scholarly journals CGM Benefits and Burdens: Two Brief Measures of Continuous Glucose Monitoring

2019 ◽  
Vol 13 (6) ◽  
pp. 1135-1141 ◽  
Author(s):  
Laurel H. Messer ◽  
Paul F. Cook ◽  
Molly L. Tanenbaum ◽  
Sarah Hanes ◽  
Kimberly A. Driscoll ◽  
...  
Keyword(s):  
Self Efficacy ◽  
Diabetes Management ◽  
Glucose Monitoring ◽  
Diabetes Distress ◽  
Internal Reliability ◽  
Confirmatory Factor Analyses ◽  
Targeted Interventions ◽  
Positive Attitudes ◽  
Technology Attitudes ◽  
Continuous Glucose Monitors

Background: Continuous glucose monitors (CGM) are underutilized by individuals with type 1 diabetes (T1D), particularly during the adolescent years. Little is known about perceptions of CGM benefit and burdens, and few tools exist to quantify this information. Methods: Two questionnaires were developed and validated—Benefit of CGM (BenCGM) and Burdens of CGM (BurCGM)—in a sample of adolescents ages 12-19 years involved in the T1D Exchange Registry. We chose to start the validation process with adolescents given their low CGM uptake and high risk for suboptimal glycemic outcomes. Exploratory and confirmatory factor analyses were conducted to confirm factor structure and select items. The resultant scales were tested for internal reliability and convergent/divergent validity with critical diabetes and quality of life outcomes: age, depression, diabetes distress, self-efficacy, technology attitudes, and diabetes technology attitudes. Results: A total of 431 adolescents with T1D completed the questionnaires (51% female, mean age 16.3 ± 2.26, 83% white non-Hispanic, 70% having used CGM). Two single factor scales emerged, and scales were reduced to 8 items each. Those who perceived higher benefit of CGM exhibited lower diabetes distress, higher self-efficacy, and more positive attitudes toward technology. Those who perceived higher burden of CGM exhibited higher diabetes distress, lower self-efficacy, and less positive technology attitudes. Conclusion: The BenCGM and BurCGM questionnaires each comprise 8-items that demonstrate robust psychometric properties for use in adolescents with T1D, and can be used to develop targeted interventions to increase CGM wear to improve diabetes management.

Combining CGM and an Online Peer Support Community for Hispanic Adults with T2D: A Feasibility Study

2021 ◽  
pp. 193229682110322
Author(s):  
Michelle L. Litchman ◽  
Ashley Ng ◽  
Ana Sanchez-Birkhead ◽  
Nancy A. Allen ◽  
Bruno Rodriguez-Gonzales ◽  
...  
Keyword(s):  
Peer Support ◽  
Feasibility Study ◽  
Self Efficacy ◽  
Diabetes Management ◽  
Qualitative Interviews ◽  
Glucose Monitoring ◽  
Participant Satisfaction ◽  
Hispanic Community ◽  
Clinical Measures ◽  
Study Participants

Background: Previous research has identified that people with type 2 diabetes (T2D) within the Hispanic community would benefit from an online peer support community (OPSC) and continuous glucose monitoring (CGM) data to facilitate diabetes self-management. Methods: A mixed-methods feasibility study enrolled Hispanic, Spanish-speaking adults with T2D, not on insulin. Participants were provided with CGM and access to an OPSC for 12 weeks. Feasibility was assessed by number of eligible participants who enrolled, attrition, quantity of CGM data, validated clinical measures of self-efficacy, quality of life and adverse events. Engagement in the OPSC was measured using objective metrics on the online platform. Qualitative interviews were conducted upon conclusion of the intervention to assess feasibility, acceptability, participant satisfaction, and key recommendations for improvement. Results: Of 46 participants screened, 39 were eligible and 26 completed the study. Participants significantly improved self-efficacy scores. Posts in the OPSC related to goal setting had the highest engagement followed by mid-week and end of week check-in posts respectively. Participant interviews described challenges accessing the OPSC platform as a barrier to engagement. Despite this, all participants were satisfied with the intervention. Key recommendations for improvement included providing greater variety of and individualized education and the use of a peer support platform that is easily accessible. Conclusions: The CGM + OPSC intervention tailored to the Hispanic community with T2D was feasible, acceptable and satisfactory and improved participant self-efficacy for diabetes management which may lead to improved clinical outcomes.

