Background
Methods
Study design and setting
Study population
Sampling method
Study tools
Data collection and study procedures
Demographic and anthropometric data collection
Questionnaires administration
HbA1c measurement
Sample size calculation
Statistical analyses
Results
Characteristics of the study population
Variables | n (%) | Mean (±SD) |
---|---|---|
Age (years) | 58.34 (±11.86) | |
30–39 | 19 (5.6) | |
40–49 | 63 (18.5) | |
50–59 | 94 (27.6) | |
≥ 60 | 164 (48.2) | |
Gender | ||
Male | 140 (41.2) | |
Female | 200 (58.8) | – |
Ethnicity | ||
Malay | 209 (61.5) | |
Chinese | 66 (19.4) | – |
Indian | 62 (18.2) | |
Others | 3 (0.9) | |
Education level | ||
None | 15 (4.4) | |
Primary school (age 7 to 12) | 119 (35) | – |
Secondary school (age 13 to 17) | 163 (47.9) | |
Tertiary (college/ university) | 43 (12.6) | |
Occupation | ||
Employed | 138 (40.6) | |
Unemployed/Pensioner | 202 (49.5) | – |
Smoking status | ||
Smokers | 40 (11.8) | – |
Non-smokers | 300 (88.2) | |
BMI (kg/m2) | 28.53 (±5.29) | |
Normal (< 23) | 48 (14.1) | |
Abnormal (≥ 23) | 291 (85.6) | |
Waist circumference (cm) | ||
Male | 91.52 (±9.89) | |
Normal (< 90) | 64 (45.7) | |
Abnormal (≥ 90) | 76 (54.3) | |
Female | 88.30 (±11.95) | |
Normal (< 80) | 39 (19.5) | |
Abnormal (≥ 80) | 161 (80.5) | |
Blood pressure (mmHg) | ||
Controlled (< 140/80) | 135 (39.7) | – |
Uncontrolled (≥140/80) | 205 (60.3) | |
Glycaemic control (%) | ||
Controlled (HbA1c < 6.5) | 46 (13.5) | 7.99 (±1.71) |
Uncontrolled (HbA1c ≥ 6.5) | 294 (86.5) |
Levels of self-efficacy and self-care behaviour
Subscale domains | Subscale items | Mean (±SD) | |
---|---|---|---|
Items (scale 0 = cannot do, 10 = certainly can do) | |||
Blood glucose monitoring | 1 | I am able to check my blood sugar if necessary | 5.43 (±3.97) |
2 | I am able to correct blood sugar when the sugar level is too high (e.g. eat different foods) | 7.19 (±2.49) | |
3 | I am able to correct my blood sugar when the blood sugar level is too low (e.g. eat different foods) | 7.19 (±2.45) | |
Total mean subscale domain score | 6.60 (±2.97) | ||
Eating plan | 4 | I am able to choose the correct foods | 7.47 (±2.09) |
5 | I am able to choose different foods and stick to a healthy eating pattern | 7.39 (±2.20) | |
6 | I am able to keep my weight under control | 7.11 (±2.24) | |
9 | I am able to adjust my eating plan when ill | 7.33 (±2.29) | |
10 | I am able to follow a healthy eating pattern most of the time | 7.28 (±2.20) | |
13 | I am able to follow a healthy eating pattern when I am away from home | 6.82 (±2.38) | |
14 | I am able to adjust my eating plan when I am away from home | 7.09 (±2.20) | |
15 | I am able to follow a healthy eating pattern during the festive periods | 6.14 (±2.57) | |
16 | I am able to follow a healthy eating pattern during wedding ceremonies or at a party | 6.24 (±2.5) | |
17 | I am able to adjust my eating plan when I am feeling stressed or anxious | 7.12 (±2.30) | |
Total mean subscale domain score | 7.00 (±1.97) | ||
Physical activity | 8 | I am able to do enough exercise | 7.12 (±2.3) |
11 | I am able to do more exercise if the doctor advises me to | 6.79 (±2.42) | |
12 | When I do more exercise, I am able to adjust my eating plan | 6.66 (±2.44) | |
Total mean subscale domain score | 6.85 (±2.19) | ||
Foot care | 7 | I am able to examine my feet for cuts | 7.40 (±2.36) |
Medications and follow-up | 19 | I am able to take my medication as prescribed | 8.77 (±1.68) |
20 | I am able to maintain my medication when I am ill | 8.68 (±1.85) | |
18 | I am able to visit my doctor four times a year to monitor my diabetes according to treatment plan to monitor my diabetes | 8.88 (±1.74) | |
Total mean subscale domain score | 8.78 (±1.76) | ||
Total mean DMSES score | 7.33 (±2.25) |
Subscale domains | Subscale items | Mean (±SD) | |
---|---|---|---|
Self-management behaviours over the previous 7 days | |||
General diet | 1 | Follow a healthy eating plan in the last week | 5.71 (±1.62) |
2 | Follow a healthy eating plan (on average per week, over the past month) | 5.75 (±1.53) | |
Total mean subscale domain score | 5.73 (±1.53) | ||
Specific diet | 3 | Eats five or more servings of fruits and vegetables | 5.41 (±1.83) |
4 | Eats high-fat foods (reverse scoring item) | 4.18 (±1.60) | |
Total mean subscale domain score | 4.80 (±1.18) | ||
Physical activity | 5 | Participates in at least 30 min of exercise | 4.60 (±2.32) |
6 | Participates in specific exercise session | 2.09 (±2.33) | |
Total mean subscale domain score | 3.35 (±1.85) | ||
Blood glucose testing | 7 | Tests for blood sugar | 1.18 (±1.89) |
8 | Tests your blood sugar acording to the number of times recommended by your health care providers | 1.19 (±1.915) | |
Total mean subscale domain score | 1.19 (±1.87) | ||
Foot care | 9 | Check your feet | 4.00 (±3.07) |
10 | Inspect the inside of your shoes | 3.48 (±3.18) | |
Total mean subscale domain score | 3.74 (±2.94) | ||
Total mean SDSCA score | 3.76 (±1.87) |
Relationships between self-efficacy with self-care behaviour and glycaemic control
DMSES score Pearson’s correlation (r) | P valuea | |
---|---|---|
SDSCA score | 0.538 | <0.001 |
HbA1c | −0.410 | <0.001 |
Factors associated with glycaemic control
Variables in the model |
R
2
| |||
---|---|---|---|---|
WC Coefficients (95% CI) | Duration DM Coefficients (95% CI) | DMSES Coefficients (95% CI) | ||
Model 1 | −0.410 (−0.024, − 0.015) | 0.168 | ||
Model 2 | 0.174 (0.002–0.007) | −0.411 (− 0.024, − 0.015) | 0.199 | |
Model 3 | 0.135 (0.006–0.35) | 0.177 (0.002–0.007) | − 0.398 (− 0.024, − 0.014) | 0.217 |
Variables | Standardized coefficients Beta (b) (95% CI) | t statistics | P valuea |
---|---|---|---|
DMSES score | - 0.398 (− 0.024, − 0.014) | −8.201 | < 0.001 |
Duration of T2DM | 0.177 (0.002, 0.007) | 3.664 | < 0.001 |
Waist Circumference | 0.135 (0.006, 0.035) | 2.791 | 0.006 |