Understanding ‘context’ in the self-management of type 2 diabetes with comorbidities: A systematic review and realist evaluation

Schmidt-Busby, Jacqueline; Wiles, Janine; Exeter, Daniel J.; Kenealy, Timothy

doi:10.1016/j.diabres.2018.06.003

Cited by 18 publications

(15 citation statements)

References 55 publications

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“…We found that patient activation is associated with contextual factors. This finding supports the need for holistic patient-centered diabetes care in which person-related factors and patient preferences should be taken into account, in addition to disease-related factors 14,34,35…”

Section: Discussionsupporting

confidence: 73%

Patient activation in individuals with type 2 diabetes mellitus: associated factors and the role of insulin

Vugt¹,

Boels²,

Weerdt³

et al. 2018

PPA

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AimThis study explored the relationship between insulin use and patient activation (a person’s internal readiness and capabilities to undertake health-promoting actions) in individuals with type 2 diabetes mellitus and aimed to identify demographic, clinical and psychosocial factors involved in patient activation.MethodsIn this cross-sectional study, baseline data from a Dutch nationwide study were analyzed. Patient activation was assessed with the Patient Activation Measure 13. A linear mixed model was used to take clustering into account.ResultsIn total, 1,189 persons were included (310 of whom were on insulin), enrolled via 47 general practices and six hospitals. Their mean Patient Activation Measure 13 score was 59±12. We found no association between insulin therapy and patient activation. In the multivariable analysis, individuals with a better health status, very good or very poor social support (vs good social support), individuals who felt they had greater control over their illness and those with a better subjective understanding of their illness showed higher patient activation. Individuals with a lower educational level and those who expected their illness to continue showed a lower activation level.ConclusionPatient activation does not differ between individuals with type 2 diabetes mellitus on insulin therapy and those on other therapies.

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Section: Discussionsupporting

confidence: 73%

Patient activation in individuals with type 2 diabetes mellitus: associated factors and the role of insulin

Vugt¹,

Boels²,

Weerdt³

et al. 2018

PPA

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“…Contextual factors appeared to be highly relevant and in some cases individual factors appeared to be on a more secondary plane. The relative importance of contextual factors in diabetes self-management and in diabetic retinopathy screening has been identified in other studies [87,88].…”

Section: Discussionmentioning

confidence: 89%

Barriers and facilitators to successful management of type 2 diabetes mellitus in Latin America and the Caribbean: A systematic review

et al. 2020

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Background Given that most evidence-based recommendations for managing type 2 diabetes mellitus (T2DM) are generated in high-income settings, significant challenges for their implementation exist in Latin America and the Caribbean region (LAC), where the rates of T2DM and related mortality are increasing. The aim of this study is to identify the facilitators and barriers to successful management of T2DM in LAC, from the perspectives of patients, their families or caregivers, healthcare professionals, and/or other stakeholders.

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“…Diabetes self-management is considered to be a multidimensional construct, but no universally accepted domains exist [6]. The most commonly identified domains/subscales have been diet, exercise, taking medications, self-monitoring of blood glucose, and foot care, in addition to less common domains such as psychological coping [6,10]. However, how the domains are mutually structured has been controversial.…”

Section: Introductionmentioning

confidence: 99%

A New Self-management Scale with a Hierarchical Structure for Patients with Type 2 Diabetes

Lee

Chae

et al. 2020

Asian Nursing Research

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Purpose: The aims of this study were to develop a new instrument for measuring self-management with a hierarchical structure [the Diabetes Self-Management Scale (DSMS)] in patients with type 2 diabetes, and evaluate its psychometric properties. Method: The DSMS instrument was developed in three phases: (1) conceptualization and item generation; (2) content validity and pilot testing; and (3) field testing of its psychometric properties. A convenience sample of 473 participants was recruited in three university hospitals and one regional health center, South Korea. Results: Exploratory and confirmatory factor analyses yielded two second-order component models explaining the common variance among six first-order factors. Principal axis factoring with a varimax rotation accounted for 60.88% of the variance. Confirmatory factor analysis of the hierarchical structure revealed the following fit indices: c 2 /df ¼ 1.373, standardized root-mean-square residual ¼ .050, goodness-of-fit index ¼ .935, incremental fit index ¼ .975, comparative fit index ¼ .974, and root-meansquare error of approximation ¼ .039. All Cronbach' a values for internal consistency exceeded the criterion of .70. All of the intraclass correlation coefficients for testeretest reliability exceeded .70 except that for the taking-medication subscale. The components of the DSMS were moderately correlated with the comparator measures of self-efficacy and health literacy administered for convergent validity. Conclusion: The DSMS is a new instrument for measuring the complex nature of self-management in patients with type 2 diabetes, comprising 17 items scored on a five-point Likert scale. The DSMS exhibits satisfactory psychometric properties for five reliability and validity metrics, and so is a suitable instrument to apply in both research and clinical practices.

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Understanding ‘context’ in the self-management of type 2 diabetes with comorbidities: A systematic review and realist evaluation

Cited by 18 publications

References 55 publications

Patient activation in individuals with type 2 diabetes mellitus: associated factors and the role of insulin

Patient activation in individuals with type 2 diabetes mellitus: associated factors and the role of insulin

Barriers and facilitators to successful management of type 2 diabetes mellitus in Latin America and the Caribbean: A systematic review

A New Self-management Scale with a Hierarchical Structure for Patients with Type 2 Diabetes

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