Purpose: The purpose of this study was to examine relationships among blood glucose, HbA1c, and self management comparing these with general and illness characteristics of subjects with Type II Diabetes living in the community. Methods: Using a comprehensive survey developed for the study, data were collected from 82 type II diabetes patients who were registered at five community health departments. The variables of self management, blood glucose and HbA1c were assessed by nurses. Data were analyzed with descriptive statistics including t-test, ANOVA and Pearson's correlation coefficient to compare self management and level of HbA1c by subject's general and illness characteristics and to examine the relationships among variables. Results: About 73.2% of the subjects' HbA1c were 7.0% or higher and 54.9% of subjects' blood glucose were 200 mg/dL or higher. The level of self management was moderate. Most frequently perceived reasons for failure of blood glucose control were dietary failure (32.9%). There was significant relationship between self management and HbA1c(r=-.223, p=.040). The mean score of self management were higher among female (t=-2.37, p=.021), who are not on diabetes medication (t=6.70, p=.011). Conclusion: Comprehensive intervention is needed to improve dietary self management, especially for male and those who is on diabetes medication.
Purpose: The purpose of this study was to construct and test a structural equation model for Diabetes self-management (DSM) behavior and Quality of life (QoL) in older adults with diabetes who use Citizen Health Promotion Centers. The theory used this study was a combination of the Information-Motivation-Behavioral Model (IMB) and Self-Determination Theory (SDT) to reflect autonomous characteristics of participants. Methods: Data were collected from April 20 to August 31, 2015 using a self-report questionnaire. The sample was 205 patients with type 2 Diabetes who regularly visited a Citizen Health Promotion Center. SPSS 22.0 and AMOS 22.0 programs were used to analyze the efficiency of the hypothesized model and calculate the direct and indirect effects of factor affecting the participants' DSM behavior and QoL. Results: The supported hypotheses were as follows; 1) The variable that had a direct effect on QoL was health behavior adherence (${\gamma}=.55$, p=.007). 2) The variables that had a direct effect on DSM behavior were DSM information (${\gamma}=.15$, p=.023), DSM confidence (${\gamma}=.25$, p<.001), and autonomous motivation (${\gamma}=.13$, p=.048). 3) The variable that had a direct effect on DSM confidence was autonomy support (${\gamma}=.33$, p<.001). Conclusion: The major findings of this study are that supporting patient's autonomous motivation is an influential predictor for adherence to DSM behavior, and integrative intervention strategies which include knowledge, experience and psychosocial support are essential for older adults with diabetes to continue DSM behavior and improve QoL.
Purpose: The purpose of this study was to identify the level of psychological insulin resistance and self-care activities and to evaluate the factors affecting self-care activities in patients with type 2 diabetes mellitus undergoing insulin therapy to provide basic data for the development of educational programs. Methods: Data were collected through the interviews using a structured questionnaire from August 29 to October 20, 2017, from the patients with type 2 diabetes mellitus visiting the Diabetes Mellitus Center at H-General Hospital in J-city. The subjects were 168 patients who had been being treated via self-injection for at least three months after the start of insulin therapy. Data analyses were conducted using t-test, ANOVA, Pearson's correlation coefficients, and stepwise multiple regression using the SAS WIN 9.2 program. Results: The mean score of psychological insulin resistance was 61.25 (range 19-95) and the mean score of self-care activities was 53.19 (range 18-90). Self-care activities were significantly different by gender (t = -2.94, p= .004), perceived health status (F= 7.00, p< .001), and hypoglycemia during the last three months (t= -2.47, p= .015). Negative correlation was observed between psychological insulin resistance and self-care activities (r= -.33, p< .001). Self-care activities were significantly predicted by psychological insulin resistance, perceived health status, gender, and hypoglycemia during the last three months, and 19.0% of the variance in self-care activities was explained (F= 9.01, p< .001). Conclusion: Psychological insulin resistance in patients undergoing insulin therapy and its effects on self-care activities identified in this study will be useful in starting and maintaining insulin therapy in the future.
