Impact of social role strain, depression, social support and age on diabetes self-efficacy in Korean women with type 2 diabetes

This study describes levels of role strain, diabetes mellitus (DM)-related self-efficacy, depression, and social support in middle-aged Korean women with type 2 DM. Using a cross-sectional correlational survey design, we examined the relationships among these constructs in a purposive sample of 154 Korean women (40-65 years old) residing in Cheon-An, a midsized city in South Korea, who had had a diagnosis of type 2 DM for 6 or more months. Our findings indicated that significant numbers of these women are experiencing significant role strain (52.43 [SD, 8.81]) and are at risk for clinical depression (30%). In bivariate analysis, the level of role strain was negatively associated with diabetes self-efficacy (r = -0.27, P < .01), whereas social support was positively associated with diabetes self-efficacy (r = 0.22, P < .05). A multivariate analysis confirmed that social role strain (β = -.33, P = .00), social support (β = 0.19, P = .05), and age (β = 0.19 P = .03) were statistically significant predictors of DM-related self-efficacy. These findings highlight the importance of social role strain in managing DM and point to the need for appropriate interventions that incorporate the ways to relieve the role strain experienced by this highly vulnerable population.     

Testing a conceptual framework for diabetes self-care management

Diabetes is a major source of morbidity, mortality, and economic expense in the United States. The majority of researchers and clinicians believe that diabetes is a self-care management disease, and that patients should be reliable, capable, and sufficiently responsible to take care of themselves. However, individuals with diabetes may or may not have diabetes knowledge, social support, self-care agency (an individual's capability to perform self-care actions), and self-efficacy (an individual's beliefs in his or her capability to perform self-care actions) that would help them to engage in diabetes self-care management. Therefore, this study examined the relationship among those factors using a cross-sectional model testing design. A convenient sample of 141 insulin-requiring individuals with either diabetes type 1 or type 2, 21 years old and over, was recruited from an outpatient diabetes care center located in a Southeast region of the United States. Simple linear regression, multiple standard regression, and multiple hierarchical regression were used to analyze the data. Individuals with greater diabetes knowledge had greater self-care agency and self-efficacy. Those with a higher score in social support had greater self-care agency and better diabetes self-care management, and those with greater self-efficacy had better diabetes self-care management. In addition, self-care agency mediated the effects of diabetes knowledge on self-efficacy and the effects of social support on diabetes self-care management. Self-efficacy mediated the effects of self-care agency on diabetes self-care management. Furthermore, the linear combination of diabetes knowledge, social support, self-care agency, and self-efficacy, taken together, positively affected diabetes self-care management. Enhancing an individual's diabetes knowledge, social support, self-care agency, and self-efficacy may be a strategy which can promote better engagement in diabetes self-care.     

Postpartum physical activity and related psychosocial factors among women with recent gestational diabetes mellitus

OBJECTIVE: In this study, we examined patterns of postpartum physical activity among women with recent gestational diabetes mellitus (GDM) and psychosocial factors related to this behavior that could be addressed in diabetes prevention interventions. RESEARCH DESIGN AND METHODS: A random sample of women who had attended diabetes clinics in Sydney, Australia, in the past 6-24 months for treatment of GDM were surveyed by telephone. Variables measured included physical activity behaviors, self-efficacy, social support, and barriers to participation. RESULTS: Of 226 women who completed the survey (mean age 33.4 years), 26.5% were classified as sedentary, and only 33.6% reported sufficient physical activity as recommended by health authorities. Walking was the most popular physical activity, and most women reported no other moderate- or vigorous-intensity activity. Lack of assistance with child care (49.1%) and insufficient time (37.6%) were the most common barriers to physical activity. The type of social support most often reported was verbal encouragement (39.1%), with more than half of the women never receiving assistance with housework or others exercising with them. Self-efficacy for physical activity was lowest when women were under time pressure or tired. Multivariate analyses showed that sufficient physical activity was associated with high social support (odds ratio 2.5 [95% CI 1.21-3.79]) and high self-efficacy (2.09 [1.06-3.20]). CONCLUSIONS: The prevalence of sufficient physical activity was found to be low and strongly related to social support and self-efficacy. This is an important group to whom diabetes prevention strategies can be targeted.     

An empirical study of self-efficacy and social support in diabetes self-management: implications for home healthcare nurses

This pilot study was conducted to evaluate relationships among self-efficacy, social support, social problem solving, and diabetes self-management in people living with Type 2 diabetes mellitus. Self-efficacy, social support, and social problem solving were significantly correlated with diabetes self-management. These relationships indicate the importance of including interventions to promote self-efficacy, social support, and social problem solving in diabetes self-management programs.     

