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Alhejaili A, Wharrad H, Windle R. Developing a Tool for Assessing the Process of Seeking Health Information: Online Think-Aloud Method. Healthcare (Basel) 2024; 12:1039. [PMID: 38786449 PMCID: PMC11120655 DOI: 10.3390/healthcare12101039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2024] [Revised: 05/11/2024] [Accepted: 05/13/2024] [Indexed: 05/25/2024] Open
Abstract
Nursing students can access massive amounts of online health data to drive cutting-edge evidence-based practice in clinical placement, to bridge the theory-practice gap. This activity requires investigation to identify the strategies nursing students apply to evaluate online health information. Online Think-Aloud sessions enabled 14 participants to express their cognitive processes in navigating various educational resources, including online journals and databases, and determining the reliability of sources, indicating their strategies for information-seeking, which helped to create this scoring system. Easy access and user convenience were clearly the instrumental factors in this behavior, which has troubling implications for the lack of use of higher-quality resources (e.g., from peer-reviewed academic journals). The identified challenges encountered during resource access included limited skills in the critical evaluation of information credibility and reliability, signaling a requirement for improved information literacy skills. Participants acknowledged the importance of evidence-based, high-quality information, but faced numerous barriers, such as restricted access to professional and specialty databases, and a lack of academic skills training. This paper develops and critiques a Performative Tool for assessing the process of seeking health information using an online Think-Aloud method, and explores factors and strategies contributing to evidence-based health information access and utilization in clinical practice, aiming to provide insight into individuals' information-seeking behaviors in online health contexts.
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Affiliation(s)
- Asim Alhejaili
- School of Health Sciences, University of Nottingham, Nottingham NG7 2HA, UK; (H.W.); (R.W.)
- College of Nursing, Taibah University, Medina 42353, Saudi Arabia
| | - Heather Wharrad
- School of Health Sciences, University of Nottingham, Nottingham NG7 2HA, UK; (H.W.); (R.W.)
| | - Richard Windle
- School of Health Sciences, University of Nottingham, Nottingham NG7 2HA, UK; (H.W.); (R.W.)
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Ahmad K, Anchah L, Ting CY, Lim SE. Effectiveness of a pharmacist-led, community group-based education programme in enhancing diabetes management: A multicentre randomised control trial. Contemp Clin Trials Commun 2024; 38:101280. [PMID: 38435429 PMCID: PMC10909608 DOI: 10.1016/j.conctc.2024.101280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2023] [Revised: 02/14/2024] [Accepted: 02/17/2024] [Indexed: 03/05/2024] Open
Abstract
Aims This study presents a protocol for the Pharmacy Integrated Community Care (PICC) program, meticulously designed to enhance Hemoglobin A1c (HbA1c) levels and augment knowledge about diabetes mellitus (DM) among individuals diagnosed with Type 2 Diabetes Mellitus (T2DM) in the Sarawak State of Malaysia. Methods From 1 May to December 31, 2023, a prospective, multicenter, parallel-design randomised controlled trial will be conducted with two groups, each consisting of 47 participants. The intervention group will receive a structured, four-session group-based program guided by experienced pharmacists, focusing on medication adherence and diabetes management. The control group will follow the standard Diabetes Mellitus Adherence Clinic program. The primary outcomes of this study encompass enhancements in knowledge regarding diabetes medication management and adherence, followed by subsequent changes in HbA1c levels. Conclusions The successful implementation of the PICC program holds promise for enhancing health outcomes in the T2DM population, potentially leading to more effective diabetes management initiatives and better health practices in the community. Trial registration clinicaltrialsgov identifier NCT05106231.
