Abstract 13213: Correlates of Dietary Self-care Behaviors in Adults With Type 2 Diabetes and Comorbid Heart Failure

Introduction: Multi-morbidity is increasingly recognized to negatively influence self-care behaviors such as dietary adherence in persons living with serious or life-threatening chronic conditions such as type 2 diabetes (T2D) and heart failure (HF). Aim: The aim of this study was to describe demographic, clinical, and psychosocialcorrelates of dietary self-care behaviors in adult patients with T2D and comorbid HF. Methods: The parent study for this secondary analysis was a randomized trial that tested a 6-month integrated self-care intervention for 180 participants with comorbid HF and T2D. Cross-sectional, baseline data was used for the predictive model which included demographic (age, sex, marital status, and education) psychosocial (depression [PhQ-9], self-efficacy [PDSMS], and diabetes knowledge [MDKT]); and clinical variables (years diagnosed with T2D and HF, New York Heart Association (NYHA) functional classification, Charlson comorbidity index (CCI), and implanted cardiac device). The general and specific diet components of the Summary of Diabetes Self-Care Activities (SDSCA) were used to measure dietary self-care behaviors. Correlational bivariate and stepwise linear regression analyses were performed to examine correlates of dietary self-care behaviors. Results: Participants mean age was 58 ±11 years and the majority were male (n = 118, 66%) and African American (n = 119, 66%). Charlson comorbidity >2 ( p <0.05) and implanted device ( p <0.05) predicted lower SDSCA general diet score. Diabetes self-efficacy ( p <0.01) predicted higher SDSCA specific diet score while implanted cardiac device ( p <0.05) predicted lower score, collectively explaining 18.2% of the variance in diabetes-specific dietary self-care behavior. Conclusion: Findings suggest that multimorbidity may increase risk for lower diabetes dietary self-care behaviors, particularly those with more advanced HF requiring an implanted device. Future research should focus on how to promote effective self-care behaviors in persons living with multimorbidity as a strategy to improve clinical outcomes and enhance quality of life.

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Impact of Health Literacy, Self-efficacy, and Outcome Expectations on Adherence to Self-care Behaviors in Iranians with Type 2 Diabetes

Oman Medical Journal ◽

10.5001/omj.2016.10 ◽

2016 ◽

Vol 31 (1) ◽

pp. 52-59 ◽

Cited By ~ 34

Author(s):

Mahnoush Reisi ◽

Firoozeh Mostafavi ◽

Homamodin Javadzade ◽

Behzad Mahaki ◽

Elahe Tavassoli ◽

...

Keyword(s):

Type 2 Diabetes ◽

Health Literacy ◽

Self Efficacy ◽

Self Care ◽

Outcome Expectations

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Effects of a tailored text messaging intervention among diverse adults with type 2 diabetes: Evidence from the 15-month REACH RCT

10.2337/figshare.13052981.v1 ◽

2020 ◽

Author(s):

Lyndsay A. Nelson ◽

Robert A. Greevy ◽

Andrew Spieker ◽

Kenneth A. Wallston ◽

Tom A. Elasy ◽

...

Keyword(s):

Type 2 Diabetes ◽

Medication Adherence ◽

Self Efficacy ◽

Text Messaging ◽

Self Care ◽

Baseline Hba1c ◽

Median Response ◽

Text Messaging Intervention

Objective: Text messaging interventions have high potential for scalability and to reduce health disparities; however, more rigorous, long-term trials are needed. We examined the long-term efficacy and mechanisms of a tailored text messaging intervention. Research Design and Methods: Adults with type 2 diabetes participated in a parallel-groups, 15-month randomized trial, assigned to receive REACH (Rapid Education/Encouragement and Communications for Health) for 12 months or control. REACH included interactive texts and tailored texts addressing medication adherence, and non-tailored texts supporting other self-care behaviors. Outcomes included HbA1c, diabetes medication adherence, self-care, and self-efficacy. Results: Participants (N=506) were approximately half racial/ethnic minority and half were underinsured, had annual household incomes <$35,000 USD and ≤ high school education; 11% were homeless. <a>Average baseline HbA1c was 8.6%±1.8%; 70.0±19.7 mmol/mol) with n=219 having HbA1c≥8.5% (69 mmol/mol)</a> and half were prescribed insulin. Retention was over 90%. Median response rate to interactive texts was 91% (interquartile range 75%, 97%). The treatment effect on HbA1c at 6 months (-0.31%; 95% CI [-0.61%, -0.02%]) was greater among those with baseline HbA1c≥8.5% (-0.74%; 95% CI [-1.26%, -0.23%]), and there was not evidence of effect modification by race/ethnicity or socioeconomic disadvantage. REACH improved medication adherence and diet through 12 months, and self-efficacy through 6 months. Treatment effects were not significant for any outcome at 15 months. REACH reduced barriers to adherence, but barrier reduction did not mediate outcome improvements. Conclusions: REACH engaged at-risk patients in diabetes self-management and improved short-term HbA1c. More than texts alone may be needed to sustain effects.

