latter approach is a simpler way to decrease severe diabetes distress (Trial registration: NCT02730078; NMRR-15-1144-24803).
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Affiliation(s)
- B H Chew
- Department of Family Medicine, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
- University of Utrecht, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | - R C Vos
- University of Utrecht, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | - R K Stellato
- University of Utrecht, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | - M Ismail
- Health Clinic, Seremban 2, Seremban, Negeri Sembilan, Malaysia
| | - G E H M Rutten
- University of Utrecht, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
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Liu L, Wang X, Cao X, Gu C, Yang C, OuYang Y. Self-care confidence mediates the relationship between type D personality and self-care adherence in chinese heart failure patients. Heart Lung 2018; 47:216-221. [DOI: 10.1016/j.hrtlng.2018.03.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2017] [Accepted: 03/02/2018] [Indexed: 11/26/2022]
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Tharek Z, Ramli AS, Whitford DL, Ismail Z, Mohd Zulkifli M, Ahmad Sharoni SK, Shafie AA, Jayaraman T. Relationship between self-efficacy, self-care behaviour and glycaemic control among patients with type 2 diabetes mellitus in the Malaysian primary care setting. BMC FAMILY PRACTICE 2018. [PMID: 29523075 PMCID: PMC5845324 DOI: 10.1186/s12875-018-0725-6] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Background Self-efficacy has been shown to be positively correlated with self-care behaviour and glycaemic control among patients with type 2 diabetes mellitus. However, such evidence is lacking in the Malaysian primary care setting. The objectives of this study were to i) determine the levels of self-efficacy, self-care behaviour and glycaemic control among patients with type 2 diabetes mellitus in the Malaysian primary care setting ii) determine the relationship between self-efficacy, self-care behaviour and glycaemic control iii) determine the factors associated with glycaemic control. Methods This was a cross-sectional study involving patients with type 2 diabetes mellitus from two public primary care clinics in Malaysia. Self-efficacy and self-care behaviour levels were measured using previously translated and validated DMSES and SDSCA questionnaires in Malay versions, respectively. Glycaemic control was measured using HbA1c. Results A total of 340 patients with type 2 diabetes mellitus were recruited. The total mean (±SD) of self-efficacy and self-care behaviour scores were 7.33 (±2.25) and 3.76 (±1.87), respectively. A positive relationship was found between self-efficacy and self-care behaviour (r 0.538, P < 0.001). Higher self-efficacy score was shown to be correlated with lower HbA1c (r − 0.41, P < 0.001). Multiple linear regression analysis demonstrated that higher self-efficacy scores (b − 0.398; 95% CI: -0.024, − 0.014; P < 0.001), shorter duration of diabetes (b 0.177; 95% CI: 0.002, 0.007; P < 0.001) and smaller waist circumference (b 0.135; 95% CI: 0.006, 0.035; P = 0.006), were significantly associated with good glycaemic control. Conclusion This study demonstrated that higher self-efficacy was correlated with improved self-care behaviour and better glycaemic control. Findings of this study suggest the importance of including routine use of self-efficacy measures in the management of type 2 diabetes mellitus in primary care. Electronic supplementary material The online version of this article (10.1186/s12875-018-0725-6) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Zahirah Tharek
- Discipline of Primary Care Medicine, Faculty of Medicine, Universiti Teknologi MARA (UiTM), Selayang Campus, Jalan Prima Selayang 7, 68100, Batu Caves, Selangor, Malaysia
| | - Anis Safura Ramli
- Discipline of Primary Care Medicine, Faculty of Medicine, Universiti Teknologi MARA (UiTM), Selayang Campus, Jalan Prima Selayang 7, 68100, Batu Caves, Selangor, Malaysia. .,Institute of Pathology, Laboratory and Forensic Medicine (I-PPerForM), Universiti Teknologi MARA (UiTM), Sungai Buloh Campus, Jalan Hospital, 47000, Sungai Buloh, Selangor, Malaysia.
