Perceived Stress as a Pathway for the Relationship Between Neighborhood Factors and Glycemic Control in Adults With Diabetes

2021 ◽  
pp. 089011712110503
Author(s):  
Joshua K. Egede ◽  
Jennifer A. Campbell ◽  
Rebekah J. Walker ◽  
Leonard E. Egede
Keyword(s):  
Glycemic Control ◽  
Perceived Stress ◽  
Self Efficacy ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Neighborhood Factors ◽  
Southeastern Us ◽  
The Relationship ◽  
General Diet

Purpose Neighborhood factors such as crime, discrimination, and violence are increasingly recognized as correlates of poor glycemic control. However, pathways for these relationships are unclear. This study examined stress and self-efficacy as potential pathways for the relationship between neighborhood factors and glycemic control in adults with type 2 diabetes. Design Cross-sectional study. Setting Two primary care clinics in southeastern US. Participants 615 adults aged 18 years and older. Measures Validated measures were used to capture neighborhood factors, stress, and self-efficacy, while hemoglobin A1c (HbA1c) was abstracted from the electronic health record. Analysis Path analysis was used to investigate direct and indirect relationships between neighborhood factors, stress, self-efficacy, and glycemic control. Results In the final model, violence (r = .17, P = .024), discrimination (r = .46, P < .001), and crime (r = .36, P = .046) were directly associated with higher perceived stress. Stress (r = −.5, P < .001) was directly associated with lower self-efficacy. Self-efficacy was directly associated with better general diet (r = .12, P < .001), better specific diet (r = .04, P < .001), more exercise (r = .08, P < .001), and lower HbA1c (r = −.11, P < .001). Stress (r = .05, P < .001), crime (r = .20, P < .001), and discrimination (r = .08, P < .001) were indirectly associated with higher HbA1c. Conclusion Stress and self-efficacy are potential pathways for the relationship between neighborhood factors like violence, discrimination, and crime and glycemic control. Interventions aimed at mitigating stress and improving self-efficacy may improve self-care behaviors and glycemic control.

scholarly journals Social Support, Self-Care Behaviour and Self-Efficacy in Patients with Type 2 Diabetes during the COVID-19 Pandemic: A Cross-Sectional Study

Healthcare ◽  
2021 ◽  
Vol 9 (11) ◽  
pp. 1607
Author(s):  
Premalatha Paulsamy ◽  
Rizwan Ashraf ◽  
Shadia Hamoud Alshahrani ◽  
Kalaiselvi Periannan ◽  
Absar Ahmed Qureshi ◽  
...  
Keyword(s):  
Social Support ◽  
Glycemic Control ◽  
Self Efficacy ◽  
Diabetes Management ◽  
Self Care ◽  
Cross Sectional Study ◽  
The Self ◽  
Sectional Study ◽  
Cross Sectional

Diabetes mellitus is a major public health issue that considerably impacts mortality, morbidity, and healthcare costs worldwide. The COVID-19 pandemic has created havoc in diabetes management, too, like other spectrums of life. A descriptive, cross-sectional study was adopted to determine the effect of Social Support, Self-Care Behaviour and Self-Efficacy in Type 2 Diabetes Mellitus (T2D) during this COVID-19 pandemic. Two hundred T2D patients who satisfied the inclusion criteria were chosen using a convenient sampling procedure. The tool consists of four sections, including socio-demographic characteristics, Multidimensional Scale of Perceived Social Support (MSPSS), revised Summary of Diabetes Self-Care Activities (SDSCA) Scale and modified Diabetes Management Self-Efficacy Scale (DMS). Descriptive and inferential statistics were used to analyze the obtained data. The mean and SD of diabetic management self-efficacy is 5.74 (1.95) and 4.37 (1.4), respectively, for patients with HbA1c < 6.5% and HbA1c ≥ 6.5%. The self-care activities of the patients who had good glycemic control were 4.31 (2.06) compared to 3.50 (1.73) who did not. The social support received by the patients was 6.13 (2.13) vs. 5.31 (1.67) among patients with glycemic control vs. no control. The results show that social support (p = 0.04), self-efficacy (p =0.01) and self-care activities (p = 0.001) were significantly related to the level of glycemic control of the T2D patients. A significant relationship was also identified between gender (p = 0.036), age (p = 0.001) and education status (p = 0.000) with HbA1c control of the participants. This study demonstrates a significant relationship between social support, self-care behaviours, self-efficacy and glycemic management in T2D patients. During this COVID-19 pandemic, interventions to enhance the self-care activities like exercise and social support to boost their self-efficacy; for better diabetes management, reducing diabetes complications or prolonging their onset are the need of the hour.

