Factors influencing diabetes self-management among adults with type 2 diabetes mellitus in China
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Keywords

self-management
diabetes mellitus type 2
adult
self-efficacy
fatalism
social support
China

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Yang, N., Masingboon, K., & Samartkit, N. (2022). Factors influencing diabetes self-management among adults with type 2 diabetes mellitus in China. Belitung Nursing Journal, 8(5), 389–395. https://doi.org/10.33546/bnj.2199
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Accepted for publication: 2022-10-04
Peer reviewed: Yes

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Abstract

Background: In China, the prevalence of Type 2 Diabetes Mellitus (T2DM) continues to rise, and Diabetes Self-Management (DSM) is generally suboptimal. Thus, identifying the factors influencing DSM in adults with T2DM is crucial for healthcare providers.

Objectives: This study aimed to 1) describe DSM among adults with T2DM in Wenzhou, China, 2) examine the correlations between diabetes knowledge, perceived self-efficacy, fatalism, social support, and DSM, and 3) determine how much power of the correlated independent variables could predict DSM.

Methods: This study adopted the cross-sectional design and included 108 adults with T2DM who were randomly selected from the outpatient clinic of a hospital in Wenzhou, China. Data were recruited using a demographic questionnaire, and standardized tools were utilized to determine the correlation between DSM, diabetes knowledge, perceived self-efficacy, fatalism, and social support. Data were analyzed using descriptive statistics, Pearson correlation, and multiple regression analysis.

Results: 62% of participants had poor blood glucose control (HbA1c ≥8.0%) and suboptimal DSM. Significant factors related to DSM were diabetes knowledge (r = 0.594, p <0.001), perceived self-efficacy (r = 0.447, p <0.001), and social support (r = 0.312, p = 0.001). The regression analysis revealed that all variables significantly explained 38.2% of the variance in DSM among adults with T2DM. However, only diabetes knowledge and perceived self-efficacy significantly predicted DSM (β = 0.468, p <0.001; β = 0.184, p = <0.05, respectively).

Conclusion: The findings indicated that increasing diabetes knowledge and perceived self-efficacy could help improve DSM in T2DM to ascertain the ultimate treatment outcomes. Nurses and healthcare providers should improve the ability of patients and their families to think critically and act autonomously.
https://doi.org/10.33546/bnj.2199
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Copyright (c) 2022 Ni Yang, Khemaradee Masingboon, Niphawan Samartkit

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This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

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Declaration of Conflicting Interest

All authors declared no potential conflict of interest to report.

Acknowledgment

The authors acknowledge Burapha University, Thailand, and the First Affiliated Hospital of Wenzhou Medical University, China, for support of this study. Our sincere gratitude also goes to the participants of this study for their kind cooperation.

Authors’ Contributions

All authors provided substantial contributions to the conception and design, acquisition of data, or analysis and interpretation of data. In addition, all drafted the manuscript or revised it critically for important intellectual content and provided approval of the final version.

Data Availability

The dataset generated during and analyzed during the current study is available from the corresponding author upon reasonable request.


References

Adu, M. D., Malabu, U. H., Malau-Aduli, A. E. O., & Malau-Aduli, B. S. (2019). Enablers and barriers to effective diabetes self-management: A multi-national investigation. PLoS One, 14(6), e0217771. https://doi.org/10.1371/journal.pone.0217771

Al-Qahtani, A. M. (2020). Frequency and factors associated with inadequate self-care behaviors in patients with type 2 diabetes mellitus in Najran, Saudi Arabia. Based on diabetes self-management questionnaire. Saudi Medical Journal, 41(9), 955-964. https://doi.org/10.15537/smj.2020.9.25339

American Diabetes Association [ADA]. (2019). 5. Lifestyle management: Standards of medical care in diabetes—2019. Diabetes Care, 42(1), S46-S60.

Asuzu, C. C., Walker, R. J., Williams, J. S., & Egede, L. E. (2017). Pathways for the relationship between diabetes distress, depression, fatalism and glycemic control in adults with type 2 diabetes. Journal of Diabetes and Its Complications, 31(1), 169-174. https://doi.org/10.1016/j.jdiacomp.2016.09.013

Beeney, L. J., Dunn, S. M., & Welch, G. (2003). Measurement of diabetes knowledge: The development of the DKN scales. (I. C. Bradley, Ed.). London: Psychology Press.

