Self‐efficacy and self‐care behavior of Malaysian patients with type 2 diabetes: a cross sectional survey

This study investigated the association between self‐efficacy and self‐care behavior to determine the degree of self‐efficacy and to examine differences in self‐efficacy according to patient variables, including state of health, of Malaysian patients with type 2 diabetes. The sample comprised 388 patients (respondents). We collected the data from December 2010 to February 2011. We found a significant positive relationship between self‐efficacy and self‐care behavior (r_s = 0.481, P < 0.001). The degree of self‐efficacy was moderately high (mean = 7.570). We found significant differences between self‐efficacy and education level (Wilk's Lambda = 0.918, F[12, 1008] = 2.779, P < 0.05), duration of diabetes (Wilk's Lambda = 0.954, F[8, 736] = 2.264, P < 0.05), other chronic conditions (Wilk's Lambda = 0.967, F[4, 383] = 3.304, P < 0.05) and diabetic complications (Wilk's Lambda = 0.963, F[4, 383] = 3.653, P < 0.05). Self‐efficacy can be used as a model to understand self‐care behavior. Individualized nursing interventions based on self‐efficacy theory should be utilized in high risk diabetic patients so as to assist and improve self‐care behavior.     

Effectiveness of a community‐based diabetes self‐management intervention for Chinese adults with type 2 diabetes: A pilot study

This pilot study examined the effects of an intervention on diabetes knowledge and self‐management among adults with type 2 diabetes in Wuhan, China. A convenience sample of 29 adults with type 2 diabetes participated in a 6‐week diabetes intervention in a community health center. Data on diabetes knowledge, diabetes self‐management, fasting blood glucose level, blood pressure, body mass index and waist circumference were collected pre‐ and postintervention and at 1‐month follow‐up. The level of diabetes knowledge was significantly greater postintervention, increasing from a score of 12.97 (± 4.04) to 17.14 (± 3.00) and remaining at 17.03 (± 2.23) at 1‐month follow‐up; Significant improvements in self‐monitoring of blood glucose and medication adherence were not found after the intervention. However, fasting blood glucose levels showed a significant decrease from baseline to postintervention and 1‐month follow‐up. Diabetes self‐management education was thus an effective way to improve diabetes self‐care in this Chinese sample.     

Self‐management practices of Chinese Americans with type 2 diabetes

The purpose of this study was to examine the level of diabetes self‐management and its association with demographic and diabetes‐related characteristics in Chinese Americans with type 2 diabetes. A questionnaire that measured diabetes self‐management and diabetes‐related characteristics was administered to a sample of 211 Chinese Americans with type 2 diabetes living in America. The results indicated that the participants were likely to take medications but less likely to carry out diet, physical activity, self‐monitoring of blood glucose, and foot care behaviors. Associations between diabetes self‐management and demographic and diabetes‐related characteristics were observed. For example, individuals who had less education and were employed were less likely to engage in diabetes self‐management than those with higher education and who were retired, while individuals who had a longer duration of diabetes and used insulin as a treatment more frequently carried out self‐monitoring than those who had a shorter duration of diabetes and used oral hypoglycemic agents. These findings indicate that the self‐management practices among the participants are suboptimal. Research on developing culturally and linguistically appropriate interventions to promote diabetes self‐management for Chinese Americans is warranted.     

Effectiveness of a self‐management support program for Thais with type 2 diabetes: Evaluation according to the RE‐AIM framework

Delivering diabetes self‐management support is an enormous challenge for healthcare providers with limited human resources. We conducted a cluster randomized controlled trial to assess the effectiveness of a DSMS program incorporating the computer‐assisted instruction. The RE‐AIM (Reach, Effectiveness, Adoption, Implementation, and Maintenance) framework was applied to evaluate the DSMS program. Ten Public Health Centers in Bangkok, Thailand were randomized into either DSMS program or usual care. Forty eligible patients with type 2 diabetes in each Public Health Center were randomly selected. Totally, 403 patients (200 controls and 203 interventions) participated. About 93.8% participants completed the six‐month follow‐up. Over six months, adjusted mean changes of hemoglobin A1c (?0.14%, 95% confidence interval = ?0.02 to ?0.26, fasting plasma glucose (?6.37 mg/dL, ?1.95 to ?10.78), health behaviors (3.31 score, 2.27 to 4.34), and quality of life (1.41 score, 0.69 to 2.12) were significantly improved in intervention compared to control group. In conclusion, the DSMS program facilitates Public Health Centers to accomplish their support for people with diabetes.