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Affiliation(s)
- Kamarudin Ahmad
- Miri Hospital and Clinical Research Center Miri, Miri, Sarawak, Malaysia
| | - Lawrence Anchah
- Pharmacology Unit, Faculty of Medicine and Health Sciences, University Malaysia Sarawak, Malaysia
| | - Chuo Yew Ting
- Pharmacy Practice and Development, Pharmacy Service Division, Sarawak State Health Department, Malaysia
| | - Su Ee Lim
- Pharmacy Practice and Development, Pharmacy Service Division, Sarawak State Health Department, Malaysia
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Martinez S, Nouryan CN, Williams MS, Patel VH, Barbero P, Correa Gomez V, Marino J, Goris N, Cigaran E, Granville D, Murray LF, Harris YT, Myers A, Guzman J, Makaryus AN, McFarlane SI, Zeltser R, Pena M, Sison C, Lesser ML, Kline M, DiClemente RJ, Pekmezaris R. Ensuring fidelity: key elements to consider in disseminating a diabetes telemanagement program for underserved Hispanic/Latinos living with type 2 diabetes. FRONTIERS IN CLINICAL DIABETES AND HEALTHCARE 2024; 5:1328993. [PMID: 38436046 PMCID: PMC10907990 DOI: 10.3389/fcdhc.2024.1328993] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Accepted: 01/30/2024] [Indexed: 03/05/2024]
Abstract
Background The Hispanic/Latino population has greater risk (estimated >50%) of developing type 2 diabetes (T2D) and developing it at a younger age. The American Diabetes Association estimates costs of diagnosed diabetes in 2017 was $327 billion; with medical costs 2.3x higher than patients without diabetes. The purpose of this manuscript is to describe the methodology utilized in a randomized controlled trial aimed at evaluating the efficacy of a diabetes telemanagement (DTM) program for Hispanic/Latino patients with T2D. The intent is to provide information for future investigators to ensure that this study can be accurately replicated. Methods This study was a randomized controlled trial with 240 participants. Eligible patients (Hispanic/Latino, aged 18+, living with T2D) were randomized to Comprehensive Outpatient Management (COM) or DTM. DTM was comprised of usual care, including routine clinic visits every three months, as well as: Biometrics (a tablet, blood glucose meter, blood pressure monitor, and scale); Weekly Video Visits (facilitated in the patient's preferred language); and Educational Videos (including culturally congruent diabetes self-management education and quizzes). COM consisted of usual care including routine clinic visits every three months. For this study, COM patients received a glucometer, glucose test strips, and lancets. Establishing a therapeutic nurse-patient relationship was a fundamental component of our study for both groups. First contact (post-enrollment) centered on ensuring that patients and caregivers understood the program, building trust and rapport, creating a non-judgmental environment, determining language preference, and establishing scheduling availability (including evenings and weekends). DTM were provided with a tablet which allowed for self-paced education through videos and weekly video visits. The research team and Community Advisory Board identified appropriate educational video content, which was incorporated in diabetes educational topics. Video visits allowed us to assess patient involvement, motivation, and nonverbal communication. Communicating in Spanish, and awareness of diverse Hispanic/Latino backgrounds was critical, as using relevant and commonly-used terms can increase adherence and improve outcomes. Shared decision-making was encouraged to make realistic health care choices. Conclusion Key elements discussed above provide a framework for future dissemination of an evidence-based DTM intervention to meet the needs of underserved Hispanic/Latino people living with T2D.