Purpose: The purpose of this study was to investigate the self-care and the physical symptom and to analyse the correlation between self-care and physical symptom in type2 diabetic patients. Method: 201 Participants were recruited from the endocrinology outpatient department of a tertiary care hospital in an urban city. The data were collected by self report self-care and physical symptom questionnaire. Results: The alcohol drinking frequency was lower in female than in male patients. The frequency of nausea or vomiting, morning headaches, lightheadedness, weakness, pain in the heart, pain in the back, stiffness in any join or muscle, and getting very tired in a short time were higher in female than in male diabetic patients. The exercise frequency was negatively correlated with physical symptom in female patients. Conclusion: The alcohol drinking frequency was lower in female than in male patients. The female patients had more physical symptoms than the male patients. The exercise frequency was negatively correlated with physical symptom in female patients.
Purpose: The purpose of this study was to investigate the depression and, the frequency of blood glucose testing in women type2 diabetic patients. Method: 114 Participants were recruited from the endocrinology outpatient department of a tertiary care hospital in an urban city. Depression was measured by visual analogue scale. Blood glucose testing was measured the frequency during past 1 week. Result: Depression was higher in hyperglycemia patient (fasting blood glucose$\geq$110mg/dl) than in normoglycemia patient(fasting blood glucose <110mg/dl). The blood glucose testing frequency as lower in 50-59 years old than in less than 39 years old. And it was lower in middle school graduate than in college graduate. The blood glucose testing was negatively correlated with patient's age. Conclusion: The depression program should be developed for hyperglycemia diabetic patients. And the blood glucose testing education program should be developed for aged and low educational level patients.
Purpose: The purpose of this study was to explore the self management and related factors that affect the self management of diabetes between the middle aged and elderly groups. Method: This study was based by the conceptual framework of Cox's interaction model of client health behavior. The subjects were two groups; the middle aged group, 80 and the elderly group, 85 who were diabetes mellitus patients. Result: In the middle aged group, gender, education and social support were significantly correlated with self-management of diabetes mellitus. In the elderly group, gender, education, social support and the duration of diagnosis were significantly correlated with self-management of diabetes mellitus. In too middle aged group, the intrinsic motivation of diabetes mellitus patients and their understanding of diabetes were significantly correlated with self-management of diabetes mellitus. Understanding of diabetes and self perception were significantly correlated with self-management in middle aged group. In the elderly group, intrinsic motivation, understanding of diabetes and the attitude of the patients were significantly correlated with self-management Conclusion: In the middle aged group, maintaining a positive attitude of diabetes, reducing stress and continuous social support were important for improving self-management of diabetes mellitus. In the elderly group, enhancing their knowledge of diabetes, and maintaining continuous social support were important to improve self-management of diabetes mellitus.
Purpose: The purpose of this study was to investigate the adherence to diabetes control recommendations (blood glucose testing, medication, diet, exercise) in patients with type 2 diabetes at home and to analyse the correlation between adherence and blood glucose level. Method: Participants, numbering 214, were recruited from the endocrinology outpatient department of a tertiary care hospital in an urban city. The data were collected by a self report adherence questionnaire. Glycosylated haemoglobin (HbA1c) was determined by the high-performance liquid chromatography technique and fasting blood glucose was analyzed by the glucose oxidase method. Result: Medication adherence was higher than diet or exercise adherence. The frequency of blood glucose testing was lower for middle school graduates than college graduates. Diet adherence was significantly lower for participants who were obese, who did not have a spouse, and who had hyperglycemia. Medication and diet adherence were negatively correlated with HbA1c. Conclusion: A diet education program should be developed for patients with type 2 diabetes who are obese, who do not have a spouse, and who have hyperglycemia.