Depression and diet-related distress among Japanese women with gestational diabetes mellitus

Although the association between gestational diabetes mellitus (GDM) and maternal postpartum depression has been reported, the association between these two factors during pregnancy has not been sufficiently examined. We compared pregnant women with and without GDM to clarify the association and examined factors related to depression in pregnant women with GDM. Questionnaires were administered longitudinally to pregnant Japanese women in the third trimester and at 2 and 4 weeks postpartum. One hundred and five and 108 pregnant women with and without GDM, respectively, were included in the study. Of the 105 women with GDM, 20 (19.0%) reported being depressed during pregnancy, which was significantly higher than that among those without GDM (9.3%). Binomial logistic regression analysis revealed that depression was significantly positively associated with diet-related distress and negatively associated with social support among women with GDM. Diet-related distress and social support are important factors in managing depression in pregnant women with GDM.     

广州市2型糖尿病患者治疗依从性影响因素的研究

目的 探讨影响2型糖尿病患者治疗依从性的因素,为健康教育及预防保健提供指导依据.方法 在广州市4家三级甲等医院用方便抽样的方法 ,连续选择符合纳入排除标准的2型糖尿病患者504例作为涮查对象,采用自行设计的问卷对入选患者进行一对一调查,内容包括一般情况、治疗依从性、糖尿病知识、社会支持和自我效能等.用相关分析以及多元线性回归分析探讨2型糖尿病患者治疗依从性的影响因素.结果 2型糖尿病患者药物治疗依从性与自我效能呈显著正相关,患者的自我效能越高,其药物治疗依从性就越好;患者的年龄越大、得到的主观和客观社会支持越多、自我效能水平越高,饮食治疗的依从性就越好;患者的客观社会支持和社会支持利用度越高,其进行血糖监测的依从性也就越好;其生活方式越健康.结论 2型糖尿病患者的治疗依从性与多种因素相关,提高患者的自我效能和开展健康教育是提高患者治疗依从性的关键.     

广州市2型糖尿病患者治疗依从性影响因素的研究

目的 探讨影响2型糖尿病患者治疗依从性的因素,为健康教育及预防保健提供指导依据.方法 在广州市4家三级甲等医院用方便抽样的方法 ,连续选择符合纳入排除标准的2型糖尿病患者504例作为涮查对象,采用自行设计的问卷对入选患者进行一对一调查,内容包括一般情况、治疗依从性、糖尿病知识、社会支持和自我效能等.用相关分析以及多元线性回归分析探讨2型糖尿病患者治疗依从性的影响因素.结果 2型糖尿病患者药物治疗依从性与自我效能呈显著正相关,患者的自我效能越高,其药物治疗依从性就越好;患者的年龄越大、得到的主观和客观社会支持越多、自我效能水平越高,饮食治疗的依从性就越好;患者的客观社会支持和社会支持利用度越高,其进行血糖监测的依从性也就越好;其生活方式越健康.结论 2型糖尿病患者的治疗依从性与多种因素相关,提高患者的自我效能和开展健康教育是提高患者治疗依从性的关键.     

Self-Efficacy,Depression, and Self-Care Activities in Adult Jordanians with Type 2 Diabetes: The Role of Illness Perception

Diabetes mellitus is reaching epidemic levels worldwide. In a developing country like Jordan, type 2 diabetes mellitus (T2DM) has reached a prevalence rate of 17.1%. This cross-sectional study examined the relationship between self-care activities and: illness perception, depression, social support, religiosity and spiritual coping, and self-efficacy among patients with T2DM. A random sample of 220 patients with T2DM, who attended Jordan University Hospital in Jordan were enrolled. The data were collected through a structured interview and the medical files. The instruments consisted of a sociodemographic and clinical standardised questionnaires: Brief Illness Perception Questionnaire, Patients’ Health Questionnaire-9; ENRICH Social Support Instrument; Religious and Spiritual Coping Subscale; Diabetes Management Self-Efficacy Scale; and Summary of Diabetes Self-Care Activities. Bivariate analysis investigated the relationship between variables. Structure Equation Modelling (SEM) was performed to test the proposed conceptual model. The study found that approximately 70% of the respondents suffered some form of depressive symptoms. The SEM showed a direct relationship between self-efficacy and self-care activities (β = 0.40; p < 0.001). Depression was indirectly related to self-care activities through self-efficacy (β = –0.20; p = 0.003); nevertheless, it was directly related to perception of: treatment control, consequences, and emotional representations. Overall, the sequence between illness perception and self-efficacy was mediated by depression. Strategies to promote self-efficacy and illness perception are vital in customising a diabetes health plan to meet Arabic cultural expectations.     