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Affiliation(s)
- Sabrina Martinez
- Northwell Health System, Department of Medicine, Manhasset, NY, United States
| | - Christian N. Nouryan
- Northwell Health System, Department of Medicine, Manhasset, NY, United States
- Zucker School of Medicine at Hofstra Northwell, Department of Medicine, Hempstead, NY, United States
- Feinstein Institutes for Medical Research, Manhasset, NY, United States
| | - Myia S. Williams
- Northwell Health System, Department of Medicine, Manhasset, NY, United States
- Zucker School of Medicine at Hofstra Northwell, Department of Medicine, Hempstead, NY, United States
| | - Vidhi H. Patel
- Northwell Health System, Department of Medicine, Manhasset, NY, United States
- Zucker School of Medicine at Hofstra Northwell, Department of Medicine, Hempstead, NY, United States
| | - Paulina Barbero
- Northwell Health System, Department of Medicine, Manhasset, NY, United States
| | | | - Jose Marino
- Northwell Health System, Department of Medicine, Manhasset, NY, United States
| | - Nicole Goris
- Northwell Health System, Department of Medicine, Manhasset, NY, United States
| | - Edgardo Cigaran
- Northwell Health System, Department of Medicine, Manhasset, NY, United States
| | - Dilcia Granville
- Nassau University Medical Center, Department of Medicine, Uniondale, NY, United States
| | - Lawrence F. Murray
- Nassau University Medical Center, Department of Medicine, Uniondale, NY, United States
| | - Yael T. Harris
- Northwell Health System, Department of Medicine, Manhasset, NY, United States
- Zucker School of Medicine at Hofstra Northwell, Department of Medicine, Hempstead, NY, United States
| | - Alyson Myers
- Northwell Health System, Department of Medicine, Manhasset, NY, United States
- Zucker School of Medicine at Hofstra Northwell, Department of Medicine, Hempstead, NY, United States
| | - Josephine Guzman
- Northwell Health System, Department of Medicine, Manhasset, NY, United States
| | - Amgad N. Makaryus
- Northwell Health System, Department of Medicine, Manhasset, NY, United States
- Zucker School of Medicine at Hofstra Northwell, Department of Medicine, Hempstead, NY, United States
- Nassau University Medical Center, Department of Medicine, Uniondale, NY, United States
| | - Samy I. McFarlane
- SUNY Downstate Health Sciences University, Department of Medicine, Brooklyn, NY, United States
| | - Roman Zeltser
- Northwell Health System, Department of Medicine, Manhasset, NY, United States
- Zucker School of Medicine at Hofstra Northwell, Department of Medicine, Hempstead, NY, United States
- Nassau University Medical Center, Department of Medicine, Uniondale, NY, United States
| | - Maria Pena
- Mount Sinai Hospital, Department of Medicine, NY, Rego Park, NY, United States
| | - Cristina Sison
- Northwell Health System, Department of Medicine, Manhasset, NY, United States
- Zucker School of Medicine at Hofstra Northwell, Department of Medicine, Hempstead, NY, United States
| | - Martin L. Lesser
- Northwell Health System, Department of Medicine, Manhasset, NY, United States
- Zucker School of Medicine at Hofstra Northwell, Department of Medicine, Hempstead, NY, United States
| | - Myriam Kline
- Northwell Health System, Department of Medicine, Manhasset, NY, United States
| | | | - Renee Pekmezaris
- Northwell Health System, Department of Medicine, Manhasset, NY, United States
- Zucker School of Medicine at Hofstra Northwell, Department of Medicine, Hempstead, NY, United States
- Feinstein Institutes for Medical Research, Manhasset, NY, United States
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Gromisch ES, Ehde DM, Neto LO, Haselkorn JK, Agresta T, Gokhale SS, Turner AP. Using participatory action research to develop a new self-management program: Results from the design stage of Managing My MS My Way. Mult Scler Relat Disord 2023; 74:104720. [PMID: 37084496 DOI: 10.1016/j.msard.2023.104720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Revised: 03/30/2023] [Accepted: 04/15/2023] [Indexed: 04/23/2023]
Abstract
BACKGROUND Self-management programs have been used with success in several clinical populations, and there is a growing body of evidence to support their use among persons with multiple sclerosis (MS). This group aimed to develop a novel self-management program, Managing My MS My Way (M4W), which is based in social cognitive theory and contains evidence-based strategies that have been shown to be effective for persons with MS. Furthermore, persons with MS would serve as stakeholders throughout the development process to ensure that the program would be useful and encourage adoption. This paper outlines the initial development stages of M4W, including determining 1) stakeholders' interest in a self-management program, 2) the general focus of the program, 3) the delivery method of the program, 4) the content of the program, and 5) potential barriers and adaptations. METHODS A three-stage study consisting of an anonymous survey (n = 187) to determine interest, topic, and delivery format; semi-structured interviews (n = 6) to follow-up on the survey results; and semi-structured interviews (n = 10) to refine the content and identify barriers. RESULTS Over 80% of survey participants were somewhat or very interested in a self-management program. Fatigue was the topic with the greatest amount of interest (64.7%). An internet-based program (e.g., mobile health or mHealth) was the most preferred delivery method (37.4%), with the first group of stakeholders proposing a module-based system with an initial in-person orientation session. The second group of stakeholders were overall enthusiastic about the program, giving moderate to high confidence scores for each of the proposed interventional strategies. Suggestions included skipping sections that were not applicable to them, setting reminders, and seeing their progress (e.g., visualizing their fatigue scores as they move through the program). In addition, stakeholders recommended larger font sizes and speech-to-text entry. CONCLUSIONS Input from the stakeholders has been incorporated into the prototype of M4W. The next steps will be to test this prototype with another group of stakeholders to assess its initial usability and identify issues before developing the functional prototype.