scholarly journals Diabetes Distress, Depressive Symptoms and Type 2 Diabetes Management and Glycemic Control: the Mediating Role of Self-efficacy

2020 ◽  
Author(s):  
Yuexia Gao ◽  
Yarong Han ◽  
Xin Zou ◽  
Judy Xu ◽  
Dean Getrude Mawen ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Depressive Symptoms ◽  
Glycemic Control ◽  
Self Efficacy ◽  
Diabetes Management ◽  
Diabetes Distress ◽  
Hierarchical Regression ◽  
Psychological Variables ◽  
Diabetes Outcomes

Abstract Background: Diabetes distress has been distinguished from depressive symptoms in the linkages to type 2 diabetes management and glycemic control. There are few evidences in rural China untangled the underlying pathways among them. The aim of our study was to examine whether self-efficacy reduced the detrimental effects of psychological variables on diabetes outcomes such as self-care behaviors, glycemic control and health-related quality of life (HRQoL).Methods: 1574 adults diagnosed with type 2 diabetes from 31 rural clinics in China were assessed for psychological variables, self-management and HRQoL. Hemoglobin A1c (HbA1c) data at 6 months after the survey were extracted from electronic medical records. Hierarchical regression model examined independent effects of psychological variables, self-efficacy on diabetes outcomes. KHB method and bootstrapping confidence intervals were employed to test the mediating effect of self-efficacy.Results: Hierarchical regression analysis showed both diabetes distress and depressive symptoms were significantly related to diet and HRQoL, but not related to glycemic control and medication adherence. Depressive symptoms, but not diabetes distress, was directly associated with physical activity. Mediation analysis demonstrated self-efficacy mediated the relationships of both diabetes distress and depressive symptoms on self-care behaviors, glycemic control and HRQoL.Conclusions: Self-efficacy may contribute to better diabetes outcome by ameliorating the effects of diabetes distress and depressive symptoms. Patients with psychological conditions may need tailored intervention that enhance self-efficacy to improve diabetes management.

scholarly journals Diabetes Distress, Depressive Symptoms and Type 2 Diabetes Management and Glycemic Control: The Mediating Role of Self-Efficacy

2020 ◽  
Author(s):  
Yuexia Gao ◽  
Yarong Han ◽  
Xin Zou ◽  
Judy Xu ◽  
Dean Getrude Mawen ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Depressive Symptoms ◽  
Glycemic Control ◽  
Self Efficacy ◽  
Diabetes Management ◽  
Self Care ◽  
Diabetes Distress ◽  
Psychological Variables ◽  
Diabetes Outcomes

Abstract BackgroundDiabetes distress has been distinguished from depressive symptoms in the linkages to type 2 diabetes management and glycemic control. There are few evidences in rural China untangled the underlying pathways among them. The aim of our study was to examine whether self-efficacy reduced the detrimental effects of psychological variables on diabetes outcomes such as self-care behaviors, glycemic control and health-related quality of life (HRQoL).Methods1574 adults diagnosed with type 2 diabetes from 31 rural clinics in China were assessed for psychological variables, self-management and HRQoL. Hemoglobin A1c (HbA1c) data at 6 months after the survey were extracted from electronic medical records. Hierarchical regression model examined independent effects of psychological variables, self-efficacy on diabetes outcomes. KHB method and bootstrapping confidence intervals were employed to test the mediating effect of self-efficacy.ResultsHierarchical regression analysis showed both diabetes distress and depressive symptoms were significantly related to diet and HRQoL, but not related to glycemic control and medication adherence. Depressive symptoms, but not diabetes distress, was directly associated with physical activity. Mediation analysis demonstrated self-efficacy mediated the relationships of both diabetes distress and depressive symptoms on self-care behaviors, glycemic control and HRQoL.ConclusionsSelf-efficacy may contribute to better diabetes outcome by ameliorating the effects of diabetes distress and depressive symptoms. Patients with psychological conditions may need tailored intervention that enhance self-efficacy to improve diabetes management.

