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Erschienen in: Quality of Life Research 2/2017

03.09.2016

Self-management behavior among patients with diabetic retinopathy in the community: a structural equation model

verfasst von: Li Yang, Qunhong Wu, Yanhua Hao, Yu Cui, Libo Liang, Lijun Gao, Mingli Jiao, Ning Ning, Hong Sun, Zheng Kang, Liyuan Han, Ye Li, Hui Yin

Erschienen in: Quality of Life Research | Ausgabe 2/2017

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Abstract

Purpose

Diabetic retinopathy (DR) is an important, chronic complication of diabetes, requiring competent self-management that depends on adherence to behavioral regimens. This study attempted to identify factors influencing self-management behaviors and develop a model illustrating the interdependence of several factors associated with DR patients.

Methods

In June–December 2012, 368 patients with DR completed questionnaires assessing self-management behavior, diabetes knowledge, health beliefs, social support, and treatment adherence. Structural equation modeling was used to test predicted pathways linking self-management behavior to diabetes knowledge, health beliefs, social support, and treatment adherence.

Results

The results indicated that health beliefs, treatment adherence, and duration of diabetes each had a direct impact on diabetes self-management (p < 0.05). Diabetes knowledge only indirectly influenced diabetes self-management, through health beliefs. Social support had a direct impact on diabetes self-management (β = 0.35, p < 0.01), and an indirect influence on diabetes self-management, through treatment adherence (β = 0.77, p < 0.01).

