Abstract
PurposeTo investigate the current status of diabetic self-management behavior and the factors influencing this behavior in Chengdu, a typical city in western China.MethodsWe performed stratified sampling in 6 urban districts of Chengdu. We used questionnaires concerning self-management knowledge, self-management beliefs, self-management efficacy, social support, and self-management behavior to investigate patients with T2DM from August to November 2011. All of the data were analyzed using the SPSS 17.0 statistical package.ResultsWe enrolled a total of 364 patients in the present study. The median score of self-management behavior was 111.00, the interquartile range was 100.00–119.00, and the index score was 77.77. Self-management was described as “good” in 46%, “fair” in 45%, and “poor” in 6% of patients. A multiple-factor analysis identified age (OR, 0.43; 95% CI, 0.20–0.91; P = 0.026), education in “foot care” (OR, 0.42; 95% CI, 0.18–0.99; P = 0.048), self-management knowledge (OR, 0.86; 95% CI, 0.80–0.92; P<0.001), self-management belief (OR, 0.92; 95% CI, 0.87–0.97; P = 0.002), self-efficacy (OR, 0.93; 95% CI, 0.90–0.96; P<0.001), and social support (OR, 0.62; 95% CI, 0.41–0.94; P = 0.023) as positive factors. Negative factors included diabetes duration (5–9 years: OR, 14.82; 95% CI, 1.64–133.73; P = 0.016; and ≥10 years: OR, 10.28; 95% CI, 1.06–99.79; P = 0.045) and hospitalization experience (OR, 2.96; 95% CI, 1.64–5.36; P<0.001).ConclusionWe observed good self-management behavior in patients with T2DM in Chengdu. When self-management education is provided, age, education, knowledge, belief, self-efficacy, and social support should be considered to offer more appropriate intervention and to improve patients' behavior.
Highlights
In mainland China, the population of Type 2 diabetes mellitus (T2DM) is predicted to reach 42.3 million in 2030[1]
We enrolled a total of 364 patients in the present study
A multiple-factor analysis identified age (OR, 0.43; 95% CI, 0.20– 0.91; P = 0.026), education in ‘‘foot care’’ (OR, 0.42; 95% CI, 0.18–0.99; P = 0.048), self-management knowledge (OR, 0.86; 95% CI, 0.80–0.92; P,0.001), self-management belief (OR, 0.92; 95% CI, 0.87–0.97; P = 0.002), self-efficacy (OR, 0.93; 95% CI, 0.90– 0.96; P,0.001), and social support (OR, 0.62; 95% CI, 0.41–0.94; P = 0.023) as positive factors
Summary
In mainland China, the population of Type 2 diabetes mellitus (T2DM) is predicted to reach 42.3 million in 2030[1]. 78% of diabetic patients in China suffer from more than one complication [2]. To lower the morbidity of diabetes complications, self-management is critical [4,5]. Self-management, proposed by Barlow, refers to therapeutic alliance, monitoring disease signs and symptoms, maintaining and improving health behavior, and addressing the negative impact of the disease on the patients’ physical function, emotional feelings, and interpersonal relationships [6]. A Finnish study suggested that good self-management could improve or control blood glucose values and reduce the severity of complications [7]. Another study reported that in a Veterans Affairs Hospital, the reduced amputation rate attributable to self-management education translated to a cost savings of $378,000 over 2 years [8]
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