The Relationship Between Dietary Knowledge and Glycemic Control in Patient with Diabetes Type 2: A Comunity-Based, Cross-Sectional Study

2017 ◽  
Vol 23 (12) ◽  
pp. 12532-12535
Author(s):  
Fahrun Nur Rosyid ◽  
Supratman ◽  
Tomy Adi Prasetyo ◽  
Desiana Dwi Astutik ◽  
Kinasih Bayu Nurseto ◽  
...  
Keyword(s):  
Glycemic Control ◽  
Diabetes Type 2 ◽  
Cross Sectional Study ◽  
Diabetes Type ◽  
Sectional Study ◽  
Cross Sectional ◽  
Dietary Knowledge ◽  
The Relationship

scholarly journals Home-Measured Blood Pressure Is Associated with Handgrip Strength in Patients with Type 2 Diabetes: The KAMOGAWA-HBP Study

2021 ◽  
Vol 10 (9) ◽  
pp. 1913
Author(s):  
Tomonori Kimura ◽  
Emi Ushigome ◽  
Yoshitaka Hashimoto ◽  
Naoko Nakanishi ◽  
Masahide Hamaguchi ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Type 2 Diabetes ◽  
Pulse Pressure ◽  
Handgrip Strength ◽  
Cross Sectional Study ◽  
Home Blood Pressure ◽  
Cross Sectional ◽  
The Relationship ◽  
At Home

The association between blood pressure measured at home and handgrip strength in patients with diabetes has not been investigated. Therefore, in this study, we aimed to assess this association among patients with type 2 diabetes. In this cross-sectional study, 157 patients with type 2 diabetes underwent muscle tests and morning and evening blood-pressure measurements at home in triplicate for 14 consecutive days throughout the study period. Univariate and multivariate regression analyses were conducted to analyze the relationship between home blood-pressure parameters and handgrip strength. The average age and hemoglobin A1c of the patients were 70.5 years and 7.1%, respectively. Morning diastolic blood pressure of [β (95% confidence interval; CI): 0.20 (0.03, 0.37)] was associated with handgrip strength in men, while morning systolic blood pressure of [−0.09 (−0.15, −0.04)], morning pulse pressure of [−0.14 (−0.21, −0.08)], and evening pulse pressure of [−0.12 (−0.19, −0.04)] were associated with handgrip strength in women. Home-measured blood pressure was associated with handgrip strength. Sex differences were found in the relationship between home blood-pressure parameters and handgrip strength.

Correlation Between Functional Health Literacy and Self-efficacy in People with Type 2 Diabetes Mellitus: Cross-sectional Study

2021 ◽  
pp. 105477382110068
Author(s):  
Luis Angel Cendejas Medina ◽  
Renan Alves Silva ◽  
Magda Milleyde de Sousa Lima ◽  
Lívia Moreira Barros ◽  
Rafael Oliveira Pitta Lopes ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Self Efficacy ◽  
Cross Sectional Study ◽  
Functional Health ◽  
Bivariate Analysis ◽  
Sectional Study ◽  
Cross Sectional

To analyze the correlation between functional health literacy (FHL) and self-efficacy (SE) in people with type 2 Diabetes Mellitus. Cross-sectional study was conducted among September and October 2019, with 196 people with type 2 diabetes. Data were collected using the Functional Literacy in Health instrument (B-TOFHLA) and the Diabetes Management Self-Efficacy Scale for Patients with Type 2 Diabetes Mellitus (DMSES). Bivariate analysis was used to verify the relationship among the constructs. Most diabetics showed an average B-TOFHLA score of 74.75, considered adequate, and self-efficacy of 4.07, high. The association between SE and FHL in the bivariate analysis found no statistical significance ( p > .05), in the same sense as the B-TOFHLA score and the DMSES domains ( p > .05). Constructs were not related to each other in terms of skills arising from judgments and decisions with motivational confidence by the investigated audience.

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

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.

scholarly journals Mediators of Food Insecurity and Obesity in Female Heads-of-Household with Children

2017 ◽  
Vol 1 (3) ◽  
pp. 1-10
Author(s):  
Emily Havrilla
Keyword(s):  
Food Insecurity ◽  
Perceived Stress ◽  
Vulnerable Populations ◽  
Self Efficacy ◽  
The United States ◽  
Mediation Model ◽  
Cross Sectional ◽  
Heads Of Household ◽  
The Relationship ◽  
General Self Efficacy

Background: The prevalence of obesity is a significant issue in the United States. Among vulnerable populations, obesity exists in the presence of household food insecurity; however the mechanisms of the relationship are not well understood. General perceived stress and general self-efficacy were evaluated as mediators of the relationship between food insecurity and obesity in female heads-of-household with children. Methods: A cross-sectional correlational design with mediation model testing was used. Subjects (N = 86) were recruited through convenience sampling. Data were collected using a demographic questionnaire, the Core Food Security Module (CFSM), the General Perceived Stress Questionnaire (PSQ), and the General Self-Efficacy Scale (SES). Body mass index and waist –to-hip circumference were calculated from measured data. Results: Significant relationships were found between food insecurity and general perceived stress, general perceived stress and obesity, and general self-efficacy and obesity. Mediation models’ testing was not completed due the lack of a significant correlation between food insecurity and obesity. Post hoc analysis was completed using bootstrapping and a revised mediation model process. Conclusion: General perceived stress and general self-efficacy are associated with obesity in female heads-of-household with children who are food insecure. Keywords: Food insecurity, Obesity, Stress, Self-efficacy, Vulnerable populations, Quantitative research, Socioeconomic factors

