Factors Related to Diabetes Self-Management Among Patients with Type 2 Diabetes: A Chinese Cross-Sectional Survey Based on Self-Determination Theory and Social Support Theory

Abstract

Purpose Self-management behavior (SMB) plays a significant role in glycemic control. This study aimed to explore the factors related to SMB among patients with type 2 diabetes and how these factors interacted with each other. Patients and Methods Patients diagnosed with type 2 diabetes were recruited from 18 community healthcare stations (CHSs) from six community healthcare centers (CHCs) in Beijing, China from April to May in 2017. Motivation, competence, autonomy support, social support, self-management skills, adherence to self-monitoring of blood glucose (SMBG) and haemoglobin A1c (HbA1c) measurement were tested by questionnaire. Correlation analysis and path analysis were performed so as to identify the factors associated with patients’ SMB. Results A total of 532 participants completed this study. Participants who have good compliance to SMBG got higher scores in social support (F = 7.68, p = 0.01), competence (F = 10.47, p = 0.01), and skills (F = 12.34, p < 0.01). Higher competence (β = 0.03, P < 0.001), higher social support (β = 0.01, P < 0.001), better skills(β = 0.01, P < 0.001) directly led to better adherence to SMBG. Social support had a positive effect on autonomy support (β = 0.69, P < 0.001), motivation (β = 0.45, P < 0.001), competence (β = 0.28, P < 0.001), skills (β = 0.14, P < 0.001), which was also indirectly linked to better adherence to SMBG. Better self-management skills directly led to better adherence to HbA1c measurement (β = 0.03, P < 0.001). Social support had a positive effect on autonomy support (β = 0.69, P < 0.001), motivation (β = 0.45, P < 0.001), competence (β = 0.28, P < 0.001), skills (β = 0.14, P < 0.001), which was also indirectly linked to better adherence to HbA1c measurement. Conclusion Self-determination theory and social support theory were practical in explaining SMB in Chinese population. Competence, motivation and social support played an important role in diabetic self-management. Paying attention to the promotion of individual’s intrinsic motivation and self-efficacy may be able to help patients maintain self-management behavior in the long-term routine.

Mediation Effect of Self-Efficacy Between Health Beliefs and Glycated Haemoglobin Levels in Elderly Patients with Type 2 Diabetes Mellitus: A Cross-Sectional Study

“…The study showed that health beliefs were significantly negatively associated with HbA1c levels and could be used as a negative predictor of HbA1c control, health beliefs may contribute to poor glycaemic control in patients through differences in perceived susceptibility, perceived severity, perceived benefits, perceived barriers, and cues to action. 35 Positive health beliefs help to improve the management of patients' blood sugar and have a significant impact on health behavior, 36 consistent with the findings of randomised controlled trials. 37,38 Further analysis showed that except for perceived severity, the other four dimensions were negatively correlated with glycosylated hemoglobin level.…”

Current status and influential factors associated with adherence to self-monitoring of blood glucose with type 2 diabetes mellitus patients in grassroots communities: a cross-sectional survey based on information-motivation-behavior skills model in China

“…Although there are a variety of self-monitoring equipment and supplies for blood glucose in China, the price of blood glucose meter and blood glucose test paper is a certain pressure for patients with poor economic affordability, which leads to a low compliance of SMBG in some T2DM patients. From the perspective of objective factors, it is found that the lack of blood glucose meter is one of the obstacles of SMBG in diabetic patients ( 27 ). While patients with blood glucose meters tend to have higher frequency SMBG, because having blood testing equipment can makes it easy for patients to perform SMBG ( 28 ).…”

Diabetes-specific quality of life scale (DSQOL): Translation and validation of Urdu short version

“…In the subscale "social relations," items highlighted challenges like others finding diabetes unattractive, restricted relationships due to diabetes, social perceptions. In the "emotional worries" subscale, items indicated feeling upset, worried due to diabetes-related issues [14,15,16,17,18] . The "physical complaints" subscale items pointed to pain, skin problems, fatigue, and dry mouth.…”

“…Vol. 14, Issue 4, October -December, 2023 Researchers and clinicians may extend this work to validate its psychometric properties by collecting data from other provinces of Pakistan or may translate this scale into their specific regional languages as well.…”