Conclusion

Health beliefs, treatment adherence, and social support directly affect diabetes self-management, and diabetes knowledge indirectly affects diabetes self-management. This suggests that enhancing DR patients’ health beliefs, treatment adherence, and social support would facilitate their diabetes self-management. Meanwhile, improved health education can strengthen diabetes knowledge, which in turn, can positively affect diabetes self-management.
Literatur
1.
Zurück zum Zitat Nagelkerk, J., Reick, K., & Meengs, L. (2006). Perceived barriers and effective strategies to diabetes self-management. Journal of Advanced Nursing, 54(2), 151–158.CrossRefPubMed Nagelkerk, J., Reick, K., & Meengs, L. (2006). Perceived barriers and effective strategies to diabetes self-management. Journal of Advanced Nursing, 54(2), 151–158.CrossRefPubMed
2.
Zurück zum Zitat Tumosa, N. (2008). Eye disease and the older diabetic. Clinics in Geriatric Medicine, 24(3), 515–527.CrossRefPubMed Tumosa, N. (2008). Eye disease and the older diabetic. Clinics in Geriatric Medicine, 24(3), 515–527.CrossRefPubMed
3.
Zurück zum Zitat Glasgow, R. E., & Anderson, R. M. (1999). In diabetes care, moving from compliance to adherence is not enough. Something entirely different is needed. Diabetes Care, 22(12), 2090–2092.CrossRefPubMed Glasgow, R. E., & Anderson, R. M. (1999). In diabetes care, moving from compliance to adherence is not enough. Something entirely different is needed. Diabetes Care, 22(12), 2090–2092.CrossRefPubMed
4.
Zurück zum Zitat Peeples, M., Tomky, D., Mulcahy, K., Peyrot, M., & Siminerio, L. (2007). Evolution of the American Association of Diabetes Educators diabetes education outcomes project. The Diabetes Educator, 33(5), 794–817.CrossRefPubMed Peeples, M., Tomky, D., Mulcahy, K., Peyrot, M., & Siminerio, L. (2007). Evolution of the American Association of Diabetes Educators diabetes education outcomes project. The Diabetes Educator, 33(5), 794–817.CrossRefPubMed
5.
Zurück zum Zitat Sousa, V. D., Zauszniewski, J. A., Musil, C. M., Price, L. P. J., & Davis, S. A. (2005). Relationships among self-care agency, self-efficacy, self-care, and glycemic control. Research and Theory for Nursing Practice, 19(3), 217–230.CrossRefPubMed Sousa, V. D., Zauszniewski, J. A., Musil, C. M., Price, L. P. J., & Davis, S. A. (2005). Relationships among self-care agency, self-efficacy, self-care, and glycemic control. Research and Theory for Nursing Practice, 19(3), 217–230.CrossRefPubMed
6.
Zurück zum Zitat Funnell, M. M., Brown, T. L., Childs, B. P., Haas, L. B., Hosey, G. M., Jensen, B., et al. (2012). National standards for diabetes self-management education. Diabetes Care, 35(Suppl 1), S101–S108.CrossRefPubMed Funnell, M. M., Brown, T. L., Childs, B. P., Haas, L. B., Hosey, G. M., Jensen, B., et al. (2012). National standards for diabetes self-management education. Diabetes Care, 35(Suppl 1), S101–S108.CrossRefPubMed
7.
Zurück zum Zitat Patel, A., MacMahon, S., Chalmers, J., Neal, B., Billot, L., Woodward, M., et al. (2008). Intensive blood glucose control and vascular outcomes in patients with type 2 diabetes. The New England Journal of medicine, 358(24), 2560–2572.CrossRefPubMed Patel, A., MacMahon, S., Chalmers, J., Neal, B., Billot, L., Woodward, M., et al. (2008). Intensive blood glucose control and vascular outcomes in patients with type 2 diabetes. The New England Journal of medicine, 358(24), 2560–2572.CrossRefPubMed
8.
Zurück zum Zitat Yu, D. S., Lee, D. T., & Woo, J. (2004). Psychometric testing of the Chinese version of the medical outcomes study social support survey (MOS-SSS-C). Research in Nursing and Health, 27(2), 135–143.CrossRefPubMed Yu, D. S., Lee, D. T., & Woo, J. (2004). Psychometric testing of the Chinese version of the medical outcomes study social support survey (MOS-SSS-C). Research in Nursing and Health, 27(2), 135–143.CrossRefPubMed
9.
Zurück zum Zitat Nam, S., Chesla, C., Stotts, N. A., Kroon, L., & Janson, S. L. (2011). Barriers to diabetes management: Patient and provider factors. Diabetes Research and Clinical Practice, 93(1), 1–9.CrossRefPubMed Nam, S., Chesla, C., Stotts, N. A., Kroon, L., & Janson, S. L. (2011). Barriers to diabetes management: Patient and provider factors. Diabetes Research and Clinical Practice, 93(1), 1–9.CrossRefPubMed
10.
Zurück zum Zitat Tang, T. S., Brown, M. B., Funnell, M. M., & Anderson, R. M. (2008). Social support, quality of life, and self-care behaviors among African Americans with type 2 diabetes. The Diabetes Educator, 34(2), 266–276.CrossRefPubMed Tang, T. S., Brown, M. B., Funnell, M. M., & Anderson, R. M. (2008). Social support, quality of life, and self-care behaviors among African Americans with type 2 diabetes. The Diabetes Educator, 34(2), 266–276.CrossRefPubMed
11.
