Diabetes Self-management Knowledge Research Articles

Illness Perception, Coping, and Self-Care Adherence Among Adults With Type 2 Diabetes

Understanding the key factors in managing type 2 diabetes over the long term has become necessary. This study aims to explore the association between illness perception, coping, and self-care adherence among adults with type 2 diabetes and find the influence of illness perception and coping on self-care adherence. A cross-sectional survey design was used to collect data from 123 adults with type 2 diabetes aged between 30 and 55 years. The questionnaires included the Brief Illness Perception Questionnaire (BIPQ), Brief COPE, Self-Care Inventory-Revised (SCI-R), and a personal information sheet. A significant correlation was found between illness perception, maladaptive and adaptive coping strategies, and self-care adherence. Adaptive coping, illness perception, and maladaptive coping strategies together explained a 59.9% variance in self-care adherence (F(3, 119) = 59.29, p < .001). The study highlights the importance of developing a less threatening perception of the illness and enhancing the practice of adaptive coping strategies for achieving better self-care adherence among people with type 2 diabetes. This study signifies the need for a collaborative approach by healthcare professionals, mental health providers, and policymakers to provide accurate diabetes self-management knowledge and develop interventions tailored to individuals’ needs.

Promoting Diabetes Self-Management in a Psychiatric Hospital.

Type 2 diabetes and psychiatric illnesses have a bidirectional association, influencing each other in direct but independent ways. People with psychiatric illnesses are more likely than the general population to develop type 2 diabetes, in part because antipsychotic medications affect the metabolic system, disrupting glucose metabolism, and also because they lack diabetes self-management education and self-care skills. This study assessed the effectiveness of diabetes self-management education and support (DSMES) in patients with mental illness and diabetes using the Diabetes Self-Management Questionnaire. Analysis of paired responses to the pre- and post-DSMES survey questions showed a statistically significant increase in diabetes self-management knowledge after participation in the education sessions. These results emphasized the importance of DSMES in strengthening patients' knowledge and skills, with additional support from their psychiatrist and medical team.

Diabetes self-management education interventions and self-management in low-resource settings; a mixed methods study.

Diabetes is largely a self-managed disease; thus, care outcomes are closely linked to self-management behaviours. Structured self-management education (DSME) interventions are, however, largely unavailable in Africa. We sought to characterise DSME interventions in two urban low-resource primary settings; and to explore diabetes self-management knowledge and behaviours, of persons living with diabetes (PLD). A convergent parallel mixed-methods study was conducted between January and February 2021 in Accra, Ghana. The sampling methods used for selecting participants were total enumeration, consecutive sampling, purposive and judgemental sampling. Multivariable regression models were used to study the association between diabetes self-management knowledge and behaviours. We employed inductive content analysis of informants' experiences and context, to complement the quantitative findings. In total, 425 PLD (70.1% (n = 298) females, mean age 58 years (SD 12), with a mean blood glucose of 9.4 mmol/l (SD 6.4)) participated in the quantitative study. Two managers, five professionals, two diabetes experts and 16 PLD participated in in-depth interviews. Finally, 24 PLD were involved in four focus group discussions. The median diabetes self-management knowledge score was 40% ((IQR 20-60). For every one unit increase in diabetes self-management knowledge, there were corresponding increases in the diet (5%;[95% CI: 2%-9%, p<0.05]), exercise (5%; [95% CI:2%-8%, p<0.05]) and glucose monitoring (4%;[95% CI:2%-5%, p<0.05]) domains of the diabetes self-care activities scale respectively. The DSME interventions studied, were unstructured and limited by resources. Financial constraints, conflicting messages, beliefs, and stigma were the themes underpinning self-management behaviour. The DSME interventions studied were under-resourced, and unstructured. Diabetes self-management knowledge though limited, was associated with self-management behaviour. DSME interventions in low resource settings should be culturally tailored and should incorporate sessions on mitigating financial constraints. Future studies should focus on creating structured DSME interventions suited to resource-constrained settings.

Enhancing knowledge of Diabetes self-management and quality of life in people with Diabetes Mellitus by using Guru Diabetes Apps-based health coaching.

