Cross-cultural comparison of predictors for self-care behaviors in patients with type 2 diabetes

They Care for Others, But What About Themselves? Understanding Self-Care Among DSPs' and Its Relationship to Professional Quality of Life

Direct support professionals (DSPs) are instrumental to the daily operations of organizations that support people with intellectual and developmental disabilities (IDD). With extensive responsibilities, DSPs often experience high levels of stress and burnout that can result in turnover and vacant positions. Self-care is the practice of behaviors that promote well-being, counter work-related stress, and foster resilience. The current study explored self-care and resilience, and their relationship with professional quality of life (i.e., satisfaction, burnout, and secondary traumatic stress) among DSPs. Using a convenient sample, 153 DSPs (71% female) completed an online survey comprised of multiple measures. Results indicated that DSPs often engaged in self-care behaviors across physical, psychological, emotional, spiritual, relational, and workplace domains, however, less than 40% engaged in self-care behaviors directly related to work. On average, DSPs reported high levels of resilience. Collectively, self-care and resilience accounted for 12% to 28% of variance in DSPs' professional quality of life. Given the contribution of self-care to resilience and professional quality of life, an active approach by IDD organizations to foster self-care among DSPs may help promote their longevity and retention.

Novel psychosocial factor involved in diabetes self-care in the Japanese cultural context

AIMS/INTRODUCTION

Recent evidence shows that cultural context can influence the management of diabetes mellitus. The aim of the present study was to examine the relationship between interdependence, which is valued in the Eastern cultural context, and diabetes self-care behavior in Japanese patients with type 2 diabetes mellitus.

MATERIAL AND METHODS

We carried out a cross-sectional survey of 161 Japanese adults with type 2 diabetes mellitus using well-established questionnaires. The association of an interdependent tendency with diabetes self-care activities was analyzed using multiple regression analysis.

RESULTS

Diabetes self-care activities had a negative correlation with interdependent tendency (r = -0.16, P = 0.047), and they had positive correlations with age (r = 0.42, P < 0.001), emotional support (r = 0.25, P = 0.001) and diabetes self-care support (r = 0.36, P < 0.001). When patients were divided into two groups at the median age (68 years), multiple regressions showed that interdependent tendency (β = -0.20, P = 0.048), male sex (β = -0.24, P = 0.023), emotional support (β = 0.22, P = 0.028) and diabetes self-care support (β = 0.39, P < 0.001) were significant determinants of diabetes self-care activities only in the younger group.

CONCLUSIONS

Interdependence might influence diabetes self-care behavior, and intervention focusing on support from close others might lead patients to more successful care among Japanese adults with type 2 diabetes mellitus, especially those aged <68 years.

Generalizability of the Self-Care of Diabetes Inventory Across Cultures and Languages: Italy and the United States

Measuring self-care behaviors is crucial in diabetes research worldwide. Having a common measure of self-care represents an unmet need limiting the development of the science. The Self-Care of Diabetes Inventory was developed to address limitations of previous tools that were not theoretically grounded, strong in psychometrics, and clinically validated. However, the generalizability and comparability of the Self-Care of Diabetes Inventory has not been tested across cultures and languages. The aim of this study was to test the invariance of the Self-Care of Diabetes Inventory measurement model between Italy and the United States. Data from two multicenter cross-sectional studies were used. Two diabetes clinics and two hospitals in Italy and the United States were involved. We enrolled 200 adults in Italy and 226 in the United States, all with a confirmed diagnosis of type 1 or type 2 diabetes. The Self-Care of Diabetes Inventory was used to measure self-care maintenance, monitoring, and management behaviors as described in the middle range theory of self-care of chronic illness. Configural, metric, scalar, and strict invariance were tested for each scale. Three of the four measurement equivalence levels were supported in the three Self-Care of Diabetes Inventory Scales, whereas strict invariance-the highest level-was reached only by the Self-Care Maintenance and Self-Care Monitoring Scales. Clear support for the use of the Self-Care of Diabetes Inventory in diabetes research was provided. Cross-national comparisons of self-care between groups of Italian and U.S. patients are supported, based on the invariance of the measurement model. Aggregation of research data obtained using the Self-Care of Diabetes Inventory across countries could support knowledge development in the field of diabetes self-care.