Zurück zum Zitat Toljamo, M., & Hentinen, M. (2001). Adherence to self-care and social support. Journal of Clinical Nursing, 10(5), 618–627.CrossRefPubMed Toljamo, M., & Hentinen, M. (2001). Adherence to self-care and social support. Journal of Clinical Nursing, 10(5), 618–627.CrossRefPubMed
12.
Zurück zum Zitat Albright, T. L., Parchman, M., & Burge, S. K. (2001). Predictors of self-care behavior in adults with type 2 diabetes: An RRNeST study. Family Medicine, 33(5), 354–360.PubMed Albright, T. L., Parchman, M., & Burge, S. K. (2001). Predictors of self-care behavior in adults with type 2 diabetes: An RRNeST study. Family Medicine, 33(5), 354–360.PubMed
13.
Zurück zum Zitat Garay-Sevilla, M. E., Nava, L. E., Malacara, J. M., Huerta, R., de Leon, J. D., Mena, A., et al. (1995). Adherence to treatment and social support in patients with non-insulin dependent diabetes mellitus. Journal of Diabetes and its Complications, 9(2), 81–86.CrossRefPubMed Garay-Sevilla, M. E., Nava, L. E., Malacara, J. M., Huerta, R., de Leon, J. D., Mena, A., et al. (1995). Adherence to treatment and social support in patients with non-insulin dependent diabetes mellitus. Journal of Diabetes and its Complications, 9(2), 81–86.CrossRefPubMed
14.
Zurück zum Zitat Chlebowy, D. O., & Garvin, B. J. (2006). Social support, self-efficacy, and outcome expectations: Impact on self-care behaviors and glycemic control in Caucasian and African American adults with type 2 diabetes. The Diabetes Educator, 32(5), 777–786.CrossRefPubMed Chlebowy, D. O., & Garvin, B. J. (2006). Social support, self-efficacy, and outcome expectations: Impact on self-care behaviors and glycemic control in Caucasian and African American adults with type 2 diabetes. The Diabetes Educator, 32(5), 777–786.CrossRefPubMed
15.
Zurück zum Zitat Rodrigues, F. F., Zanetti, M. L., dos, S. M. A., Martins, T. A., Sousa, V. D., & de Sousa Teixeira, C. R. (2009). Knowledge and attitude: Important components in diabetes education. Revista Latino-Americana de Enfermagem, 17(4), 468–473.CrossRefPubMed Rodrigues, F. F., Zanetti, M. L., dos, S. M. A., Martins, T. A., Sousa, V. D., & de Sousa Teixeira, C. R. (2009). Knowledge and attitude: Important components in diabetes education. Revista Latino-Americana de Enfermagem, 17(4), 468–473.CrossRefPubMed
16.
Zurück zum Zitat Mazzuca, S. A. (1982). Does patient education in chronic disease have therapeutic value. Journal of Chronic Diseases, 35(7), 521–529.CrossRefPubMed Mazzuca, S. A. (1982). Does patient education in chronic disease have therapeutic value. Journal of Chronic Diseases, 35(7), 521–529.CrossRefPubMed
17.
Zurück zum Zitat Harvey, J. N., & Lawson, V. L. (2009). The importance of health belief models in determining self-care behaviour in diabetes. Diabetic Medicine: A Journal of the British Diabetic Association, 26(1), 5–13.CrossRef Harvey, J. N., & Lawson, V. L. (2009). The importance of health belief models in determining self-care behaviour in diabetes. Diabetic Medicine: A Journal of the British Diabetic Association, 26(1), 5–13.CrossRef
18.
Zurück zum Zitat Brownlee-Duffeck, M., Peterson, L., Simonds, J. F., Goldstein, D., Kilo, C., & Hoette, S. (1987). The role of health beliefs in the regimen adherence and metabolic control of adolescents and adults with diabetes mellitus. Journal of Consulting and Clinical Psychology, 55(2), 139–144.CrossRefPubMed Brownlee-Duffeck, M., Peterson, L., Simonds, J. F., Goldstein, D., Kilo, C., & Hoette, S. (1987). The role of health beliefs in the regimen adherence and metabolic control of adolescents and adults with diabetes mellitus. Journal of Consulting and Clinical Psychology, 55(2), 139–144.CrossRefPubMed
19.
Zurück zum Zitat Gillibrand, R., & Stevenson, J. (2006). The extended health belief model applied to the experience of diabetes in young people. British Journal of Health Psychology, 11(Pt 1), 155–169.CrossRefPubMed Gillibrand, R., & Stevenson, J. (2006). The extended health belief model applied to the experience of diabetes in young people. British Journal of Health Psychology, 11(Pt 1), 155–169.CrossRefPubMed
20.
Zurück zum Zitat Zimet, G. D., Powell, S. S., Farley, G. K., Werkman, S., & Berkoff, K. A. (1990). Psychometric characteristics of the multidimensional scale of perceived social support. Journal of Personality Assessment, 55(3–4), 610–617.CrossRefPubMed Zimet, G. D., Powell, S. S., Farley, G. K., Werkman, S., & Berkoff, K. A. (1990). Psychometric characteristics of the multidimensional scale of perceived social support. Journal of Personality Assessment, 55(3–4), 610–617.CrossRefPubMed
21.
Zurück zum Zitat Guan, N. C., Huai, S. L., Hway, A. A. Y., & Ong, H. K. (2015). Factorial validity and reliability of the malaysian simplified chinese version of multidimensional scale of perceived social support (MSPSS-SCV) among a group of university students. Asia-Pacific Journal of Public Health, 27(2), 225–231.CrossRefPubMed Guan, N. C., Huai, S. L., Hway, A. A. Y., & Ong, H. K. (2015). Factorial validity and reliability of the malaysian simplified chinese version of multidimensional scale of perceived social support (MSPSS-SCV) among a group of university students. Asia-Pacific Journal of Public Health, 27(2), 225–231.CrossRefPubMed