| | - David Leonard Whitford
- Department of General Practice, Royal College of Surgeons in Ireland (RCSI), Mercer Building, Noel Purcell Walk, Dublin, Republic of Ireland
| | - Zaliha Ismail
- Discipline of Population Health and Preventive Medicine, Faculty of Medicine, Universiti Teknologi MARA (UiTM), Sungai Buloh Campus, Jalan Hospital, 47000 Sungai Buloh, Selangor, Malaysia
| | - Maryam Mohd Zulkifli
- Department of Family Medicine, School of Medical Sciences, Universiti Sains Malaysia (USM), 16150 Kubang Kerian, Kelantan, Malaysia
| | - Siti Khuzaimah Ahmad Sharoni
- Department of Nursing, Faculty of Health Sciences, Universiti Teknologi MARA (UiTM), Puncak Alam Campus, 42300 Bandar Puncak Alam, Selangor, Malaysia
| | - Asrul Akmal Shafie
- Discipline of Social and Administrative Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia (USM), 11800 Penang, Malaysia
| | - Thevaraajan Jayaraman
- Discipline of Medicine, Faculty of Medicine, Universiti Teknologi MARA, Sungai Buloh Campus, Jalan Hospital, 47000 Sungai Buloh, Selangor, Malaysia
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Chew BH, Vos RC, Heijmans M, Shariff-Ghazali S, Fernandez A, Rutten GEHM. Validity and reliability of a Malay version of the brief illness perception questionnaire for patients with type 2 diabetes mellitus. BMC Med Res Methodol 2017; 17:118. [PMID: 28774271 PMCID: PMC5543429 DOI: 10.1186/s12874-017-0394-5] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2017] [Accepted: 07/26/2017] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Illness perceptions involve the personal beliefs that patients have about their illness and may influence health behaviours considerably. Since an instrument to measure these perceptions for Malay population in Malaysia is lacking, we translated and examined the psychometric properties of the Malay version of the Brief Illness Perception Questionnaire (MBIPQ) in adult patients with type 2 diabetes mellitus. METHODS The MBIPQ has nine items, all use a 0-10 response scale, except the ninth item about causal factors, which is an open-ended item. A standard procedure was used to translate and adapt the English BIPQ into Malay language. Construct validity was examined comparing item scores and scores on the Diabetes Management Self-Efficacy Scale, the Morisky Medication Adherence Scale, the World Health Organization Quality of Life-brief, the 9-item Patient Health Questionnaire, the 17-item Diabetes Distress Scale, HbA1c and the presence of complications. In addition, 2-week and 4-week test-retest reliability were studied. RESULTS A total of 312 patients completed the MBIPQ. Out of this, 97 and 215 patients completed the 2- or 4-weeks test-retest reliability questionnaire, respectively. Moderate inter-items correlations were observed between illness perception dimensions (r = -0.31 to 0.53). MBIPQ items showed the expected correlations with self-efficacy (r = 0.35), medication adherence (r = 0.29), quality of life (r = -0.17 to 0.31) and depressive symptoms (r = -0.18 to 0.21). People with severe diabetes-related distress also were more concern (t-test = 4.01, p < 0.001) and experienced lower personal control (t-test = 2.07, p = 0.031). People with any diabetes-related complication perceived the consequences as more serious (t-test = 2.04, p = 0.044). The 2-week and 4-week test-retest reliabilities varied between ICCagreement 0.39 to 0.70 and 0.58 to 0.78, respectively. CONCLUSIONS The psychometric properties of items in the MBIPQ are moderate. The MBIPQ showed good cross-cultural validity and moderate construct validity. Test-retest reliability was moderate. Despite the moderate psychometric properties, the MBIPQ may be useful in clinical practice as it is a useful instrument to elicit and communicate on patient's personal thoughts and feelings. Future research is needed to establish its responsiveness and predictive validity. TRIAL REGISTRATION ClinicalTrials.gov NCT02730754 registered on March 29, 2016; NCT02730078 registered on March 29, 2016.
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Affiliation(s)
- Boon-How Chew
- 0000 0001 2231 800Xgrid.11142.37Department of Family Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400 Serdang, Selangor Malaysia
- 0000000090126352grid.7692.aJulius Center for Health Sciences and Primary Care, Department of General Practice, University Medical Center Utrecht, Huispost Str.6.131, P.O. Box 85500, 3508 GA Utrecht, The Netherlands
| | - Rimke C. Vos
- 0000000090126352grid.7692.aJulius Center for Health Sciences and Primary Care, Department of General Practice, University Medical Center Utrecht, Huispost Str.6.131, P.O. Box 85500, 3508 GA Utrecht, The Netherlands
| | - Monique Heijmans
- 0000 0001 0681 4687grid.416005.6NIVEL, Netherlands Institute for Health Services Research, Utrecht, Netherlands
| | - Sazlina Shariff-Ghazali
- 0000 0001 2231 800Xgrid.11142.37Department of Family Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400 Serdang, Selangor Malaysia
| | - Aaron Fernandez
- 0000 0001 2231 800Xgrid.11142.37Department of Psychiatry, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400 Serdang, Selangor Malaysia
