Diabetes self‐care behaviors in adults with disabilities: A systematic review

Abstract

Aim The integrated evidence on diabetes self‐care behaviors in people with a disability is not commensurate with the growing number of people with both diabetes and a disability. This study aims to identify factors influencing self‐care behaviors in adults with diabetes and a disability based on a thorough review of the current evidence. Methods This review followed the Cochrane guidelines for systematic review research and complies with the Preferred Reporting Items for Systematic Reviews and Meta‐Analysis. To find eligible articles, five electronic databases—PubMed, Embase, CINAHL, Psych‐articles, and the Cochrane Library—were searched, from the beginning of the chronological period covered by each database to June 2017. Four researchers independently conducted study selections, extracted data, and assessed the data quality. Results Twenty studies were reviewed to identify barriers to and facilitators of diabetes self‐care behaviors. For people with developmental disabilities, the most prominent facilitator of self‐care behaviors was the support they received for the behaviors. For people with visual impairments, that facilitator was the use of helpful assistive devices that take advantage of another sense. The main barriers to self‐care behaviors were mobility limitation for people with physical disabilities and lack of accessibility for people with visual impairments. Conclusions This review has identified barriers to and facilitators of diabetes self‐care behaviors by type of disability. Healthcare services need to be tailored to these facilitators and barriers, and differentiated by type of disability.

An overview of systematic reviews to determine the impact of socio‐environmental factors on health outcomes of people with disabilities

“…The role that carers and supporters play in assisting people with disabilities, accommodating their role within healthcare spaces and providing practical support was acknowledged in the reviews. However, two support mechanisms of carer training and the importance of the availability of respite care were viewed as additional strategies that could positively impact the health and wellbeing of disabled people (Bradbury‐Jones et al., 2013; Wilbur et al., 2019; Yang et al., 2020). Two reviews flagged that opportunities for increasing awareness among family members and carers of the need to provide support to the disabled person in overcoming barriers (e.g.…”

“…Inaccessible information and communication barriers were found to impact both on disabled people's access to, and utilisation of, healthcare, the quality of care received, and their ability to be fully informed decision‐makers in their own care (Beverley et al., 2004; Bradbury‐Jones et al., 2013; Edwards et al., 2020; Heideveld‐Gerritsen et al., 2021; Horner‐Johnson et al., 2019; Yang et al., 2020). Common barriers included the provision of inaccessible or confusing information in letters, referrals, brochures and medication labels (Beverley et al., 2004; Homeyard et al., 2016; Matin et al., 2021).…”

Pathways linking health literacy to self-care in diabetic patients with physical disabilities: A moderated mediation model

“…Self-care adherence behaviors are reported to be poor in diabetic patients with physical disabilities [ 5 ]. Considering that the mortality rates caused by diabetes were 7.7 times higher in the population with disability [ 6 ], diabetes has accounted for a large part of premature death in the population with disabilities.…”

Effect of Diabetes Distress and Self-care Activities on the Quality of Life of Type 2 Diabetic Patients: A Structural Equation Model

“…These behaviors lead to improved quality of life (10). Nonadherence or poor adherence to self-care behaviors, on the other hand, leads to complications and increased mortality (11).…”