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Affiliation(s)
- Elizabeth S Gromisch
- Mandell Center for Multiple Sclerosis, Mount Sinai Rehabilitation Hospital, Trinity Health Of New England, 490 Blue Hills Avenue, Hartford, CT 06112, USA; Department of Rehabilitative Medicine, Frank H. Netter MD School of Medicine at Quinnipiac University, 370 Bassett Road, North Haven, CT 06473, USA; Department of Medical Sciences, Frank H. Netter MD School of Medicine at Quinnipiac University, 370 Bassett Road, North Haven, CT 06473, USA; Department of Neurology, University of Connecticut School of Medicine, 263 Farmington Avenue, Farmington, CT 06030, USA.
| | - Dawn M Ehde
- Department of Rehabilitation Medicine, University of Washington, 325 Ninth Avenue, Seattle, WA 98104, USA
| | - Lindsay O Neto
- Mandell Center for Multiple Sclerosis, Mount Sinai Rehabilitation Hospital, Trinity Health Of New England, 490 Blue Hills Avenue, Hartford, CT 06112, USA; Department of Rehabilitative Medicine, Frank H. Netter MD School of Medicine at Quinnipiac University, 370 Bassett Road, North Haven, CT 06473, USA
| | - Jodie K Haselkorn
- Department of Rehabilitation Medicine, University of Washington, 325 Ninth Avenue, Seattle, WA 98104, USA; Multiple Sclerosis Center of Excellence West, Veterans Affairs, 1660 South Columbian Way, Seattle, WA 98108, USA; Rehabilitation Care Service, VA Puget Sound Health Care System, 1660 South Columbian Way, Seattle, WA 98108, USA; Department of Epidemiology, University of Washington, 325 Ninth Avenue, Seattle, WA 98104, USA
| | - Thomas Agresta
- Department of Family Medicine, University of Connecticut Health Center, 99 Woodland Street, Hartford, CT 06105, USA; Center for Quantitative Medicine, University of Connecticut Health Center, 195 Farmington Avenue, Farmington, CT 06032, USA
| | - Swapna S Gokhale
- Department of Computer Science and Engineering, University of Connecticut, Storrs, CT, 06269, USA
| | - Aaron P Turner
- Department of Rehabilitation Medicine, University of Washington, 325 Ninth Avenue, Seattle, WA 98104, USA; Multiple Sclerosis Center of Excellence West, Veterans Affairs, 1660 South Columbian Way, Seattle, WA 98108, USA; Rehabilitation Care Service, VA Puget Sound Health Care System, 1660 South Columbian Way, Seattle, WA 98108, USA
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Zainuddin, Abdullah AZ, Jafar N, Suriah, Nursalam, Darmawansyah, Syahrul S, Wahiduddin, Widiantoro FX, Irfandi R. The application of social cognitive theory (SCT) to the mHealth diabetes physical activity (PA) app to control blood sugar levels of type 2 diabetes mellitus (T2DM) patients in Takalar regency. J Public Health Res 2023; 12:22799036231172759. [PMID: 37152113 PMCID: PMC10155009 DOI: 10.1177/22799036231172759] [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] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Accepted: 01/09/2023] [Indexed: 09/20/2023] Open
Abstract
Background: People with Diabetes Mellitus (DM) experience an increased health risk due to reduced physical activities. Cellular health technology (mHealth) offers a way that people with DM can engage in more complex physical activities. Social Cognitive Theory (SCT) is the most commonly used theory in increasing physical activities. This study aims to find out the application of SCT in mHealth app to control blood sugar (GDP, HbA1C) of T2DM patients. Design and Method: This present study used a mixed method sequential explanatory design related to the application of mHealth Diabetes Physical Activity in Takalar Regency. The first step was to use qualitative methods with rapid assessment procedures in developing the application of SCT in mHealth. The