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

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.

2020 ◽  
Author(s):  
Ming-Jye Wang ◽  
Hung-Ming Lin ◽  
Li-Chen Hung ◽  
Yi-Ting Lo

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.


2020 ◽  
Author(s):  
Ming-Jye Wang ◽  
Hung-Ming Lin ◽  
Li-Chen Hung ◽  
Yi-Ting Lo

Abstract Background The effects of patient sustained self-care behaviors (SCB) on glycemic control are even greater than the effects of medical treatment, indicating the value of identifying the factors that influence SCB. To date, these factors have not been placed in one model to clarify the critical path affecting SCB. The aims of this study were to explore the relationships of these factors and the differences by decision-making preference.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 (HL) to self-efficacy (SE), patient empowerment (PE), and SCB; from SE to SCB; and from PE to SCB. Indirect pathways were from HL to SCB via SE or PE. The pathway from HL to SE was significantly stronger in those preferring shared decision-making than in those who preferred physician decision-making.Conclusions HL is a critical factor in improving SCB in patients with type 2 diabetes, and the pathway from HL to SE differed the most by patient preference for making decisions. Therefore, developing an effective promotion strategy and application tools to improve the overall HL of diabetic is the cornerstone of enhancing SCB in this population.


2021 ◽  
Vol 10 ◽  
pp. 100703
Author(s):  
Ajoy Tiwari ◽  
Dinesh Kumar ◽  
Mohammad S. Ansari ◽  
Santosh Kumar Chaubey ◽  
Nitin R. Gupta ◽  
...  

2021 ◽  
pp. 105477382110068
Author(s):  
Luis Angel Cendejas Medina ◽  
Renan Alves Silva ◽  
Magda Milleyde de Sousa Lima ◽  
Lívia Moreira Barros ◽  
Rafael Oliveira Pitta Lopes ◽  
...  

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.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Daniel Tajdar ◽  
Dagmar Lühmann ◽  
Regina Fertmann ◽  
Tim Steinberg ◽  
Hendrik van den Bussche ◽  
...  

Abstract Background Low health literacy is believed to be associated with behaviours that increase the risk of type 2 diabetes. But there is limited knowledge on the relation between health literacy (HL) and diabetes risk, and whether improving HL could be a potential prevention strategy. Therefore, the main purpose of this study was to examine the link between HL and diabetes risk among non-diabetic adults. Methods We used data from the Hamburg Diabetes Prevention Survey, a population-based cross-sectional study in Germany. One thousand, two hundred and fifty-five non-diabetic subjects aged 18–60 years were eligible. The German Diabetes Risk Score (GDRS, ranging 0 to 123 points) was used to determine the individual risk of type 2 diabetes. The short version of the European Health Literacy Questionnaire (HLS-EU-Q16, ranging 0 to 16 points) was applied to assess the individual self-reported HL. Subjects were asked to self-estimate their diabetes risk, which was then compared with the calculated GDRS. Descriptive statistics were calculated to investigate group differences in the GDRS and self-estimated diabetes risk. Linear as well as logistic regression models were performed to analyse potential influencing variables of the GDRS as well as incorrect self-estimated diabetes risk. In three nested statistical models for each outcome, these analyses were adjusted for age, gender, educational level and the presence of chronic conditions. Results According to the criteria of the GDRS, 996 (79.4%) subjects showed “low risk”, 176 (14.0%) “still low risk”, 53 (4.2%) “elevated risk”, and 30 (2.4%) “high to very high risk” to develop type 2 diabetes within the next 5 years. In the statistical models including all control variables, subjects with “inadequate HL” scored 2.38 points higher on the GDRS (95% CI 0.378 to 4.336; P = 0.020) and had a 2.04 greater chance to estimate their diabetes risk incorrectly (OR 2.04; 95% CI 1.33 to 3.14; P = 0.001) compared to those with “sufficient HL”. Conclusion The risk of type 2 diabetes is increased in people with inadequate self-reported HL. People with high diabetes risk and inadequate HL might be provided with educational programs to improve diabetes knowledge and reduce behavioural risk factors.


2016 ◽  
Vol 31 (1) ◽  
pp. 52-59 ◽  
Author(s):  
Mahnoush Reisi ◽  
Firoozeh Mostafavi ◽  
Homamodin Javadzade ◽  
Behzad Mahaki ◽  
Elahe Tavassoli ◽  
...  

BMJ Open ◽  
2020 ◽  
Vol 10 (5) ◽  
pp. e034757
Author(s):  
Asuka Kato ◽  
Yuko Fujimaki ◽  
Shin Fujimori ◽  
Akihiro Isogawa ◽  
Yukiko Onishi ◽  
...  

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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