School Nurses’ Diabetes-Related Attitudes and Self-efficacy in Diabetes Education and Management

2021 ◽  
pp. 105984052110431
Author(s):  
Mee Kyung Lee ◽  
Elaine Walsh ◽  
Mayumi Willgerodt ◽  
M. Rebecca O’Connor
Keyword(s):  
Public Schools ◽  
Self Efficacy ◽  
Diabetes Management ◽  
Diabetes Education ◽  
School Nurses ◽  
Full Time ◽  
Positive Attitudes ◽  
Education And Care ◽  
Consolidated Schools

This study explored relationships between school nurses’ diabetes-related attitudes, self-efficacy in diabetes management and education, and care practices. One-hundred fourteen school nurses who have taken care of students with type 1 diabetes in public schools comprised this descriptive study sample. Participants completed online surveys. School nurses’ diabetes-related attitudes were not related to their self-efficacy in diabetes education, but nurses’ attitudes towards the psychosocial impact of diabetes were significantly related to their self-efficacy in diabetes management, and the number of students with diabetes was a significant contributor to this relationship. Nurses’ full-time status and the type of school they worked in were significantly related to their self-efficacy in providing diabetes education. School nurses’ positive attitudes about providing care for students with diabetes were related to having a higher level of self-efficacy in providing diabetes management. Based on the findings, recommendations are made for health consolidated schools and full-time school nurses.

scholarly journals The Effect of Self-Efficacy in Self-Management on Diabetes Distress in Young People with Type 2 Diabetes

Healthcare ◽  
2021 ◽  
Vol 9 (12) ◽  
pp. 1736
Author(s):  
Pao-Yu Lin ◽  
Tzu-Ying Lee ◽  
Chieh-Yu Liu ◽  
Yann-Jinn Lee
Keyword(s):  
Type 2 Diabetes ◽  
Psychological Distress ◽  
Young People ◽  
Self Efficacy ◽  
Diabetes Management ◽  
Self Management ◽  
Diabetes Distress ◽  
Cross Sectional ◽  
Duration Of Illness

To understand the relationship among glycemic control, self-efficacy in diabetes management, and diabetes distress in young people with type 2 diabetes, a cross-sectional descriptive study with convenience sampling was designed. A total of 60 young people who had type 2 diabetes (T2D), with 24 (40%) males and 36 (60%) females were included. The mean age was 17.2 and ranged from 10.5 to 24.5 years, and they completed a Perceived Diabetes Self-Management Scale, the Problem Areas in Diabetes Scale and their pharmacologic management and life adjustment. Glycated hemoglobin (HbA1c) was routinely drawn before the outpatient visit. HbA1c and diabetic distress were positively correlated. Self-efficacy was negatively correlated with HbA1c and diabetic distress. In the hierarchical multiple regression analysis, only the duration of illness and self-efficacy remained significant in the final model. The variance for the overall model was 64%, with self-efficacy alone explaining 30% of the variance. In addition, 31.6% of participants had extremely high levels of psychological distress. Conclusions: T2D is an early onset chronic disease, and the young people may have had other health problems, which made the diabetes management a complex process. Nursing staff should regularly assess both the confidence and ability to manage treatment regimen of young people with type 2 diabetes and their psychological distress.

A Randomized Trial About Glycemic Index and Glycemic Load Improves Outcomes Among Adults With Type 2 Diabetes

2008 ◽  
Vol 36 (3) ◽  
pp. 615-626 ◽  
Author(s):  
Carla K. Miller ◽  
Melissa Gutschall
Keyword(s):  
Type 2 Diabetes ◽  
Dietary Intake ◽  
Glycemic Index ◽  
Self Efficacy ◽  
Diabetes Management ◽  
Glycemic Load ◽  
Self Regulation ◽  
Glucose Monitoring ◽  
Outcome Expectations