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Non-health outcomes affecting self-care behaviors and medical decision-making preference in patients with type 2 diabetes: a cross-sectional study

10.21203/rs.2.21066/v2 ◽

2020 ◽

Author(s):

Ming-Jye Wang ◽

Hung-Ming Lin ◽

Li-Chen Hung ◽

Yi-Ting Lo

Keyword(s):

Type 2 Diabetes ◽

Decision Making ◽

Health Literacy ◽

Self Efficacy ◽

Patient Empowerment ◽

Self Care ◽

Cross Sectional Study ◽

Medical Decision ◽

Cross Sectional

Abstract Background: The effects of patient sustained self-care behaviors on glycemic control are even greater than the effects of medical treatment, indicating the value of identifying the factors that influence self-care behaviors. To date, these factors have not been placed in a single model to clarify the critical path affecting self-care behaviors. The aims of this study were to explore the relationships of these factors and the differences in patient preference for medical decision-making.Methods: A cross-sectional study was conducted among outpatients with type 2 diabetes at a regional teaching hospital. Purposive sampling was adopted to recruit 316 eligible patients via self-administered questionnaires. Partial least squares structural equation modeling was used for analysis.Results: Significant direct pathways were identified from health literacy to self-efficacy, patient empowerment, and self-care behaviors; from self-efficacy to self-care behaviors; and from patient empowerment to self-care behaviors. Indirect pathways were from health literacy to self-care behaviors via self-efficacy or patient empowerment. The pathway from health literacy to self-efficacy was significantly stronger in those preferring shared decision-making than in those who preferred physician decision-making. Conclusions: Health literacy is a critical factor in improving self-care behaviors in patients with type 2 diabetes, and the effect of health literacy on self-efficacy was more significant in the shared decision-making than in the physician decision-making. Therefore, developing an effective health strategy to strengthen health literacy awareness and designing friendly, diverse health literacy materials, and application tools is the most important factor to facilitate self-care behaviors in this population.

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The Role Of Family Support And Self-Efficacy On Self-Care Behavior In The Elderly With Type 2 Diabetes

Journal of Health Sciences ◽

10.33086/jhs.v14i02.1801 ◽

2021 ◽

Vol 14 (02) ◽

pp. 82-89

Author(s):

Ratna Yunita Sari ◽

Umdatus Soleha ◽

Erika Chandra Dewi

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Family Support ◽

Self Efficacy ◽

Self Care ◽

The Elderly ◽

Rank Test ◽

Care Behavior

Introduction: Diabetes self-care is an effort to control type 2 diabetes mellitus. Family support and self-efficacy are needed for elderly people with type 2 diabetes mellitus to increase independence in managing their disease. This study aims to determine the relationship between family support and self-efficacy with self-care behavior in the elderly with type 2 diabetes mellitus at the Elderly Posyandu in Wadungasri Village. Methods: This study is a quantitative study with a correlational analytic research design using a cross-sectional approach. The population in this study was 132 elderly with type 2 diabetes mellitus using a probability sampling method with a technique used simple random sampling and obtained a sample of 100 elderly DM type 2. Results: The results showed that most of the elderly have family support and good self-efficacy. with less self-care behavior. The results of the analysis using the Spearman rank test showed that family support was associated with self-care for people with diabetes mellitus type 2 (p-value = 0.006, ɑ = 0.05). The results of the Spearman rank test analysis showed that self-efficacy was related to self-care for people with diabetes mellitus type 2 (p-value = 0.001, ɑ = 0.05). Conclusion: Family support and self-efficacy gave to elderly people with type 2 diabetes mellitus can influence health behavior patterns that will make self-care behavior well.

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Factors Related to Self-care in Patients with Type 2 Diabetes

The Open Nursing Journal ◽

10.2174/1874434602014010064 ◽

2020 ◽

Vol 14 (1) ◽

pp. 64-73

Author(s):

Seung-Yeon Kong ◽

Mi-Kyoung Cho

Keyword(s):

Type 2 Diabetes ◽

Self Efficacy ◽

Smoking Status ◽

Explanatory Power ◽

Fasting Blood Glucose ◽

Self Care ◽

Self Report ◽

University Hospital ◽

Diabetes Patients

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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