Purpose: The study aimed to design and develop an automated personalized self-care (APSC) program for patients with type 2 diabetes mellitus. The secondary aim was to present a clinical protocol as a mixed-method research to test the program effects. Methods: The APSC program was developed in the order of analysis, design, implementation, and evaluation according to the software development life cycle, and was guided by the self-regulatory theory. The content validity, heuristics, and usability of the program were verified by experts and patients with type 2 diabetes mellitus. Results: The APSC program was developed based on goal setting, education, monitoring, and feedback components corresponding to the phases of forethought, performance/volitional control, and self-reflection of self-regulatory theory. Using the mobile application, the participants are able to learn from educational materials, monitor their health behaviors, receive weekly-automated personalized goals and feedback messages, and use an automated conversation system to solve the problems related to self-care. The ongoing two-year study utilizes a mixed method design, with 180 patients having type 2 diabetes mellitus randomized to receive either the intervention or usual care. The participants will be reviewed for self-care self-efficacy, health behaviors, and health outcomes at 6, 12, 18, and 24 months. Participants in the intervention group will be interviewed about their experiences. Conclusion: The APSC program can serve as an effective tool for facilitating diabetes health behaviors by improving patients' self-care self-efficacy and self-regulation for self-care. However, the clinical effectiveness of this program requires further investigation.
Purpose: The purpose of this study was to examine the relationships among self-care, self-care agency, self-efficacy, and quality of life in type II diabetic patients registered at a public health center. Method: The study subjects were 128 type II diabetic patients who were living in G city. The data were collected from March 2001 to February 2002. The instruments used for this study were the self-care scale developed by Jeung(1997) and designed by Park (1984) based on the original scale, the self-care agency scale developed by So (1992), the self-efficacy scale developed by a Jeung (1997) and designed by Paek (1996) based on the original scale, and the quality of life scale developed by Ro (1988). The data were analyzed using descriptive statistics, pearson correlation coefficient, and stepwise multiple regression. Results: 1. The relationships among self-care, self-care agency, self-efficacy, and quality of life were significant. Self-care was significantly related to self-care agency (r=.609. p<.01), self-efficacy (r=.763. p<.01), and quality of life (r=.493. p<.01). 2. The stepwise multiple regression analysis was performed to identify factors influencing quality of life of the subjects. The most powerful predictor was self-care agency (48.4%). The combination of self-care, complication status, age, education level, and self-efficacy accounted for 88.7% of the variance of quality of life in type II diabetic patients. Conclusion: The results suggest that self-care, self-care agency, self-efficacy, and quality of life are important variables for development of nursing intervention programs for patients with diabetes.
Purpose: The purpose of this study was to identify predictors of cardiovascular risk factors of type 2 diabetic patients. Methods: Diabetic patients (N=160) were interviewed from November, 2003 to June, 2004. The 24 hour dietary recall, the International Physical Activity Questionnaire, the Diabetes Management Self-Efficacy Scale for patient with Type 2 diabetes, the Revised Summary of Diabetes Self-Care Activities Measure Scale and Parma Cardiovascular Risk Index were used to measure the predictors. Data were analyzed by descriptive analyses, Pearson correlation coefficients, and stepwise multiple regression using the SPSS WIN 10.0. Results: Mean dietary intakes of the participants were protein(P) of 64.5g, carbohydrate(C) of 280.74g, fat(F) of 30g, and calcium of 511.45mg. The ratio of CPF was 75:17:8. About 45% of the participants didn't exercise on a regular basis. The levels of self-efficacy, self-care, and cardiovascular risk factors of the participants were moderate. Self-efficacy was the most important predictor of cardiovascular risk factors along with self-care, exercising for more than 6 months, carbohydrate intakes and levels of physical activities. Conclusion: The findings of the study suggest that intervention programs increasing self-efficacy on diabetic management would be more beneficial than the fractional approach focusing only on diet or physical activities.
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