| | - Guy E. H. M. Rutten
- 0000000090126352grid.7692.aJulius Center for Health Sciences and Primary Care, Department of General Practice, University Medical Center Utrecht, Huispost Str.6.131, P.O. Box 85500, 3508 GA Utrecht, The Netherlands
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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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Kurnia AD, Amatayakul A, Karuncharernpanit S. Predictors of diabetes self-management among type 2 diabetics in Indonesia: Application theory of the health promotion model. Int J Nurs Sci 2017; 4:260-265. [PMID: 31406750 PMCID: PMC6626170 DOI: 10.1016/j.ijnss.2017.06.010] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2017] [Revised: 06/22/2017] [Accepted: 06/26/2017] [Indexed: 11/29/2022] Open
Abstract
Objective This study aimed to identify factors predicting diabetes self-management among adults with type 2 diabetes mellitus in Malang City, East Java, Indonesia. Methods A cross-sectional design was used in this study. Participants were selected from five primary health centers in Malang City, East Java, Indonesia using the multistage sampling method. A total of 127 adults with type 2 diabetes mellitus were recruited. Data were collected by questionnaires which were the general diabetes knowledge, the Beliefs of Treatment Effectiveness, the Diabetes Distress Scale, the Self-efficacy for Diabetes Scale, the brief Chronic Illness Resources Survey, the Situational Questionnaire and the Summary of Diabetes Self-care Activities. A self-administered questionnaire was used to collect the data. Multiple linear regression with stepwise method was used toanalyze the data. Results The scores of seven questionnaires (i.e, diabetes knowledge, perceived benefit of diabetes self-management, diabetes distress, perceived self-efficacy, social support, situational influence, and diabetes self-management) were 13.75 ± 3.59, 34.9 ± 4.89, 3.03 ± 0.86, 3.60 ± 0.53, 27.79 ± 5.56, 3.27 ± 0.58,3.81 ± 1.08, respectively. The significant predictors of diabetes self-management were treatment, perceived self-efficacy, and situational influences. These variables explained 20.8% (adjusted R 2 = 0.208) of the variance in diabetes self-management among adults with type 2 diabetes mellitus in Malang City. Conclusion Diabetes self-management among adults with type 2 diabetes mellitus could be improved by enhancing their perceived self-efficacy to achieve their self-management behavior, such as having a healthy diet, exercising regularly, actively monitoring blood glucose level, taking medication and foot care, and providing support to promote good situational influence.
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Affiliation(s)
- Anggraini Dwi Kurnia
- Nursing Department, Faculty of Health Science, University of Muhammadiyah Malang, Indonesia
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Ishak NH, Mohd Yusoff SS, Rahman RA, Kadir AA. Diabetes self-care and its associated factors among elderly diabetes in primary care. J Taibah Univ Med Sci 2017; 12:504-511. [PMID: 31435286 PMCID: PMC6694907 DOI: 10.1016/j.jtumed.2017.03.008] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2017] [Revised: 03/02/2017] [Accepted: 03/05/2017] [Indexed: 12/04/2022] Open
Abstract
Objectives Diabetes is a primarily self-manageable condition. Healthcare professionals usually offer education, treatment, and support, but patients themselves are responsible for the daily management of their condition. Increasing the effectiveness of self-management support may have a considerable impact on health care, especially for elderly people. The aim of this study was to describe diabetes self-care among elderly diabetics and to determine its associated factors. Methods This report describes a cross-sectional study involving 143 elderly diabetes patients in the outpatient department of the Hospital Universiti Sains Malaysia (HUSM). Self-care activities assessed in this study included dietary control, physical activity, self-monitoring of blood glucose, medication adherence, and situational related adherence behaviour, all of which were obtained using the validated Malay Elderly Diabetes Self-Care Questionnaire (MEDSCaQ). Results The mean (±SD) age of the subjects was 67.9 (±5.4) years old. A majority was Malay, with a mean HbA1c of 8.4 (±1.9). The mean diabetes self-care score was 26.5 (±8.0). Factors with a positive impact on diabetes self-care included being non-Malay (β = 5.275, p = 0.002), having family as care givers (β = 8.995, p = 0.004), having a higher level of family support (β = 0.159, p = 0.042), and possessing acceptable (β = 4.375, p = 0.001) or good knowledge of diabetes (β = 5.893, p = 0.004). The presence of neuropathy negatively impacted self-care, while diabetes nephropathy had a positive impact on self care (β = −4.053, p = 0.003). Conclusions Elderly individuals with type 2 diabetes in HUSM have a moderate score of diabetes self-care practice based on the MEDSCaQ. Determinants for good diabetes self-care include race, social support, having care-takers during periods of illness, diabetes knowledge, and diabetic microvascular complications.