second step was to validate and test the app through usability testing. The last step was intervening the development of mHealth app using quasi-experimental designs related to the influence of mHealth Diabetes Physical activity interventions in controlling blood sugar (GDP, HbA1c) in T2DM patients. The first group was the mHealth diabetes Physical activity (PA) intervention group; the second intervention group was a group monitored through Whatsapp group; and the third group was the group with physical activity module but without monitoring. Expected outcome: The findings of this study are expected to be the basis of evidence for nurses holding DM programs to make relevant policies and design an app-based physical activity promotion programs for T2DM patients. Conclusion: This protocol qualifies to be the basis of evidence for nurses holding Diabetes Mellitus programs in improving health services through IT-based health promotion programs.
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Affiliation(s)
- Zainuddin
- Student of Doctoral Public Health, Hasanuddin
University, Makassar, South Sulawesi, Indonesia
- Department of Nursing, School of Health
Sciences Tanawali Takalar, Takalar city, Indonesia
| | - Andi Zulkifli Abdullah
- Department of Epidemiology Science, Faculty
of Public Health, Hasanuddin University, Makassar, South Sulawesi, Indonesia
| | - Nurhaedar Jafar
- Department of Nutrition Science, Faculty of
Public Health, Hasanuddin University, Makassar, South Sulawesi, Indonesia
| | - Suriah
- Department of Health Promotion, Faculty of
Public Health, Hasanuddin University, Makassar, South Sulawesi, Indonesia
| | - Nursalam
- Department of Nursing, Faculty of Nursing,
Airlangga University, Surabaya, Indonesia
| | - Darmawansyah
- Department of Health Administration and
policy study program, Faculty of Public Health, Hasanuddin University, Makassar, South
Sulawesi, Indonesia
| | - Syahrul Syahrul
- Department of Nursing, Faculty of Nursing,
Hasanuddin University, Makassar, South Sulawesi, Indonesia
| | - Wahiduddin
- Department of Health Promotion, Faculty of
Public Health, Hasanuddin University, Makassar, South Sulawesi, Indonesia
| | | | - Rizal Irfandi
- Department of Biology Education, Faculty of
Teacher Training and Education, Puangrimaggalatung University, South Sulawesi,
Indonesia
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Su M, Chang M, Sun J. Self-management experience of first-time diagnosed gestational diabetes mellitus: A focus group interview. Nurs Open 2022; 10:1744-1754. [PMID: 36285704 PMCID: PMC9912431 DOI: 10.1002/nop2.1431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Revised: 08/03/2022] [Accepted: 10/11/2022] [Indexed: 11/12/2022] Open
Abstract
AIM Gestational diabetes mellitus (GDM) has become the most common complication in women during pregnancy in Taiwan. Since several clinical trials have demonstrated benefits of aggressive treatment, which rely heavily on self-management. The present study was conducted to explore the self-management experience of women with first-time diagnosed GDM. DESIGN A qualitative descriptive approach was applied to conduct this study. METHODS Purposive sampling was used to recruit patients with first-time diagnosed GDM from the maternity outpatient clinics of medical centre in Taiwan. A total of three focus groups interviews with 22 women were conducted to collect the data. Content analysis was applied to analyse the data. RESULTS Four themes were identified: (1) unexpectedly having a high-risk pregnancy, (2) different perceptions for self-management, (3) implementation predicament of self-management and (4) maternal duty to ensure the safety of mother and child.
