scholarly journals Pathways Linking Health Literacy to Self-Management in People with Type 2 Diabetes

Healthcare ◽  
2021 ◽  
Vol 9 (12) ◽  
pp. 1734
Author(s):  
Eun-Hyun Lee ◽  
Young Whee Lee ◽  
Duckhee Chae ◽  
Kwan-Woo Lee ◽  
Seongbin Hong ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Health Literacy ◽  
Social Isolation ◽  
Indirect Effect ◽  
Self Efficacy ◽  
Self Management ◽  
Mediation Model ◽  
Cross Sectional ◽  
Management Interventions

Health literacy is considered to be an emerging determinant of health behaviors and outcomes. The underlying mechanisms linking health literacy to diabetes self-management are currently unclear. This study assessed a mediation model consisting of a direct pathway between health literacy and self-management, and indirect pathways via social isolation only, self-efficacy only, and social isolation and self-efficacy serially in people with type 2 diabetes. A cross-sectional design was employed, and a total of 524 participants were recruited from outpatient clinics of multi-institutions from June 2020 to February 2021. The mediation model was analyzed using the PROCESS macro on SPSS with bootstrap bias-corrected 95% confidence intervals (CIs) with 10,000 bootstrapping iterations. Health literacy positively affected self-management. The estimated indirect effect of health literacy on self-management via social isolation was significant, at 0.018 (95% CI = 0.004–0.036). The indirect effect via self-efficacy was estimated at 0.214 (95% CI = 0.165–0.266). The indirect effect via social isolation and self-efficacy serially was 0.013 (95% CI = 0.006–0.023). The findings of this study suggest that clinical practice can be improved through more comprehensive diabetes self-management interventions that promote all of the components of health literacy, social contacts/networks, and self-efficacy in particular.

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 Predictors of Diabetes Self-Management among Type 2 Diabetes Patients

2016 ◽  
Vol 2016 ◽  
pp. 1-7 ◽  
Author(s):  
Azylina Gunggu ◽  
Chang Ching Thon ◽  
Cheah Whye Lian
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Family Support ◽  
Self Efficacy ◽  
Fasting Blood Glucose ◽  
Health Concern ◽  
Self Management ◽  
Cross Sectional ◽  
The Mean

Diabetes mellitus is a public health concern in Malaysia. Treatment of diabetes is costly and can lead to complications if disease is poorly controlled. Diabetes self-management (DSM) is found to be essential for optimal glycemic control. This cross-sectional study was conducted among samples from four randomly selected diabetes clinics in Sarawak, Malaysia. The aim was to determine the predictors for DSM. Face-to-face interview using questionnaire was used to collect data. Four hundred respondents with type 2 diabetes mellitus (T2DM) were recruited. Majority of the respondents were Sarawak Bumiputra (Iban and Bidayuh, 48.6%) and female (68.6%). The mean age was 58.77 years (SD = 11.46) and approximately half of the respondents (50.6%) had T2DM for six years (SD = 4.46). The mean fasting blood glucose (FBG) was 8.06 mmol/L (SD = 2.94), with majority (76.1%) having the level higher than 6.1 mmol/L. Multiple logistic regression tests showed significant linear relationship between DSM and belief in treatment effectiveness (p=0.001), family support (p=0.007), and self-efficacy (p=0.027). Health care personnel must convince patients with T2DM of the effectiveness of the treatment, empower and enhance their self-efficacy, and enlist the family support so as to ensure patients sustain their DSM efforts.

scholarly journals A Cross-Sectional Analysis of the Stigma Surrounding Type 2 Diabetes in Colombia

2021 ◽  
Vol 18 (23) ◽  
pp. 12657
Author(s):  
Victor Pedrero ◽  
Jorge Manzi ◽  
Luz Marina Alonso
Keyword(s):  
Type 2 Diabetes ◽  
Health Care ◽  
Self Efficacy ◽  
Self Esteem ◽  
Self Management ◽  
Psychosocial Variables ◽  
Cross Sectional ◽  
The Relationship ◽  
Management Behaviors

Type 2 diabetes is a global epidemic, and many people feel stigmatized for having this disease. The stigma is a relevant barrier to diabetes management. However, evidence in this regard is scarce in Latin America. This study aimed to analyze the level of stigma surrounding type 2 diabetes in the Colombian population and its relationships with sociodemographic, clinical, psychosocial variables and behaviors related to management of the disease (self-management behaviors). This cross-sectional study included 501 Colombian adults with type 2 diabetes. We estimated the relation between stigma and selected variables through linear regression models. Additionally, we analyzed the mediator role of psychosocial variables in the relationship between stigma and self-management behaviors through structural equation models. A total of 16.4% of patients showed concerning levels of stigma. The time elapsed since diagnosis (β = −0.23) and socioeconomic status (β = −0.13) were significant predictors of the level of stigma. Stigma was negatively correlated with self-efficacy (β = −0.36), self-esteem (β = −0.37), and relationship with health care provider (β = −0.46), and positively correlated with stress (β = 0.23). Self-efficacy, self-esteem, and the relationships with health care providers had a mediation role in the relationship between stigma and self-management behaviors. These variables would be part of the mechanisms through which the perception of stigma harms self-management behaviors. The stigma of type 2 diabetes is frequent in the Colombian population and negatively associated with important aspects of disease management.

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.