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Affiliation(s)
- Nor H Ishak
- Klinik Kesihatan Jalan lanang, Sibu, Sarawak, Malaysia
| | - Siti S Mohd Yusoff
- Department of Family Medicine, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kerian, Kelantan, Malaysia
| | - Razlina A Rahman
- Department of Family Medicine, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kerian, Kelantan, Malaysia
| | - Azidah A Kadir
- Department of Family Medicine, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kerian, Kelantan, Malaysia
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D'Souza MS, Karkada SN, Parahoo K, Venkatesaperumal R, Achora S, Cayaban ARR. Self-efficacy and self-care behaviours among adults with type 2 diabetes. Appl Nurs Res 2017; 36:25-32. [PMID: 28720235 DOI: 10.1016/j.apnr.2017.05.004] [Citation(s) in RCA: 62] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2017] [Accepted: 05/20/2017] [Indexed: 10/19/2022]
Abstract
BACKGROUND Type 2 Diabetes Mellitus (T2DM) has an impact on an individuals' health and is influenced by glycemic control. AIM To examine the relationship between glycemic control, demographic and clinical factors on self-efficacy and self-care behaviours among adults with T2DM. DESIGN A correlational, descriptive study was used. One hundred and forty Omani adults with T2DM were recruited from a public hospital. METHODS Data on self-efficacy, self-care behaviours and glycemic control were collected between April and July 2016. The study was approved by the College Ethics Committee and Hospital Board. Bivariate and multivariate analyses were conducted. RESULTS Most adults had a fasting blood glucose >7.2mmol/L (90.7%), with the majority demonstrating 'uncontrolled' or poor HbA1c of >8% (65%). Variance of self-care behaviour (20.6%) and 31.3% of the variance of the self-efficacy was explained by the age, duration of diabetes, medication, HbA1c and prevention of activities of living. CONCLUSIONS Adults with T2DM with poor glycemic control were more probable to have poor self-efficacy and self-care behaviours. Glycemic control has an effect on improving diet, exercise, medication, foot care efficacy and behaviours. CLINICAL RELEVANCE The study recommends using these findings to plan self-efficacy and self-care behaviour to improve glycemic control among adults with T2DM.
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Affiliation(s)
- Melba Sheila D'Souza
- Adult Health and Critical Care, College of Nursing, Sultan Qaboos University, Muscat, Oman.
| | | | - Kader Parahoo
- School of Nursing University of 3Ulster, Coleraine campus, Londonderry, BT52 1SA, United Kingdom.
| | | | - Susan Achora
- Adult Health and Critical Care, College of Nursing, Sultan Qaboos University, Muscat, Oman.
| | - Arcalyd Rose R Cayaban
- Fundamentals and Administration, College of Nursing, Sultan Qaboos University, Muscat, Oman.
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Chew BH, Vos RC, Shariff Ghazali S, Shamsuddin NH, Fernandez A, Mukhtar F, Ismail M, Mohd Ahad A, Sundram NN, Ali SZM, Rutten GEHM. The effectiveness of a value-based EMOtion-cognition-Focused educatIonal programme to reduce diabetes-related distress in Malay adults with Type 2 diabetes (VEMOFIT): study protocol for a cluster randomised controlled trial. BMC Endocr Disord 2017; 17:22. [PMID: 28376921 PMCID: PMC5379686 DOI: 10.1186/s12902-017-0172-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2017] [Accepted: 03/23/2017] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Type 2 diabetes mellitus (T2DM) patients experience many psychosocial problems related to their diabetes. These often lead to emotional disorders such as distress, stress, anxiety and depression, resulting in decreased self-care, quality of life and disease control. The purpose of the current study is to evaluate the effectiveness of a brief value-based emotion-focused educational programme in adults with T2DM on diabetes-related distress (DRD), depressive symptoms, illness perceptions, quality of life, diabetes self-efficacy, self-care and clinical outcomes. METHODS A cluster randomised controlled trial will be conducted in 10 public health clinics in Malaysia, all providing diabetes care according to national clinical practice guidelines. Patients' inclusion criteria: Malay, ≥ 18 years with T2DM for at least 2 years, on regular follow-up with one of three biomarkers HbA1c, systolic blood pressure and LDL-cholesterol sub-optimally controlled, and with a mean 17-item Diabetes Distress Scale (DDS-17) score ≥ 3. The intervention consists of four sessions and one booster over a period of 4 months that provide information and skills to assist patients in having proper perceptions of their T2DM including an understanding of the treatment targets, understanding and managing their emotions and goal-setting. The comparator is an attention-control group with three meetings over a similar period. With an estimated intra-cluster correlation coefficient ρ of 0.015, a cluster size of 20 and 20% non-completion, the trial will need to enroll 198 patients. PRIMARY OUTCOME the between groups difference in proportion of patients achieving a mean DDS-17 score < 3 (non-significant distress) at 6 months post-intervention. Secondary outcomes will be the differences in the above mentioned variables between groups. DISCUSSION We hypothesize that primary and secondary outcomes will improve significantly after the intervention compared to the comparator group. The results of this study can contribute to better care for T2DM patients with DRD. TRIAL REGISTRATION ClinicalTrials.gov NCT02730078 . Registered on 29 March 2016, last updated on 4 January 2017.