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Affiliation(s)
- Mei‐Chen Su
- School of NursingNational Taipei University of Nursing and Health SciencesTaipeiTaiwan
| | - Min‐Yu Chang
- Department of NursingNew Taipei Municipal TuCheng Hospital (Built and Operated by Chang Gung Medical Foundation)New TaipeiTaiwan
| | - Jui‐Chiung Sun
- Department of NursingChang Gung University of Science and TechnologyTaoyuanTaiwan
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Barreiro RG, de Oliveira Lopes MV. Content validity of the nursing diagnosis low self-efficacy in health. Int J Nurs Knowl 2022. [PMID: 36217864 DOI: 10.1111/2047-3095.12395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Accepted: 08/30/2022] [Indexed: 11/27/2022]
Abstract
PURPOSE The purpose of this study was to verify the validity of the content of the proposal for the nursing diagnosis of low self-efficacy in health. METHODS Content validation study using the approach proposed by Lopes, a panel of 47 experts on the phenomenon of interest analyzed the content of the diagnosis using a Likert-type scale to evaluate the relevance of 16 clinical indicators and 18 etiological factors of the nursing diagnosis under investigation. These components were previously identified and defined through a middle-range theory. Based on the predictive diversity model, the experts' verifications were weighted according to their level of expertise. The pseudomedian and 95% confidence intervals were calculated. A content validity index above 0.9 was considered valid, and the Wilcoxon test was used to validate each pseudomedian with a p-value above 0.05. FINDINGS Thirteen clinical indicators were considered relevant, demonstrating the importance of these elements for the clinical identification of low self-efficacy in health. Three clinical indicators were excluded because they were not representative for this diagnosis. The eighteen etiological factors analyzed were considered relevant. CONCLUSION The findings of the present study may help nurses to identify low self-efficacy in health early and direct effective interventions to increase people's confidence in their abilities to promote their health. IMPLICATIONS FOR NURSING PRACTICE A new diagnostic framework is presented with peer-reviewed content, representing a phenomenon frequently reported by clinicians. This new diagnosis can guide nursing care and produce better health outcomes that depend on patients' confidence in their ability to take care of their own health.
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Affiliation(s)
- Reinaldo Gutiérrez Barreiro
- Program in Nursing, Federal University of Ceará, Fortaleza, Brazil.,Nursing Diagnosis, Interventions, and Results Study Group (GEDIRE), Federal University of Ceará, Fortaleza, Brazil
| | - Marcos Venícios de Oliveira Lopes
- Nursing Diagnosis, Interventions, and Results Study Group (GEDIRE), Federal University of Ceará, Fortaleza, Brazil.,Department of Nursing, Federal University of Ceará, Fortaleza, Brazil
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Obirikorang Y, Acheampong E, Anto EO, Afrifa-Yamoah E, Adua E, Taylor J, Fondjo LA, Lokpo SY, Adu EA, Adutwum B, Antwi EO, Acheampong EN, Gyamfi MA, Aidoo F, Owiredu EW, Obirikorang C. Nexus between constructs of social cognitive theory model and diabetes self-management among Ghanaian diabetic patients: A mediation modelling approach. PLOS GLOBAL PUBLIC HEALTH 2022; 2:e0000736. [PMID: 36962448 PMCID: PMC10022127 DOI: 10.1371/journal.pgph.0000736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Accepted: 06/13/2022] [Indexed: 11/19/2022]
Abstract
The promotion of Diabetes Self-Management (DSM) practices, education, and support is vital to improving the care and wellbeing of diabetic patients. Identifying factors that affect DSM behaviours may be useful to promote healthy living among these patients. The study assessed the determinants of DSM practices among Type 2 diabetes mellitus (T2DM) patients using a model-based social cognitive theory (SCT). This cross-sectional study comprised 420 (T2DM) patients who visited the Diabetic Clinic of the Komfo Anokye Teaching Hospital (KATH), Kumasi-Ghana. Data was collected using self-structured questionnaires to obtain socio-demographic characteristics, T2DM-related knowledge, DSM practices, SCT constructs; beliefs