Virtual diabetes coaching through applications has the potential to improve self-management in people with Type 2 Diabetes Mellitus. However, applications designed for Asian's diabetic have never been studied. Therefore, our study aimed to identify the effect of Guru Diabetes Apps-Based Health Coaching on the level of glycemic hemoglobin, knowledge, and quality of life in Indonesians, as one of Asian ethnicities. This study used an experimental design. Participants with T2DM were recruited from three primary care health centers. The intervention included 3 months of virtual health coaching through the Guru Diabetes application. The daily monitoring of glycemic blood glucose, blood pressure, body weight, nutrition intake, and activity provided were used as baseline to conduct virtual in-person coaching. The glycemic hemoglobin level, knowledge level, and quality of life were assessed at baseline and post-enrollment. A multilevel modeling approach was used for statistical analysis. A total of 66 respondents were enrolled, and 62 respondents (93.93%) remained in the study at 3 months. After completing the intervention, the HbA1c level decreased in all groups, however it did not differ among the groups. On the other hand, the results indicate significant improvement in the average diabetes self-management knowledge score (pre = 14.97 vs post = 19.07, p < 0.05) and quality of life score (pre = 54.34 vs post = 60.28, p < 0.05), with significant difference among the groups (p < 0.05). Participants in the Android Application-Based Health Coaching experienced a significant improvement in diabetes self-management knowledge and quality of life scores at 3 months. In conclusion, the Guru Diabetes Apps-Based Health Coaching has the potential to support people with T2DM in performing diabetes self-management at home.

Self-Management Knowledge among Patients with Type 2 Diabetes Mellitus in Hospital Taiping, Malaysia

Type 2 diabetes mellitus (T2DM) is characterised by hyperglycaemia resulting from insulin insufficiency, insulin resistance or both. Although different anti-diabetic agents are available to control blood glucose, patient self-management is essential for achieving good glycaemic control. Good knowledge of disease self-management is a pre-requisite to enable patients in making informed decisions in disease management. In this study, we aimed to determine the knowledge of self-management among patients with T2DM visiting outpatient pharmacy at Hospital Taiping. Adult patients with T2DM were invited to participate in a survey from December 2018 to February 2019. A pre-validated, selfadministered questionnaire was used to capture patients’ demographics, glucose level and diabetes self-management knowledge. A total of 148 patients responded to the survey. More than half of the patients (54.7%) in this study were found to have low knowledge scores (&lt; 70%). The level of education (p = 0.041), occupation (p = 0.024) and the use of insulin (p &lt; 0.001) were significantly associated with patients’ level of self-management knowledge whereas no significant relationships were found between knowledge score across age, gender, ethnicity, living status, use of oral anti-diabetic agents, attending diabetes education before and the duration of diabetes. A low but significant negative correlation was found between the score of self-management knowledge and fasting blood glucose (r = −0.264, p = 0.002). Despite the fact that nearly half of the respondents had good knowledge scores, the knowledge gaps remain to be filled s o t hat p atients are empowered to practise self-management in managing their T2DM.

A health-based coaching program for diabetes self-management (DSM) practice: A sequential exploratory mixed-method approach

BackgroundDiabetes self-management (DSM) is crucial for glycemic control among type-2 diabetic (T2D) people. MethodThis was a sequential exploratory mixed-method approach to assess whether a health-based coaching program designed to fit the unmet needs of T2D was the best intervention for improving DSM practice. Twenty-eight participants from different backgrounds were involved in phase 1 (Qualitative study) to explore DSM knowledge and practice, any difficulties obstructing such knowledge and practice, and the feasibility of implementing an intervention program nationwide. Sixty patients were recruited for phase 2 (Quasi-experimental study). A health-based coaching program, constructed to fit the unmet needs from phase 1 was implemented among thirty patients in an experimental group. By comparison, 30 patients in the control group received their usual care. Diabetes and DSM knowledge, DSM practice, and health outcomes were measured and compared between the two groups at baseline and after the 12th week of the intervention. ResultsThe following problems were found: (1) a low perception of susceptibility to and severity of illness, (2) inadequate DSM knowledge and skills, (3) a lack of motivation to perform DSM practice, and (4) social exclusion and feelings of embarrassment. After the implementation of the program among the experimental group, all the variables improved relative to baseline and to the control group. ConclusionA health-based coaching program can improve DSM knowledge and practice and health outcomes. A nationwide program is recommended to promote DSM practice among Indonesian communities.

Integrated Diabetes Self-Management Program Using Smartphone Application: A Randomized Controlled Trial.