Glycemic index (GI) represents the postprandial glucose response of carbohydrate foods, and glycemic load (GL) represents the quantity and quality of carbohydrate consumed. A diet lower in GI and GL may improve diabetes management. A 9-week intervention regarding GI and GL was evaluated among adults in the age range of 40-70 years who had had type 2 diabetes ≥1 year ( n = 103). Randomized pre—post test design with immediate and delayed treatment groups was employed. Dietary intake, knowledge, outcome expectations, self-efficacy, and empowerment regarding GI and GL and glucose monitoring were assessed. Four components were identified for outcome expectations using principal components analysis (dietary barrier, glycemic control, family support, and glucose monitoring), and two components were identified for self-efficacy (GI and self-regulation). Significant improvements in GI, knowledge, empowerment, self-efficacy, and outcome expectations (all p < .05) were observed except for glucose monitoring expectations. Only self-regulation efficacy significantly declined ( p < .05) at the follow-up assessment in the immediate group. Nutrition education regarding GI and GL can improve dietary intake, knowledge, outcome and efficacy expectations, and empowerment for diabetes management.

scholarly journals Acceptability of Implantable Continuous Glucose Monitoring Sensor

2017 ◽  
Vol 12 (3) ◽  
pp. 634-638 ◽  
Author(s):  
Katharine D. Barnard ◽  
Jort Kropff ◽  
Pratik Choudhary ◽  
Sankalpa Neupane ◽  
Stephen C. Bain ◽  
...  
Keyword(s):  
Continuous Glucose Monitoring ◽  
Diabetes Management ◽  
Glucose Monitoring ◽  
Ease Of Use ◽  
Psychosocial Assessment ◽  
Insulin Pump Therapy ◽  
Diabetes Distress ◽  
Therapy Regimen ◽  
Impact Scale ◽  
Distress Scale

Background: Real-time continuous glucose monitoring is associated with significant benefits for diabetes management. Implantable sensors could overcome some challenges reportedly associated with device visibility, psychosocial functioning and sensor durability. Methods: A psychosocial assessment was conducted to determine acceptability and impact of an implantable continuous glucose monitoring (CGM) sensor as part of the PRECISE trial. Questionnaires were administered to participants comprising the Diabetes Distress Scale, the CGM impact scale, and bespoke device satisfaction. Results: Fifty-one participants across the United Kingdom (n = 10) and Germany (n = 41) completed the questionnaires. Of these, 90% had T1D, 50% followed an insulin pump therapy regimen, and 45% of the participants were previous CGM users. CGM Impact Scale results show 86% (n = 44) of participants reported feeling better (14% neutral) about their diabetes control with 90% CGM naïve participants and 81% previous CGM users reporting increased confidence about their diabetes management. Furthermore, 73% (n = 37) felt more safe (27% neutral) while sleeping and 78% (n = 39) more confident (22% neutral) about avoiding serious hypoglycemia. Responses correspond with an average improvement in HbA1c from 7.51 to 7.05 ( P < .0001) over the 90 days use of the CGM. Overall, the system was rated highly on ease of use, convenience and comfort. 84% would choose to be inserted again with 93% of CGM naïve participants (86% previous CGM users) reporting minimized burden of diabetes. Conclusions: Implantable CGM devices are acceptable to users and are evaluated favorably. The considerable majority of participants (93% of first time users and 77% previous CGM users) would like to continue using the system to help manage their diabetes more effectively.

scholarly journals From Wary Wearers to d-Embracers: Personas of Readiness to Use Diabetes Devices

2018 ◽  
Vol 12 (6) ◽  
pp. 1101-1107 ◽  
Author(s):  
Molly L. Tanenbaum ◽  
Rebecca N. Adams ◽  
Esti Iturralde ◽  
Sarah J. Hanes ◽  
Regan C. Barley ◽  
...  
Keyword(s):  
Glucose Monitoring ◽  
Diabetes Duration ◽  
Diabetes Distress ◽  
Psychosocial Variables ◽  
Psychosocial Needs ◽  
Chi Square ◽  
High Distress ◽  
Technology Attitudes ◽  
Readiness To Adopt ◽  
Device Use