in treatment effectiveness, level of self-efficacy, perceived family support, and healthcare provider-patient communication. Path analysis was used to determine direct and indirect effects of T2DM-related knowledge, perceived family support, and healthcare provider service on DSM practices with level of self-efficacy mediating the relationships, and beliefs in treatment effectiveness as moderators. The mean age of the participants was 53.1(SD = 11.4) years and the average disease duration of T2DM was 10 years. Most of the participants (65.5%) had high (>6.1mmol/L) fasting blood glucose (FBG) with an average of 6.93(SD = 2.41). The path analysis model revealed that age (p = 0.176), gender (p = 0.901), and duration of T2DM (p = 0.119) did not confound the relationships between the SCT constructs and DSM specified in the model. A significant direct positive effect of family and friends' support (Critical ratio (CR) = 5.279, p < 0.001) on DSM was observed. Self-efficacy was a significant mediator in this relationship (CR = 4.833, p < 0.001). There were significant conditional indirect effects (CIE) for knowledge of T2DM and family and friends' support at medium and high levels of belief in treatment effectiveness (p < 0.05) via level of self-efficacy on DSM practices. However, no evidence of moderated-mediation was observed for the exogenous variables on DSM. Diabetes-related knowledge of T2DM, family and friends' support, level of self-efficacy, and belief in treatment effectiveness are crucial in DSM practices among Ghanaian T2DM patients. It is incumbent to consider these factors when designing interventions to improve DSM adherence.
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Affiliation(s)
- Yaa Obirikorang
- Department of Nursing, Faculty of Health Sciences, Garden City University College (GCUC), Kenyasi, Kumasi, Ghana
| | - Emmanuel Acheampong
- Department of Molecular Medicine, School of Medical Science, Kwame Nkrumah University of Science and Technology (KNUST), Kumasi, Ghana
- Centre for Precision Health, ECU Strategic Research Centre, Edith Cowan University, Perth, Australia
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Australia
| | - Enoch Odame Anto
- Centre for Precision Health, ECU Strategic Research Centre, Edith Cowan University, Perth, Australia
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Australia
- Department of Medical Diagnostics, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | | | - Eric Adua
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Australia
| | - John Taylor
- Centre for Precision Health, ECU Strategic Research Centre, Edith Cowan University, Perth, Australia
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Australia
| | - Linda Ahenkorah Fondjo
- Department of Molecular Medicine, School of Medical Science, Kwame Nkrumah University of Science and Technology (KNUST), Kumasi, Ghana
| | - Sylvester Yao Lokpo
- Department of Medical Laboratory Sciences, School of Allied Health Sciences, University of Health and Allied Sciences, Ho, Ghana
| | - Evans Asamoah Adu
- Department of Molecular Medicine, School of Medical Science, Kwame Nkrumah University of Science and Technology (KNUST), Kumasi, Ghana
| | - Bernard Adutwum
- Department of Nursing, Faculty of Health Sciences, Garden City University College (GCUC), Kenyasi, Kumasi, Ghana
| | - Enoch Ofori Antwi
- Department of Nursing, Faculty of Health Sciences, Garden City University College (GCUC), Kenyasi, Kumasi, Ghana
| | - Emmanuella Nsenbah Acheampong
- Department of Molecular Medicine, School of Medical Science, Kwame Nkrumah University of Science and Technology (KNUST), Kumasi, Ghana
| | - Michael Adu Gyamfi
- Department of Medical Laboratory Sciences, School of Allied Health Sciences, University of Health and Allied Sciences, Ho, Ghana
| | - Freeman Aidoo
- Department of Molecular Medicine, School of Medical Science, Kwame Nkrumah University of Science and Technology (KNUST), Kumasi, Ghana
| | - Eddie-Williams Owiredu
- Department of Molecular Medicine, School of Medical Science, Kwame Nkrumah University of Science and Technology (KNUST), Kumasi, Ghana
| | - Christian Obirikorang
- Department of Molecular Medicine, School of Medical Science, Kwame Nkrumah University of Science and Technology (KNUST), Kumasi, Ghana
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