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Affiliation(s)
- Boon-How Chew
- Department of Family Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400 Serdang, Selangor Malaysia
- Department of General Practice, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Huispost Str.6.131, P.O. Box 85500, 3508 GA Utrecht, The Netherlands
| | - Rimke C. Vos
- Department of General Practice, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Huispost Str.6.131, P.O. Box 85500, 3508 GA Utrecht, The Netherlands
| | - Sazlina Shariff Ghazali
- Department of Family Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400 Serdang, Selangor Malaysia
| | - Nurainul Hana Shamsuddin
- Department of Family Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400 Serdang, Selangor Malaysia
| | - Aaron Fernandez
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400 Serdang, Selangor Malaysia
| | - Firdaus Mukhtar
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400 Serdang, Selangor Malaysia
| | - Mastura Ismail
- Health Clinic Seremban 2, Jalan S2, A2, Seremban 2, 27300 Seremban, Negeri Sembilan Malaysia
| | - Azainorsuzila Mohd Ahad
- Health Clinic Port Dickson, KM 1, Jalan Seremban-Port Dickson, 71000 Port Dickson, Negeri Sembilan Malaysia
| | | | | | - Guy E. H. M. Rutten
- Department of General Practice, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Huispost Str.6.131, P.O. Box 85500, 3508 GA Utrecht, The Netherlands
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Depression, distress and self-efficacy: The impact on diabetes self-care practices. PLoS One 2017; 12:e0175096. [PMID: 28362861 PMCID: PMC5376339 DOI: 10.1371/journal.pone.0175096] [Citation(s) in RCA: 71] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2017] [Accepted: 03/20/2017] [Indexed: 11/19/2022] Open
Abstract
The prevalence of type 2 diabetes is increasing in Malaysia, and people with diabetes have been reported to suffer from depression and diabetes distress which influences their self-efficacy in performing diabetes self-care practices. This interviewer administered, cross sectional study, conducted in the district of Hulu Selangor, Malaysia, involving 371 randomly selected patients with type 2 diabetes, recruited from 6 health clinics, aimed to examine a conceptual model regarding the association between depression, diabetes distress and self-efficacy with diabetes self-care practices using the partial least square approach of structural equation modeling. In this study, diabetes self-care practices were similar regardless of sex, age group, ethnicity, education level, diabetes complications or type of diabetes medication. This study found that self-efficacy had a direct effect on diabetes self-care practice (path coefficient = 0.438, p<0.001). Self-care was not directly affected by depression and diabetes distress, but indirectly by depression (path coefficient = -0.115, p<0.01) and diabetes distress (path coefficient = -0.122, p<0.001) via self-efficacy. In conclusion, to improve self-care practices, effort must be focused on enhancing self-efficacy levels, while not forgetting to deal with depression and diabetes distress, especially among those with poorer levels of self-efficacy.
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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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Rashidi K, Safavi M, Yahyavi H, Farahani H. The impact of peers’ support on the hemoglobin A1C and fasting blood sugar level of patients with type 2 diabetes. INDIAN JOURNAL OF MEDICAL SPECIALITIES 2017. [DOI: 10.1016/j.injms.2016.10.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Sangruangake M, Jirapornkul C, Hurst C. Psychometric Properties of Diabetes Management Self-Efficacy in Thai Type 2 Diabetes Mellitus Patients: A Multicenter Study. Int J Endocrinol 2017; 2017:2503156. [PMID: 29201051 PMCID: PMC5671723 DOI: 10.1155/2017/2503156] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2017] [Revised: 09/23/2017] [Accepted: 10/03/2017] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE The aims of this study were to translate and psychometrically evaluate the Thai version of diabetes management self-efficacy scale (T-DMSES) and to examine its association with HbA1c control in diabetic individuals. METHODS This study recruited patients from outpatient diabetes clinics of both community and university hospitals. The first phases of this study involved translation of the existing DMSES into Thai, and in the second phase, we evaluated its psychometric properties. The construct validity was evaluated using confirmatory factor analysis. Criterion validity of DMSES was subsequently evaluated by examining DMSES's association with HbA1c control. RESULTS The T-DMSES contains 20 items across four factors. Confirmatory factor analysis demonstrated the construct validity of T-DMSES (χ2 = 645.142, df = 164, p < 0.001, CFI = 0.98, RMSEA = 0.065, TLI = 0.977, and AGFI = 0.981). The T-DMSES was also shown to be criterion valid with most subscales highly associated with HbA1c control. CONCLUSION The T-DMSES was shown to have good psychometric properties. It is likely to provide valuable insights into the epidemiology of diabetes management self-efficacy and may also prove useful in evaluating interventions for raising diabetes management self-efficacy, which in turn, improve both patient self-management and blood sugar control.