Background: Diabetes devices such as insulin pumps and continuous glucose monitoring (CGM) are associated with improved health and quality of life in adults with type 1 diabetes (T1D). However, uptake remains low. The aim of this study was to develop different “personas” of adults with T1D in relation to readiness to adopt new diabetes technology. Methods: Participants were 1498 T1D Exchange participants who completed surveys on barriers to uptake, technology attitudes, and other psychosocial variables. HbA1c data was available from the T1D Exchange for 30% of the sample. K-means cluster analyses grouped the sample by device barriers and attitudes. The authors assigned descriptive labels based on cluster characteristics. ANOVAs and chi-square tests assessed group differences by demographic and psychosocial variables (eg, diabetes duration, diabetes distress). Results: Analyses yielded five distinct personas. The d-Embracers (54% of participants) endorsed few barriers to device use and had the highest rates of device use, lowest HbA1c, and were the least distressed. The Free Rangers (23%) had the most negative technology attitudes. The Data Minimalists (10%) used pumps but had lower CGM use and did not want more diabetes information. The Wary Wearers (11%) had lower overall device use, were younger, more distressed, endorsed many barriers, and had higher HbA1c. The High Distress (3%) group members were the youngest, had the shortest diabetes duration, reported the most barriers, and were the most distressed. Conclusion: These clinically meaningful personas of device readiness can inform tailored interventions targeting barriers and psychosocial needs to increase device uptake.

scholarly journals Development of a Questionnaire for Measuring Employees’ Perception of Selection, Optimisation and Compensation at the Leadership, Group and Individual Levels

2021 ◽  
Vol 18 (12) ◽  
pp. 6475
Author(s):  
Annette Meng ◽  
Iben L. Karlsen ◽  
Vilhelm Borg ◽  
Thomas Clausen
Keyword(s):  
Validity And Reliability ◽  
Cross Sectional Survey ◽  
Internal Reliability ◽  
Cross Sectional ◽  
Confirmatory Factor Analyses ◽  
Targeted Interventions ◽  
Working Lives ◽  
Healthy Working ◽  
Dairy Workers ◽  
Leadership Group

This study is the first to develop a questionnaire to measure employees’ perceptions of the use of the action strategies selection, optimisation, and compensation (SOC) beyond the individual level, which has so far been lacking in research and practice. The study thus contributes an important tool for research into the role of SOC strategies at the leadership, group, and individual levels for long and healthy working lives. It may also be used by practitioners as a tool to provide input when developing targeted interventions to support long and healthy working lives. The development of the questionnaire was based on SOC theory, qualitative and cognitive interviews, and existing SOC questionnaires. The validity and reliability of the questionnaire were tested on data from a cross-sectional survey with responses from 785 nurses and 244 dairy workers. Results from confirmatory factor analyses supported the theoretically expected nine-factor structure of the questionnaire in both study populations (nurses and dairy workers). Furthermore, the results largely supported the criterion validity and internal reliability of the scales in the questionnaire. Nevertheless, further validation across additional occupational groups is needed.

An Adapted Measure of Teacher Self-Efficacy for Preservice Teachers: Exploring its Validity Across two Countries

2014 ◽  
Vol 28 (3) ◽  
pp. 83-92 ◽  
Author(s):  
Franziska Pfitzner-Eden ◽  
Felicitas Thiel ◽  
Jenny Horsley
Keyword(s):  
Preservice Teachers ◽  
Self Efficacy ◽  
Confirmatory Factor Analyses ◽  
3 Dimensional ◽  
Multiple Group ◽  
Three Samples ◽  
Confirmatory Factor ◽  
Teacher Self Efficacy ◽  
Dimensional Assessment ◽  
Metric Measurement

Teacher self-efficacy (TSE) is an important construct in the prediction of positive student and teacher outcomes. However, problems with its measurement have persisted, often through confounding TSE with other constructs. This research introduces an adapted TSE instrument for preservice teachers, which is closely aligned with self-efficacy experts' recommendations for measuring self-efficacy, and based on a widely used measure of TSE. We provide first evidence of construct validity for this instrument. Participants were 851 preservice teachers in three samples from Germany and New Zealand. Results of the multiple-group confirmatory factor analyses showed a uniform 3-factor solution for all samples, metric measurement invariance, and a consistent and moderate correlation between TSE and a measure of general self-efficacy across all samples. Despite limitations to this study, there is some first evidence that this measure allows for a valid 3-dimensional assessment of TSE in preservice teachers.

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