Social Support, Self-Efficacy, and Psychological Wellbeing of Adults with Type 2 Diabetes

2020 ◽  
pp. 019394592092110
Author(s):  
Tariq N. Al-Dwaikat ◽  
Jehad A. Rababah ◽  
Mohammed Munther Al-Hammouri ◽  
Diane Orr Chlebowy
Keyword(s):  
Social Support ◽  
Type 2 Diabetes ◽  
Self Efficacy ◽  
Psychological Outcomes ◽  
Self Management ◽  
Diabetes Clinic ◽  
Cross Sectional ◽  
Cross Sectional Design ◽  
The Relationship

Social support improves self-efficacy, which in turns enhances self-management that lead to better psychological outcomes of persons with type 2 diabetes (T2D). The purpose of this study was to examine the relationship between social support and psychological outcomes of adults with T2D. A cross-sectional design was used to recruit a sample of 339 participants from a diabetes clinic. The participants responded to a series of questionnaires on demographics, social support dimensions, and self-management; self-efficacy; and psychological outcomes. The function and quality of social support were positively associated with self-efficacy. Self-efficacy was significantly associated with both self-management and psychological outcomes. In addition, self-efficacy demonstrated successful mediation role in the relationship between social support and psychological outcomes of T2D, however, self-management failed to mediate this relationship. The quality and functionality of social support are distinctive variables that should be recognized to promote social support interventions to reduce or prevent T2D-related psychological outcomes.

Effectiveness of Smartphone-Based Self-Management Interventions on Self-care and Health Relevant Outcomes in Patients with Type 2 Diabetes: A Systematic Review and Meta-analysis (Preprint)

2018 ◽  
Author(s):  
Haziqah Binte Aminuddin ◽  
Nana Jiao ◽  
Ying Jiang ◽  
Jingfang Hong ◽  
Wenru Wang
Keyword(s):  
Type 2 Diabetes ◽  
Self Efficacy ◽  
Meta Analysis ◽  
Self Care ◽  
Self Management ◽  
Significant Heterogeneity ◽  
Major Health Problem ◽  
Management Interventions

BACKGROUND Type 2 Diabetes Mellitus (T2DM) is a major health problem worldwide. Proper self-management can improve health outcomes and reduces risk of diabetic complications. Recently, smartphone-based technology has been used for self-management programs but their effectiveness in improving self-efficacy, self-care activities, health-related quality of life (HRQoL) and clinical outcomes for patients with T2DM is not well understood. OBJECTIVE To review the evidence and determine the effectiveness of smartphone-based self-management interventions on self-efficacy, self-care activities, HRQoL, glycated haemoglobin (HbA1c), body mass index (BMI), blood pressure (BP) levels of adults with T2DM. METHODS A systematic search of five databases (PubMed, Embase, Cochrane, CINAHL and Scopus) was conducted. Study published in English, from January 2007 to January 2018, were considered. Only randomised controlled trials (RCTs) of smartphone-based self-management interventions for patients with T2DM that reported any of the study outcomes were included. Two reviewers independently screened the studies, extracted data and assessed the quality of the studies. Meta-analyses were conducted for the different study outcomes. RESULTS A total of 26 articles, consisting of 22 studies with 2645 participants were included in the review. A meta-analysis conducted on self-efficacy revealed a large improvement of 0.98 (95% confidence interval [CI] 0.42 to 1.55; P < 0.001) with smartphone-based self-management interventions. The effect size on self-care activities was also large (d = 0.90; 95% CI 0.24 to 1.57; P < 0.001). Significant heterogeneity was present among studies pooled for both outcomes and subgroup analyses were conducted for self-efficacy. Smartphone-based self-management interventions also gave a small improvement on HRQoL (d = 0.26; 95% CI 0.06 to 0.47; P = .01) and a significant reduction in HbA1c (pooled MD = -0.55; 95% CI -0.60 to -0.40; P < 0.001). The effects on BMI and BP were not statistically significant. CONCLUSIONS Smartphone-based self-management interventions appear to have beneficial effects on self-efficacy, self-care activities and health-relevant outcomes for patients with T2DM. However, more research with good study designs is needed to evaluate the effectiveness of smartphone-based self-care interventions for T2DM. CLINICALTRIAL NA

scholarly journals Gender Difference in Care of Type 2 Diabetes

2013 ◽  
Vol 52 (189) ◽  
pp. 245-250 ◽  
Author(s):  
Aamod Dhoj Shrestha ◽  
Kalpana Kosalram ◽  
Vijayaprasad Gopichandran
Keyword(s):  
Type 2 Diabetes ◽  
Gender Differences ◽  
Gender Difference ◽  
Diabetes Care ◽  
Self Efficacy ◽  
Cross Sectional Study ◽  
Self Management ◽  
Dietary Practices ◽  
Cross Sectional

Introduction: Biologically male and female have similar diabetes prevalence. Gender differences in the social structure bring differences in life style modifications and all other self care behaviors in type 2 diabetes. The primary purpose of this study was to assess the gender difference in care of type 2 diabetes in Western region, Nepal.   Methods: Hundred men and hundred women respondents participated in a cross-sectional study conducted in two hospitals in Pokhara, Nepal. A pre-tested questionnaire was administered to each of the respondents. Results: Dry mouth (χ2 = 3.977, P = 0.046) and abdominal pain (χ2 = 3.840, P = 0.050) were reported as symptoms of diabetes in 51% and 31% women compared to 37% and 19% men respectively. The study revealed that women had low self-efficacy with respect to their diabetes care (35%) in comparison to men (65%). There was significant association between gender and diet practices which showed men have 0.328 (95% CI: 0.184 - 0.585) times less chances of bad dietary practices compared to women. After adjusting for age, education, occupation and self-efficacy, men were less likely to have bad dietary practices (OR= 0.513, 95% CI: 0.266, 0.992). Conclusions: The result of this study provided evidence that there are gender differences in reporting of symptoms, mode of diagnosis and certain self-management behaviors. Therefore there is a need to design gender specific behavior change communication strategies for better management of type 2 diabetes.Keywords: diabetes care; gender; self-efficacy; self-management.

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.

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