22.
Zurück zum Zitat Toobert, D. J., Hampson, S. E., & Glasgow, R. E. (2000). The summary of diabetes self-care activities measure: Results from 7 studies and a revised scale. Diabetes Care, 23(7), 943–950.CrossRefPubMed Toobert, D. J., Hampson, S. E., & Glasgow, R. E. (2000). The summary of diabetes self-care activities measure: Results from 7 studies and a revised scale. Diabetes Care, 23(7), 943–950.CrossRefPubMed
23.
Zurück zum Zitat Wang, R. H., & Lin, C. C. (1998). Self-care behaviors and related factors in outpatients newly diagnosed with non-Insulin dependent. The Journal of Nursing (in Chinese), 4(5), 60–74. Wang, R. H., & Lin, C. C. (1998). Self-care behaviors and related factors in outpatients newly diagnosed with non-Insulin dependent. The Journal of Nursing (in Chinese), 4(5), 60–74.
24.
Zurück zum Zitat Hu, L. T., & Bentler, P. M. (1999). Cutoff criteria for fit indexes in covariance structure analysis: Conventional criteria versus new alternatives. Structural Equation Modeling, 6(1), 1–55.CrossRef Hu, L. T., & Bentler, P. M. (1999). Cutoff criteria for fit indexes in covariance structure analysis: Conventional criteria versus new alternatives. Structural Equation Modeling, 6(1), 1–55.CrossRef
25.
Zurück zum Zitat Hamta, A., Khalilian, A. R., Farhadi, R., & Ranjbaran, H. (2013). Path analysis of the risk of low birth weight for multipara. Iranian Red Crescent Medical Journal, 15(6), 462–466.CrossRefPubMedPubMedCentral Hamta, A., Khalilian, A. R., Farhadi, R., & Ranjbaran, H. (2013). Path analysis of the risk of low birth weight for multipara. Iranian Red Crescent Medical Journal, 15(6), 462–466.CrossRefPubMedPubMedCentral
26.
Zurück zum Zitat Gallant, M. P. (2003). The influence of social support on chronic illness self-management: A review and directions for research. Health Education and Behavior: The Official Publication of the Society for Public Health Education, 30(2), 170–195.CrossRef Gallant, M. P. (2003). The influence of social support on chronic illness self-management: A review and directions for research. Health Education and Behavior: The Official Publication of the Society for Public Health Education, 30(2), 170–195.CrossRef
27.
Zurück zum Zitat Rosland, A. M., Kieffer, E., Israel, B., Cofield, M., Palmisano, G., Sinco, B., et al. (2008). When is social support important? The association of family support and professional support with specific diabetes self-management behaviors. Journal of General Internal Medicine, 23(12), 1992–1999.CrossRefPubMedPubMedCentral Rosland, A. M., Kieffer, E., Israel, B., Cofield, M., Palmisano, G., Sinco, B., et al. (2008). When is social support important? The association of family support and professional support with specific diabetes self-management behaviors. Journal of General Internal Medicine, 23(12), 1992–1999.CrossRefPubMedPubMedCentral
28.
Zurück zum Zitat Mayberry, L. S., & Osborn, C. Y. (2012). Family support, medication adherence, and glycemic control among adults with type 2 diabetes. Diabetes Care, 35(6), 1239–1245.CrossRefPubMedPubMedCentral Mayberry, L. S., & Osborn, C. Y. (2012). Family support, medication adherence, and glycemic control among adults with type 2 diabetes. Diabetes Care, 35(6), 1239–1245.CrossRefPubMedPubMedCentral
29.
Zurück zum Zitat Xu, Y., Toobert, D., Savage, C., Pan, W., & Whitmer, K. (2008). Factors influencing diabetes self-management in Chinese people with type 2 diabetes. Research in Nursing and Health, 31(6), 613–625.CrossRefPubMed Xu, Y., Toobert, D., Savage, C., Pan, W., & Whitmer, K. (2008). Factors influencing diabetes self-management in Chinese people with type 2 diabetes. Research in Nursing and Health, 31(6), 613–625.CrossRefPubMed
30.
Zurück zum Zitat Chan, Y. M., & Molassiotis, A. (1999). The relationship between diabetes knowledge and compliance among Chinese with non-insulin dependent diabetes mellitus in Hong Kong. Journal of Advanced Nursing, 30(2), 431–438.CrossRefPubMed Chan, Y. M., & Molassiotis, A. (1999). The relationship between diabetes knowledge and compliance among Chinese with non-insulin dependent diabetes mellitus in Hong Kong. Journal of Advanced Nursing, 30(2), 431–438.CrossRefPubMed
Metadaten
Titel
Self-management behavior among patients with diabetic retinopathy in the community: a structural equation model
verfasst von
Li Yang
Qunhong Wu
Yanhua Hao
Yu Cui
Libo Liang
Lijun Gao
Mingli Jiao
Ning Ning
Hong Sun
Zheng Kang
Liyuan Han
Ye Li
Hui Yin
Publikationsdatum
03.09.2016
Verlag
Springer International Publishing
Erschienen in
Quality of Life Research / Ausgabe 2/2017
Print ISSN: 0962-9343
Elektronische ISSN: 1573-2649
DOI
https://doi.org/10.1007/s11136-016-1396-1

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