Long-term changes of psychological factors regarding exercise in patients with type 2 diabetes after discharge and the effect of these changes on glycemic control

[Purpose] In the medical treatment guidelines for type 2 diabetes, the utility of the approach using self-efficacy and stage of change has been previously demonstrated. Although the effects of short-term approaches have been shown, a few studies have examined long-term changes over time. The purpose of the present study was to investigate longitudinally the factors that affect the stage of change, self-efficacy for exercise, and glycemic control for 12 months in patients with type 2 diabetes after the intervention of the disease by receiving diabetes and glycemic control education. [Participants and Methods] The study included 29 patients with type 2 diabetes as participants who were able to follow up for 12 months after the intervention. The changes over time were investigated using stage of change and self-efficacy as psychological indicators of exercise. Factors affecting HbA1c values after 12 months of intervention were examined with information on diabetes and social background. [Results] There was no significant difference in self-efficacy for exercising at 3, 6, and 12 months after discharge. In contrast, participants in the stage of change showed a significant improvement at 6 and 12 months after discharge in comparison to 3 months after discharge. HbA1c values decreased at 12 months while comparing patients after 3 months and 12 months after discharge. The only factor affecting HbA1c value 12 months after discharge was the duration of diabetes. [Conclusion] The results suggested that stage of change and self-efficacy for exercise might have a little long-term effect on glycemic control.     

社区慢性腰背痛患者自我效能水平及其影响因素

目的调查社区慢性腰背痛患者自我效能水平并分析其影响因素。方法 2014年4月至2015年1月,便利抽样法选取南京市玄武区、栖霞区、河西新区以及常州市天宁区等8个社区的慢性腰背痛患者157例为研究对象,采用一般情况调查表、长海痛尺、慢性病管理自我效能感量表、简易应对方式问卷、简明健康状况量表、中文版恐惧-回避行为量表、社会支持评定量表和综合医院焦虑抑郁量表对其进行调查。结果慢性腰背痛患者自我效能得分为(6.55±1.89)分。患者对于腰背痛感觉描述中使用频率最高的是"痉挛牵扯痛"、"持续固定痛"和"腰痛"。不同婚姻状况及文化程度患者的自我效能评分的差异均有统计学意义(均P0.05)。慢性腰背痛患者自我效能与其当前疼痛、积极应对、生理功能、生理职能、躯体疼痛、总体健康、活力、社会职能、情感职能、情感健康、恐惧-回避信念总分、社会支持总分、焦虑得分和抑郁得分等14个变量均具有相关性(均P0.05)。多元线性回归结果显示,生理职能、总体健康、社会支持和积极应对是慢性腰背痛患者自我效能的主要影响因素。结论建议相关部门针对社区慢性腰背痛患者自我效能的主要影响因素制定相关政策,从而提高其自我效能水平。     

An examination of social support influences on participation for older adults with chronic health conditions

Abstract

Social support can improve participation in everyday activities among older adults with chronic health conditions, but the specific types of support that are needed are unclear. Purpose: This study examined the types of social support that most strongly predict participation in everyday activities. Method: Two hundred and twenty-seven participants completed a self-administered cross-sectional survey. The sample included adults aged 60 years or more with arthritis, diabetes, chronic obstructive pulmonary disease and/or heart disease. Participation was defined as satisfaction with participation in 11 life areas. Social support was defined as availability of tangible, affectionate, emotional/informational and positive social interaction support. Results: Multiple regression analyses showed that participants who perceived greater tangible support and positive social interaction support had higher satisfaction with participation than participants with lower levels of these types of support. Conclusions: Targeting and developing tangible and social interaction support may help to facilitate satisfaction with participation for older adults with chronic conditions. Creating networks for companionship appears equally as important as providing support for daily living needs.

• Implications for Rehabilitation

• Varying types of social support can improve participation in older adults with chronic health conditions.

• Tangible support and positive social interaction support are the strongest predictors of participation.

• Creating networks for companionship may be equally as important as providing support for daily living needs.

