Influences of Patient Activation on Diabetes Self-Care Activities and Diabetes-Specific Distress

Abstract

The purpose of the study was to evaluate the influence of patient activation on diabetes self-care activities and diabetes-specific distress among patients with type 2 diabetes mellitus. Methods: This cross-sectional correlational study was a secondary data analysis, utilizing data collected from September 2016 to July 2017, for 151 adults diagnosed with type 2 diabetes in ambulatory endocrinology units of two tertiary hospitals in a metropolitan city. The instruments used for data collection included the Summary of Diabetes Self-Care Activities Questionnaire, the Patient Activation Scale, and the Brief Diabetes Distress Screening Instrument. Hierarchical multiple linear regression analyses were conducted to test the influence of patient activation levels on self-care activities and diabetes-specific distress, after controlling for demographic and clinical variables. Results: The average patient activation level was 67.8±16.72 (with the possible range from 0 to 100), and the average diabetes-specific distress level was 6.91±2.69 (with the possible range from 2 to 12). Diabetes self-care activities scores were highest in medication adherence and lowest in glucose self-monitoring. Patient activation was the significant factor influencing self-care activities, after controlling for demographic and clinical variables, but showed no significant influence on diabetes-specific distress. Oral hypoglycemic agents and insulin medications were the significant factors influencing diabetes-specific distress. Conclusion: These findings indicate the importance of nursing interventions to improve patient activation and to alleviate diabetes-specific distress. Therefore, in order to improve diabetes self-care activities, it is necessary to facilitate patient activation for diabetes care.

The Mediating Effect of Experiential Avoidance on the Relationship between Diabetes Distress and Self-Stigma in People with Diabetes Mellitus Type 2 in Republic of Korea

“…Keum et al [29] reported that diabetes distress increases with age, but there was no difference in diabetes distress according to age in this study. Similar to this study, the subjects in Choi and Kim [30] had a shorter duration of illness compared to the subjects in Keum et al [29]. This suggests that diabetes distress in people with diabetes is influenced more by disease-related characteristics than by age.…”

“…The diabetes distress score exceeded the average of 2.30 points in a similar study conducted by Keum et al [29] utilizing the same assessment tool. However, although Choi and Kim [30] did not use the same tools, the results were similar to their findings, where the diabetes distress level of patients with diabetes was 6.91 points (out of 12 points). Keum et al [29] reported that diabetes distress increases with age, but there was no difference in diabetes distress according to age in this study.…”

“…Indeed, in this study, diabetes distress was affected by the type of hospital and treatment. Choi and Kim [30] also confirmed that the administration of oral hypoglycemic agents or insulin had a significant effect on diabetes distress [30]. Diabetes patients often experience frustration when they become aware of their condition and start taking medication, particularly insulin [31].…”

Psychometric Evaluation of the Korean Version of PROMIS Self-Efficacy for Managing Symptoms Item Bank: Item Response Theory

“…The participants displayed effective outcomes with regard to DM control. For example, the HbA1c was 7.5 ± 1.5%, performing lower than that reported in previous studies [79,80]. In addition, over 90% of the participants controlled their glucose with oral medication.…”

Factors related to negative self-care adherence in individuals with diabetes mellitus

“…Quanto às pessoas que não faziam dieta hipoglicemiante e nem exercício físico, uma investigação realizada na Coreia ratifica os achados desta pesquisa, pois mostra que quando os indivíduos não fazem nem uma atividade nem outra, demonstram negatividade em relação à adesão aos demais cuidados, e quando ocorre o contrário, as pessoas realizam melhor o autocuidado, principalmente àqueles relacionados com a adesão à terapia medicamentosa e aos cuidados com os pés (15) . Sabe-se que a alimentação adequada, principalmente em indivíduos diabéticos, colabora para o controle glicêmico e ganho de peso ideal (16) .…”