Bezo, B. H., Huang, Y. T., & Lin, C. C. (2020). Factors influencing self-management behaviours among patients with type 2 diabetes mellitus in the Solomon Islands. Journal of Clinical Nursing, 29(5-6), 852-862. https://doi.org/10.1111/jocn.15139

Bijl, J. V., Poelgeest-Eeltink, A. V., & Shortridge-Baggett, L. (1999). The psychometric properties of the diabetes management self-efficacy scale for patients with type 2 diabetes mellitus. Journal of Advanced Nursing, 30(2), 352-359. https://doi.org/10.1046/j.1365-2648.1999.01077.x

Chen, X. Y., Yan, J., Yuan, C. X., & Chen, X. (2018). Impact of Type D personality on self-management behavior in patients with type 2 diabetes mellitus. Journal of Nursing Science, 33(21), 65-68. https://doi.org/10.3870/j.issn.1001-4152.2018.21.065

Clark, M. (2004). Is weight loss a realistic goal of treatment in type 2 diabetes? The implications of restraint theory. Patient Education and Counseling, 53, 277-283. https://doi.org/10.1016/j.pec.2003.07.008

Cui, Y., Chang, T. T., & Zhang, Y. L. (2020). Current situation and influencing factors of self-management behavior in adult diabetic patients. Medical Journal of National Defending Forces in Northwest China, 41(11), 694-698. https://doi.org/10.16021/j.cnki.1007-8622.2020.11.009

Egede, L. E., & Osborn, C. Y. (2010). Role of motivation in the relationship between depression, self-care, and glycemic control in adults with type 2 diabetes. Diabetes Education, 36(2), 276-283. https://doi.org/10.1177/0145721710361389

Gonzalez-Zacarias, A. A., Mavarez-Martinez, A., Arias-Morales, C. E., Stoicea, N., & Rogers, B. (2016). Impact of demographic, socioeconomic, and psychological factors on glycemic self-management in adults with Type 2 diabetes mellitus. Front Public Health, 4, 195. https://doi.org/10.3389/fpubh.2016.00195

Han, Y. H., Yuan, J., Yang, Y., & Shen, S. D. (2013). A study of self-management and psychological control sources in elderly hospitalized diabetic patients. Journal of Nursing (China), 20(5), 58-62. https://doi.org/DOI:10.16460/j.issn1008-9969.2013.05.009

Hou, J. J., Bai, G. R., XIao, Z. X., & Xie, X. M. (2020). A study on the current status of self-management knowledge and beliefs of patients with type 2 diabetes in Ningxia communities and the factors affecting them. Journal of Ningxia Medical University, 42(7), 732-736. https://doi.org/10.16050/j.cnki.issn1674-6309.2020.07.018

Hu, F. B. (2011). Globalization of diabetes: the role of diet, lifestyle, and genes. Diabetes Care, 34(6), 1249-1257. https://doi.org/10.2337/dc11-0442

Hu, J., Gruber, K. J., Liu, H., Zhao, H., & Garcia, A. A. (2013). Diabetes knowledge among older adults with diabetes in Beijing, China. Journal of Clinical Nursing, 22(1-2), 51-60. https://doi.org/10.1111/j.1365-2702.2012.04273.x

International Diabetes Federation [IDF]. (2021). IDF Diabetes Atlas. International Diabetes Federation. www.diabetesatlas.org

Ji, M., Ren, D., Dunbar-Jacob, J., Gary-Webb, T. L., & Erlen, J. A. (2020). Self-management behaviors, glycemic control, and metabolic syndrome in type 2 diabetes. Nursing Research, 69(2), E9-E17. https://doi.org/10.1097/NNR.0000000000000401

Jiang, Q. J. (1996). Perceived Social Support Scale. (In Editorial Board of Chinese Behavioral Medical Sciences ed., Vol. 206-207). China: Chinese Medical Multimedia Press.

Keeley, B., Wright, L., & Condit, C. M. (2009). Functions of health fatalism: fatalistic talk as face saving, uncertainty management, stress relief and sense making. Sociology of Health and Illness, 31(5), 734-747. https://doi.org/10.1111/j.1467-9566.2009.01164.x

Kurnia, A. D., Amatayakul, A., & Karuncharernpanit, S. (2017). Predictors of diabetes self-management among type 2 diabetics in Indonesia: Application theory of the health promotion model. International Journal of Nursing Sciences, 4(3), 260-265. https://doi.org/10.1016/j.ijnss.2017.06.010

Lange, L. J., & Piette, J. D. (2006). Personal models for diabetes in context and patients’ health status. Journal of Behavioral Medicine, 29(3), 239-253. https://doi.org/10.1007/s10865-006-9049-4

Li, C. Q., Jing, K. J., Liu, Y. Y., & Ma, Q. (2018). Sinicization and evaluation of the reliability and validity of diabetes self-management questionnaire. Modern Preventive Medicine, 45(24), 4477-4481.