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Affiliation(s)
- Monthida Sangruangake
- Public Health Program, Khon Kaen University, Khon Kaen, Thailand
- Faculty of Nursing, Ratchathani University, Udonthani, Thailand
| | - Chananya Jirapornkul
- Department of Epidemiology and Biostatistics, Faculty of Public Health, Khon Kaen University, Khon Kaen, Thailand
| | - Cameron Hurst
- Center of Excellence in Biostatistics, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
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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 YJ, Shin SJ, Wang RH, Lin KD, Lee YL, Wang YH. Pathways of empowerment perceptions, health literacy, self-efficacy, and self-care behaviors to glycemic control in patients with type 2 diabetes mellitus. PATIENT EDUCATION AND COUNSELING 2016; 99:287-94. [PMID: 26341940 DOI: 10.1016/j.pec.2015.08.021] [Citation(s) in RCA: 127] [Impact Index Per Article: 15.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/09/2015] [Revised: 08/11/2015] [Accepted: 08/14/2015] [Indexed: 05/21/2023]
Abstract
OBJECTIVE To validate a hypothesized model exploring the influencing pathways of empowerment perceptions, health literacy, self-efficacy, and self-care behaviors to glycosylated hemoglobin (HbA1c) levels in patients with type 2 diabetes (T2DM). METHODS Overall, 295 patients with T2DM were recruited from five endocrine clinics in Taiwan through convenience sampling. Data regarding personal characteristics, empowerment perceptions, health literacy, self-efficacy, self-care behaviors, and HbA1c levels were collected. A structural equation modeling was used to validate the hypothesized model. RESULTS Significant direct pathways were determined from empowerment perceptions to health literacy, from health literacy to self-efficacy, from self-efficacy to self-care behaviors, and from self-care behaviors to HbA1c levels. CONCLUSIONS The empowerment perceptions and health literacy relatively influenced self-efficacy and self-care behaviors. Self-efficacy and self-care behaviors relatively influenced glycemic control in patients with T2DM. PRACTICE IMPLICATIONS Modifying self-care behaviors have been demonstrated to be the most essential for improving glycemic control. To improve self-care behaviors, healthcare providers should target improving self-efficacy, and enhancing health literacy can be considered to be a potential strategy for improving self-efficacy. To enhance health literacy, healthcare providers could use an empowerment approach rather than an authoritative approach that emphasizes patient compliance in managing patients with T2DM.
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Affiliation(s)
| | - Shyi-Jang Shin
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.
| | - Ruey-Hsia Wang
- College of Nursing, Kaohsiung Medical University, Kaohsiung, Taiwan.
| | - Kun-Der Lin
- Division of Endocrinology and Metabolism, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung, Taiwan.
| | - Yu-Li Lee
- Division of Endocrinology and Metabolism, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung, Taiwan.
| | - Yi-Hsien Wang
- Research Center for Nonlinear Analysis and Optimization, Kaohsiung Medical University, Kaohsiung, Taiwan.
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Tregea H, Lee C, Browne JL, Pouwer F, Speight J. Does self-efficacy mediate the cross-sectional relationship between perceived quality of health care and self-management of diabetes? Results from Diabetes MILES – Australia. Psychol Health 2016; 31:592-604. [DOI: 10.1080/08870446.2015.1128543] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
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Snyder H, Engström J. The antecedents, forms and consequences of patient involvement: A narrative review of the literature. Int J Nurs Stud 2016; 53:351-78. [DOI: 10.1016/j.ijnurstu.2015.09.008] [Citation(s) in RCA: 74] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2015] [Revised: 09/01/2015] [Accepted: 09/09/2015] [Indexed: 12/19/2022]
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Saffari M, Zeidi IM, Fridlund B, Chen H, Pakpour AH. A Persian Adaptation of Medication Adherence Self-Efficacy Scale (MASES) in Hypertensive Patients: Psychometric Properties and Factor Structure. High Blood Press Cardiovasc Prev 2015; 22:247-55. [PMID: 25986076 DOI: 10.1007/s40292-015-0101-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2015] [Accepted: 05/09/2015] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION Poor adherence to anti-hypertensive treatment significantly contributes to the failure to achieve well-controlled blood pressure in patients with hypertension. AIM To convert the original English version of Medication Adherence Self-efficacy Scale (MASES) into a Persian version for clinical application in hypertensive patients. METHODS The backward-forward translation method was used to produce the Persian version of the questionnaire. Then the internal consistency was assessed using Cronbach's alpha. Exploratory Factor Analysis was applied to extract the components of the questionnaire. Correlation between blood pressures and drug adherence was then determined using the Persian MASES in hypertensive patients. RESULTS Cronbach's alpha coefficient of the Persian version of MASES was >0.92, suggesting that it can yield consistent results. Exploratory Factor Analysis suggested an uni-dimensionality of the scale. Patients with uncontrolled hypertension showed poor adherence to hypertensive medications, therefore had significant lower self-efficacy scores than those with well-controlled blood pressure by medications. CONCLUSION The Persian version of MASES is valid and reliable to assess self-efficacy of antihypertensive medication adherence in hypertensive patient, which is helpful to improve medication compliance in such patients in order to achieve better blood pressure controls.