scholarly journals The relationship between high-density lipoprotein cholesterol (HDL-C) and glycosylated hemoglobin in diabetic patients aged 20 or above: a cross-sectional study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Rui Huang ◽  
Li Yan ◽  
Yuhua Lei
Keyword(s):  
Glycemic Control ◽  
Interaction Analysis ◽  
Glycosylated Hemoglobin ◽  
Density Lipoprotein ◽  
Cross Sectional Study ◽  
Cerebrovascular Diseases ◽  
Diabetic Patients ◽  
Cross Sectional ◽  
Race Ethnicity ◽  
The Relationship

Abstract Aim The incidence rate of diabetes is increasing year by year, seriously threatening human health. As a predictor of glycemic control, glycated hemoglobin is reported to be related to various complications and prognoses of diabetes. Besides, HDL-C dyslipidemia is a component of metabolic syndrome and may be related to various cardiovascular and cerebrovascular diseases. The principal objective of this project was to investigate the relationship between HDL-C and glycosylated hemoglobin in adult diabetic patients. Methods A total of 3171 adult diabetic patients aged 20 years and above were included in the present study from the National Health and Nutrition Examination Survey (NHANES). HDL-C and glycosylated hemoglobin were regarded as independent and dependent variables, respectively. EmpowerStats software and R (version 3.4.3) were used to examine the association between HDL-C and glycosylated hemoglobin. Results HDL-C was inversely associated with glycohemoglobin after adjusting for other covariates (β = − 0.004, 95% CI:− 0.008 to − 0.000, p = 0.044). Race/ethnicity and age were considered the most prominent interactive factors that affect the relationship between HDL and glycosylated hemoglobin by the interaction analysis. A U-shaped association was detected between HDL-C and glycosylated hemoglobin for people of other race/ethnicity or aged 60 and above, which had an inflection point of HDL-C at 60 mg/dL. In contrast, we observed an inverted U-shaped distribution between HDL-C and glycosylated hemoglobin in people under 40 with point of inflection located at 60 mg/dL as well. Conclusions HDL-C in diabetic patients is inversely associated with glycosylated hemoglobin and may be relevant to glycemic control. However, a U-shaped relationship was also observed in a certain kind of people, which implied that, though HDL-C is considered as metabolism and anti-atherogenic property, for diabetics, it is not the higher, the better.

scholarly journals How self-stigma affects patient activation in persons with type 2 diabetes: a cross-sectional study

BMJ Open ◽  
2020 ◽  
Vol 10 (5) ◽  
pp. e034757
Author(s):  
Asuka Kato ◽  
Yuko Fujimaki ◽  
Shin Fujimori ◽  
Akihiro Isogawa ◽  
Yukiko Onishi ◽  
...  
Keyword(s):  
Self Efficacy ◽  
Goodness Of Fit ◽  
Patient Activation ◽  
Self Care ◽  
Self Esteem ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Fit Index

ObjectivesSelf-stigma is associated with lower patient activation levels for self-care in persons with type 2 diabetes mellitus (T2DM). However, the causal pathway linking self-stigma with patient activation for self-care has not been shown. In order to determine how self-stigma affects patient activation for self-care, we tested a two-path hypothetical model both directly and as mediated by self-esteem and self-efficacy.DesignA cross-sectional study.SettingTwo university hospitals, one general hospital and one clinic in Japan.ParticipantsT2DM outpatients receiving treatment (n=209) completed a self-administered questionnaire comprising the Self-Stigma Scale, Patient Activation Measure, Rosenberg Self-Esteem Scale, General Self-Efficacy Scale, Patient Health Questionnaire, haemoglobin A1c test, age, sex and body mass index.Primary and secondary outcome measuresSelf-stigma levels were measured by using the Self-Stigma Scale. Patient activation levels were measured by the Patient Activation Measure.ResultsPath analysis showed a strong relationship between self-stigma and patient activation (χ2=27.55, p=0.120; goodness-of-fit index=0.97; adjusted goodness-of-fit index=0.94; comparative fit index=0.98; root mean square error of approximation=0.04). Self-stigma had a direct effect on patient activation (β=−0.20; p=0.002). Indirectly, self-stigma affected patient activation along two paths (β=0.31; p<0.001) by reducing self-esteem (β=−0.22; p<0.001) and self-efficacy (β=−0.36; p<0.001).ConclusionsDue to the cross-sectional design of the study, longitudinal changes between all the variables cannot be established. However, the findings indicate that self-stigma affected patient activation for self-care, both directly and as mediated by self-esteem and self-efficacy. Interventions that increase self-esteem and self-efficacy may decrease self-stigma in patients with T2DM, thus increasing patient activation for self-care.

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