     

The moderating effect of social cognitive factors on self-management activities and HbA1c in Thai adults with type-2 diabetes

BackgroundDiabetes mellitus (DM) has become a serious chronic disease. Self-management strategies help persons with DM make choices which will develop skills needed to reach their goal of blood glucose control and allow them to be successful in reaching goals.ObjectiveTo examine the impact of self-management activities on HbA1c for persons with DM and to examine the impact of social support, self-efficacy and Buddhist values as moderators on the relationship between the self-management activities and HbA1c.MethodThis study is a cross-sectional design. The sample included 401 Thai adults diagnosed with type 2 diabetes, aged 20–65 years old who had at least one HbA1c test in the last three months were recruited. Participants completed four questionnaires to measure self-management activities, as well as self-efficacy, Buddhist values and social support as moderating factors on self-management activities and HbA1c.ResultsThe self-management activities were negatively associated (β = −2.05, p ≤ 0.001) with HbA1c. The Social support, self-efficacy and Buddhist values had a significant interaction effect between selfmanagement activities and HbA1c (β = −0.97, p ≤ 0.05, β = −0.18, p ≤ 0.05 and β = −2.76, p ≤ 0.001).ConclusionThe diabetes self-management activities were more strongly associated with HbA1c under conditions of high social support, self-efficacy and health beliefs with Buddhist values. Future interventions for T2DM self-management programs should incorporate mechanisms to measure and support these factors.     

鼻咽癌患者自我效能水平及其相关因素分析

目的了解鼻咽癌患者的自我效能水平及其相关因素,为制定护理干预措施提供科学依据。方法采用一般自我效能感量表、社会支持评定量表、抑郁自评量表、简易应对方式问卷量表及个人一般情况调查表对140例鼻咽癌住院患者进行调查。结果鼻咽癌患者自我效能得分均值为（27．33±4．49）分,与社会支持、积极应对方式、文化程度、经济状况呈正相关,与抑郁程度、消极应对方式呈负相关。结论多方面因素影响着鼻咽癌患者的自我效能水平,护理人员应通过有效的护理干预措施提高患者的自我效能水平,从而提高患者的身心健康及生活质量。     

The protective role of tangible support on post-traumatic stress disorder symptoms in urban women survivors of violence

We examined social support as a protective factor in the relationship between lifetime exposure to traumatic events and Post-Traumatic Stress Disorder (PTSD) symptomatology among urban women. Seventy-six women who sought care in a trauma center for injuries from physical or sexual violence completed an interview. When tangible support, rather than total social support, and the interaction of tangible support and lifetime trauma were tested, tangible support moderated the relationship between lifetime trauma and PTSD. Given the complex etiology of lifetime trauma, risk for future trauma and the health needs of women who have experienced trauma, a broader range of intervention strategies that include attention to tangible support need to be developed and evaluated.     

Epilepsy self-management: Partial replication and extension

The purpose of this study was to determine the association between selected social cognitive variables and self-management behaviors among a sample of adults with epilepsy. The study, based on Social Cognitive Theory, was a partial replication and extension of a previous study that explored the role of self-efficacy and social support in epilepsy self-management. The variables examined in the present study were self-efficacy, social support, regimen-specific support, self-esteem, and self-management. Data collected from 80 adults attending an epilepsy clinic were analyzed using correlation and regression procedures. Statistically significant relationships were found between self-efficacy and self-management and between regimen-specific support and self-management. Regression analyses revealed that self-efficacy and regimen-specific support made significant contributions to the variance in self-management, whereas social support and self-esteem did not.     

妊娠期糖尿病病人自我管理现状及相关影响因素调查分析

目的:探讨妊娠期糖尿病(GDM)病人自我管理现状及相关影响因素。方法:选取2016年6月—2019年6月于医院建档产检的GDM病人398例作为研究对象。通过问卷调查法收集病人一般资料、临床资料及自我管理现状情况进行回顾性分析,采用单因素分析法分析其自我管理的相关影响因素、多元线性回归分析法分析其独立影响因素。结果:GMD病人自我管理总分为(58.94±3.76)分。单因素分析显示,孕周、居住地、文化程度、家庭收入、付费方式、分娩次数、焦虑程度、自我效能及社会支持为GDM病人自我管理的相关影响因素(P<0.05);多元线性回归分析显示,居住地、付费方式、分娩次数、自我效能及社会支持为GDM病人自我管理的独立影响因素。结论:GDM病人自我管理水平处于一般水平,居住地、付费方式、分娩次数、自我效能及社会支持为GDM病人自我管理的独立影响因素,帮助病人提高其自我效能感是提高其自我管理水平的有效方式。