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Affiliation(s)
- Mohsen Saffari
- Health Research Center, Baqiyatallah University of Medical Science, Tehran, Iran
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Uncertainty, Self-efficacy, and Self-care Behavior in Patients With Breast Cancer Undergoing Chemotherapy in China. Cancer Nurs 2015; 38:E19-26. [DOI: 10.1097/ncc.0000000000000165] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Abstract
BACKGROUND The number of people in Thailand who have Type 2 diabetes has increased dramatically making it one of the country's major health problems. The rising prevalence of diabetes in Thailand is associated with dietary changes, reduced physical activity and health education. Although there is much research about health education programmes, the most effective methods for promoting sustainability and adherence to self-management among diabetics remains unclear. OBJECTIVES To examine the perceptions of participants in Thailand regarding Type 2 diabetes and to utilize the findings to formulate a model for patient education. METHODS A grounded theory approach was selected and semi-structured face to face interviews and focus group were used to gather data from 33 adults with Type 2 diabetes. RESULTS Five explanatory categories emerged from the data: causing lifelong stress and worry, finding their own ways, after a while, still cannot and wanting a normal life. CONCLUSION A new approach to patient education about Type 2 diabetes in Thailand is needed to give patients a better understanding, provide recommendations that they can apply to their daily lives, and include information about alternative medication. The Buddhist way of thinking and effective strategies enhancing self-efficacy should be applied to patient education to promote sustainability and adherence to self-management.
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Affiliation(s)
- Nitima Suparee
- Faculty of Health, Birmingham City University, Birmingham, UK
| | - Paula McGee
- Faculty of Health, Birmingham City University, Birmingham, UK
| | - Salim Khan
- Faculty of Health, Birmingham City University, Birmingham, UK
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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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Holm AL, Severinsson E. Perceptions of the need for improvements in healthcare after implementation of the Chronic Care Model. Nurs Health Sci 2014; 16:442-8. [PMID: 24785824 DOI: 10.1111/nhs.12136] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2013] [Revised: 12/30/2013] [Accepted: 01/21/2014] [Indexed: 11/27/2022]
Abstract
Older people with depression constitute a vulnerable group, and evidence from different parts of the world has demonstrated the need for healthcare improvements at the community level. In this study, we described team members' perceptions of improvements in the care of older people with depression living in the community after the implementation of the Chronic Care Model, with a focus on delivery-system design, self-management support, and teamwork. This follow-up study was based on focus-group interviews with healthcare team members. The data were analyzed by qualitative content analysis. Four themes emerged: (i) ensuring a pathway to the top level of the organization; (ii) the need for leadership from senior managers; (iii) the need to formalize collaboration; and (iv) increasing self-management. Senior managers should cooperate with specialist care givers and administrators in the community. They must also redesign the delivery system to facilitate teamwork and the self-management ability of older people with depression.
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Affiliation(s)
- Anne Lise Holm
- The Centre for Women's, Family and Child's Health, Buskerud and Vestfold University College, Tønsberg, Norway
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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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Yang SO, Jeong GH, Kim SJ, Lee SH. Correlates of self-care behaviors among low-income elderly women with hypertension in South Korea. J Obstet Gynecol Neonatal Nurs 2013; 43:97-106. [PMID: 24354464 DOI: 10.1111/1552-6909.12265] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVE To identify correlates of self-care behaviors among elderly, low-income Korean women with hypertension. RESEARCH DESIGN A secondary analysis of data from a community-based intervention trial for hypertension control. SETTING Three community health posts in the Gangwon province, South Korea. PARTICIPANTS Two hundred thirty-four (234) low-income elderly women (age 60-93) who had previously participated in a community-based intervention trial for hypertension control. METHODS The researchers collected data that included patient background characteristics, hypertension self-care behavior, self-efficacy of hypertension control, general knowledge of hypertension, and social support. The data were analyzed using descriptive and inferential statistics, including hierarchical regression analysis. RESULTS The model explained 41.1% of the total variance in hypertension self-care behavior scores. Among elderly, low-income Korean women, the significant factors of their hypertension self-care behavior included: (a) self-efficacy of hypertension control (β = .62), (b) social support (β = .16), and (c) age (β = -.14). Hierarchical regression analysis showed that elderly Korean women that had higher self-efficacy of hypertension control, higher social support, and were younger were more likely to have higher hypertension self-care behavior scores. CONCLUSIONS The results highlight the need for interventions that focus on improving an individual's self-efficacy and social support to enhance hypertension self-care. The findings of this study can help nurses better understand hypertension self-care behavior in elderly, low-income Korean women.