Lin, K., Park, C., Li, M., Wang, X., Li, X., Li, W., & Quinn, L. (2017). Effects of depression, diabetes distress, diabetes self-efficacy, and diabetes self-management on glycemic control among Chinese population with type 2 diabetes mellitus. Diabetes Research and Clinical Practice, 131, 179-186. https://doi.org/10.1016/j.diabres.2017.03.013

Liu, T. (2012). A concept analysis of self-efficacy among Chinese elderly with diabetes mellitus. Nursing Forum, 47(4), 226-235. https://doi.org/10.1111/j.1744-6198.2012.00282.x

Liu, T., & Wei, W. (2021). Analysis of self-management behaviors and its influencing factors among diabetic patients. Chinese Journal of Health Education, 37(08), 714-717. https://doi.org/10.16168/j.cnki.issn.1002-9982.2021.08.009

Luo, X., Liu, T., Yuan, X., Ge, S., Yang, J., Li, C., & Sun, W. (2015). Factors Influencing self-management in Chinese adults with type 2 diabetes: A systematic review and meta-analysis. International Journal of Environmental Research and Public Health, 12(9), 11304-11327. https://doi.org/10.3390/ijerph120911304

Osborn, C. Y., Bains, S. S., & Egede, L. E. (2010). Health literacy, diabetes self-care, and glycemic control in adults with type 2 diabetes. Diabetes Technology & Therapeutics, 12(11), 913-919. https://doi.org/10.1089/dia.2010.0058

Ryan, P., & Sawin, K. J. (2009). The Individual and Family Self-Management Theory: background and perspectives on context, process, and outcomes. Nursing Outlook, 57(4), 217-225. https://doi.org/10.1016/j.outlook.2008.10.004

Schmidt-Busby, J., Wiles, J., Exeter, D., & Kenealy, T. (2018). Understanding’ context’ in the self-management of type 2 diabetes with comorbidities: A systematic review and realist evaluation. Diabetes Research and Clinical Practice, 142, 321-334. https://doi.org/10.1016/j.diabres.2018.06.003

Schmitt, A., Gahr, A., Hermanns, N., Kulzer, B., Huber, J., & Haak, T. (2013). The Diabetes Self-Management Questionnaire (DSMQ): development and evaluation of an instrument to assess diabetes self-care activities associated with glycaemic control. Health and Quality of Life Outcomes, 11, 138. https://doi.org/10.1186/1477-7525-11-138

Shen, L., Condit, C. M., & Wright, L. (2009). The psychometric property and validation of a fatalism scale. Psychology & Health, 24(5), 597-613. https://doi.org/10.1080/08870440801902535

Sukkarieh-Haraty, O., Egede, L. E., Abi Kharma, J., & Bassil, M. (2018). Predictors of diabetes fatalism among Arabs: a cross-sectional study of Lebanese adults with type 2 diabetes. Journal of Religion and Health, 57(3), 858-868. https://doi.org/10.1007/s10943-017-0430-0

Suo, R. F., Yan, J., & Zhang, L. J. (2019). Research progress of cancer fatalism. Chinese Journal of Nursing, 54(10), 1588-1592. https://doi.org/10.3761/j.issn.0254-1769.2019.10.028

Tabachnick, B. G., & Fidell, L. S. (2007). Using Multivariate Statistics (5th ed.). Boston: Pearson/ Allyn & Bacon.

Walker, R. J., Smalls, B. L., Hernandez-Tejada, M. A., Campbell, J. A., Davis, K. S., & Egede, L. E. (2012). Effect of diabetes fatalism on medication adherence and self-care behaviors in adults with diabetes. General Hospital Psychiatry, 34(6), 598-603. https://doi.org/10.1016/j.genhosppsych.2012.07.005

Wang, M., Gong, W. W., Pan, J., Fei, F. R., Wang, H., Yu, M., Zhou, X. Y., & Hu, R. Y. (2020). Incidence and time trends of type 2 diabetes mellitus among adults in Zhejiang Province, China, 2007-2017. Journal of Diabetes Research, 2020, 2597953. https://doi.org/10.1155/2020/2597953

Yamashita, T., Kart, C. S., & Noe, D. A. (2012). Predictors of adherence with self-care guidelines among persons with type 2 diabetes: Results from a logistic regression tree analysis. Journal of Behavioral Medicine, 35(6), 603-615. https://doi.org/10.1007/s10865-011-9392-y

Yao, J., Wang, H., Yin, X., Yin, J., Guo, X., & Sun, Q. (2019). The association between self-efficacy and self-management behaviors among Chinese patients with type 2 diabetes. PLoS One, 14(11), e0224869. https://doi.org/10.1371/journal.pone.0224869

Yin, X., Savage, C., Toobert, D., Wei, P., & Whitmer, K. (2008). Adaptation and testing of instruments to measure diabetes self-management in people with type 2 diabetes in mainland China. Journal of Transcultural Nursing, 19(3), 234-242. https://doi.org/10.1177/1043659608319239

Zhang, X., Zuo, B., & Zhao, Y. (2018). Revision of the Chinese version of fatalism scale. Chinese Journal of Clinical Psychology, 26(5), 914-917. https://doi.org/10.16128/j.cnki.1005-3611.2018.05.017

Zhang, X. X., Wu, S. Y., Mayinuer, Y. S. F., Sun, K. G., Hu, K., Zhang, X., Sun, X. Y., & Edwin, B. F. (2017). Association between social support and self-management behaviors among patients with diabetes in community. Journal of Peking University, 49(3), 455-461.

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. https://doi.org/10.1080/00223891.1990.9674095


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