An integrated model to evaluate the impact of social support on improving self-management of type 2 diabetes mellitus

Xiaojia Wang,Weiqun Xu,Keyu Zhu,Shanshan Zhang,Yuxiang Guan,Ling Xin,Linglan He

doi:10.1186/s12911-019-0914-9

Abstract

BackgroundType 2 Diabetes Mellitus (T2DM) is a chronic disease closely related to personal life style. Therefore, achieving effective self-management is one of the most important ways to control it. There is evidence that social support can help to improve the self-management ability of patients with T2DM, but which social support is more effective has been rarely explored. The purpose of this study is to construct an integrated model to analyze which social support has more significant impact on self-management of T2DM, and provide reasonable suggestions to health care providers on how to effectively play the role of social support.MethodsWe established a social support indicator evaluation system and proposed an integrated model that combines ANP (Analytical Network Process) and CRITIC (CRiteria Importance through Intercriteria Correlation) methods to evaluate the impact of social support on T2DM self-management from both subjective and objective perspectives. The weights calculated by the model will serve as the basis for us to judge the importance of different social support indicators.ResultsInformational support (weighting 49.26%) is the most important criteria, followed by tangible support (weighting 39.24%) and emotional support (weighting 11.51%). Among 11 sub-criteria, guidance (weighting 23.05%) and feedback (weighting 14.68%) are two most relevant with T2DM self-management. This result provides ideas and evidence for health care providers on how to offer more effective social support.ConclusionTo our knowledge, this is the first study in which Multi-Criteria Decision Making (MCDM) tools, specifically ANP and CRITIC, are used to evaluate the impact of social support on improving self-management of type 2 diabetes. The study suggests that incorporating two sub-indicators of guidance and feedback into the diabetes care programs may have great potential to improve T2DM self-management and further control patient blood glucose and reduce complications.

Highlights

Type 2 Diabetes Mellitus (T2DM) is a chronic disease closely related to personal life style
In order to visualize the importance of different social support indicators, we proposed the ANP (Analytic Network Process)–CRITIC (CRiteria Importance through Intercriteria Correlation) model to quantify the indicators weights
We invited experts to rate the importance of indicators, and converted the expert scores into subjective weights through the ANP method; on the other hand, we recruited 3000 patients with type 2 diabetes to fill out the Social Support Measurement Questionnaire we developed and converted the results into objective weights through the CRITIC method

Summary

Introduction

Type 2 Diabetes Mellitus (T2DM) is a chronic disease closely related to personal life style. There is evidence that social support can help to improve the self-management ability of patients with T2DM, but which social support is more effective has been rarely explored. According to the International Diabetes Federation (IDF), the number of individuals affected by diabetes was over 425 million in 2017 and is predicted to surge to 642 million by 2040 [3] Most of these cases are type 2 diabetes. Effective self-management can help improve T2DM health outcomes by modifying these unhealthy lifestyles. There is some evidence to suggest that the self-management of T2DM is the cornerstone to achieving good glycemic control and reducing the risk of developing microvascular (retinopathy, nephropathy, and neuropathy) and macrovascular (cardiovascular and cerebrovascular disease) complications [5].

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Discussion

Conclusion