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Ounnapiruk L, Wirojratana V, Meehatchai N, Turale S. Effectiveness of a behavior modification program for older people with uncontrolled Type 2 Diabetes. Nurs Health Sci 2013; 16:216-23. [DOI: 10.1111/nhs.12089] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2012] [Revised: 07/07/2013] [Accepted: 07/09/2013] [Indexed: 01/06/2023]
Affiliation(s)
| | | | | | - Sue Turale
- HOPE School of Nursing; Wuhan University; Wuhan China
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Kim CJ, Park JW, Park HR. Effects of a community-based intervention on cardio-metabolic risk and self-care behaviour in older adults with metabolic syndrome. Int J Nurs Pract 2013; 20:212-220. [PMID: 24713018 DOI: 10.1111/ijn.12139] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
This pilot study was performed to investigate the effects of a community-based intervention (CBI) on cardio-metabolic risk and self-care behaviour in 92 older adults with metabolic syndrome at public health centres in Suwon, Korea. A prospective, pretest and posttest, controlled, quasi-experimental design was used. The older adults in the intervention group participated in an 8-week intensive lifestyle counselling, whereas those in the control group received usual care. The mean (standard deviation) age of the participants was 71.4 (4.43) years ranging from 60 to 84, and 75.0% of the participants were female. The intervention group at 8 weeks showed significant reduction in waist circumference by -1.35 cm (P<0.001) and improved self-care behaviour (+5.17 score, P<0.05) and self-efficacy (+4.84 score, P<0.001) when compared with the control group. The percentages of those who successfully completed the targeted behavioural modification were 71.7% for exercise and 52.2% for dietary control in the intervention group at 8 weeks. This pilot study provided evidence of the beneficial impact of the CBI for Korean older adults with metabolic syndrome.
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Affiliation(s)
- Chun-Ja Kim
- Ajou University College of Nursing, Suwon, South Korea
| | - Jee-Won Park
- Ajou University College of Nursing, Suwon, South Korea
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Yeun EJ, Baek S, Kim H. Health promotion behavior in middle-aged Koreans: A cross sectional survey. Nurs Health Sci 2013; 15:461-7. [DOI: 10.1111/nhs.12056] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2012] [Revised: 02/23/2013] [Accepted: 03/01/2013] [Indexed: 11/27/2022]
Affiliation(s)
- Eun Ja Yeun
- Department of Nursing; Konkuk University; Chungju South Korea
| | - Sunsook Baek
- Red Cross College of Nursing; Chung Ang University; Seoul South Korea
| | - Heejeong Kim
- Department of Nursing; Namseoul University; Chungnam South Korea
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Ahola AJ, Groop PH. Barriers to self-management of diabetes. Diabet Med 2013; 30:413-20. [PMID: 23278342 DOI: 10.1111/dme.12105] [Citation(s) in RCA: 172] [Impact Index Per Article: 15.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2012] [Revised: 10/31/2012] [Accepted: 12/18/2012] [Indexed: 12/27/2022]
Abstract
People with diabetes hold major responsibility for the day-to-day management of their chronic condition. The management that, amongst others, includes blood glucose monitoring, medication taking, diet and physical activity, aims at normalizing blood glucose levels. In many individuals, the level of glycaemia, however, frequently exceeds the recommendations. This observation, together with patients' and practitioners' reports, suggests that active self-management is suboptimal. Various reasons, both individual and environment related, contribute to the suboptimal concordance with treatment regimen. The aim of this review is to discuss some of the barriers to optimal diabetes self-management.
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Affiliation(s)
- A J Ahola
- Folkhälsan Institute of Genetics, Folkhälsan Research Center, Biomedicum Helsinki, Finland
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Experiences of obesity among Saudi Arabian women contemplating bariatric surgery: An interpretative phenomenological analysis. J Health Psychol 2013; 19:664-77. [DOI: 10.1177/1359105313476977] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
This study explored experiences of obesity, its perceived causes and motives for surgery, as described by seven Saudi women contemplating bariatric surgery. The women experienced cultural restrictions on their physical and social activities. Obesity embodied these restrictions, attracting stigma and moral failure. Traditional clothing, foods, hospitality norms and limited outdoor female activities were regarded as barriers to weight loss. Bariatric surgery was chosen to protect health and to access normative female roles. Some were encouraged by relatives who had undergone surgery. Opting for surgery reflected both participants’ sense of powerlessness to self-manage weight and the social acceptability, within their family context, of this biomedical approach.
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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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Sato M, Yamazaki Y. Work-related factors associated with self-care and psychological health among people with type 2 diabetes in Japan. Nurs Health Sci 2012; 14:520-7. [DOI: 10.1111/j.1442-2018.2012.00729.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
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