This study identified the effects of an integrated diabetes self-management program using smartphone application (app), based on the Information-Motivation-Behavioral skills (IMB) model. A randomized comparison, using a pre-and post-test design, was conducted with 32 participants in the experimental group and 36 in the control group. The integrated diabetes self-management program consisted of face-to-face educational sessions, a diabetes self-management smartphone app, and phone counseling. In the experimental group, diabetes self-management knowledge (Z=-2.70, p=.007), social motivation (Z=-1.97, p=.048), and behavior (t=3.22, p=.002) improved, with their hemoglobin A1c (Z=-4.83, p<.001) decreasing compared to the control group. At the post-test, the experimental group's fasting blood sugar level (t=2.79, p=.009), total calorie intake (t=3.94, p=.001), carbohydrate intake (t=5.69, p<.001), and fat intake (t=2.54, p=.021) decreased compared to the pre-test. An integrated diabetes self-management program using smartphone app, based on the IMB model, should be utilized as a nursing intervention.

A health-based coaching program for diabetes self-management (DSM) practice: A sequential exploratory mixed-method approach

BackgroundDiabetes self-management (DSM) is crucial for glycemic control among type-2 diabetic (T2D) people. MethodThis was a sequential exploratory mixed-method approach to assess whether a health-based coaching program designed to fit the unmet needs of T2D was the best intervention for improving DSM practice. Twenty-eight participants from different backgrounds were involved in phase 1 (Qualitative study) to explore DSM knowledge and practice, any difficulties obstructing such knowledge and practice, and the feasibility of implementing an intervention program nationwide. Sixty patients were recruited for phase 2 (Quasi-experimental study). A health-based coaching program, constructed to fit the unmet needs from phase 1 was implemented among thirty patients in an experimental group. By comparison, 30 patients in the control group received their usual care. Diabetes and DSM knowledge, DSM practice, and health outcomes were measured and compared between the two groups at baseline and after the 12th week of the intervention. ResultsThe following problems were found: (1) a low perception of susceptibility to and severity of illness, (2) inadequate DSM knowledge and skills, (3) a lack of motivation to perform DSM practice, and (4) social exclusion and feelings of embarrassment. After the implementation of the program among the experimental group, all the variables improved relative to baseline and to the control group. ConclusionA health-based coaching program can improve DSM knowledge and practice and health outcomes. A nationwide program is recommended to promote DSM practice among Indonesian communities.

Multidisciplinary Team Approach in Diabetes Self Management

Diyabet, önemli morbidite ve mortalite ile ilişkili olan, küresel boyutta en hızlı artan, ciddi ve maliyeti yüksek halk sağlığı sorunlarından birisidir. Hastalar tarafından günlük olarak yapılması gereken karmaşık bakım faaliyetleri ve öz yönetimle ilgili çok sayıda karar vermeyi gerektiren kronik bir hastalıktır. Diyabetle ilişkili komplikasyonları azaltma ve geciktirmede bireylerin yeterli ve etkili öz yönetim eğitimi ve desteği alması önemlidir. Bu nedenle etkili diyabet öz yönetim bilgi ve becerilerini geliştirmek için diyabeti olan bireylerin özellikle birinci basamakta aile hekimi ve hemşire liderliğinde gerçekleştirilen müdahalelerle desteklenmesi bir gerekliliktir. Bu derlemede çok disiplinli ekip yaklaşımı ile hastanın gereksinimleri, kültürel değerleri, inançları, eğitim ve ekonomik durumu göz önünde bulundurularak, uygulanabilir, kolay ve erişilebilir müdahalelerle diyabette sağlık ve öz yönetim ilişkisinin anlaşılabilirliğinde temel etkenler, objektif ve kapsamlı olarak ortaya koymak amaçlanmıştır.

645-P: Diabetes Pueblo: A Community Health Worker–Led Educational Intervention for Latinos with T2D

In the U.S., Latinos have the highest proportion of type 2 diabetes (T2D) of any racial/ethnic group. Addressing cultural barriers and limited access to diabetes education may improve diabetes care and outcomes in this population. Diabetes Pueblo (DP) is an 11-week, culturally tailored, diabetes self-management education and support (DSMES) program led by Latinos in the community (Promotores). The program has two modules, diabetes fundamentals (DF) and insulin success. A pilot study was conducted to evaluate the feasibility of DP through class attendance and participant satisfaction. Additional endpoints included biometric data, HbA1c, the Diabetes Self-Management Questionnaire (DSMQ), and the Insulin Treatment Appraisal Scale (ITAS). Participants were 25 Latinos with T2D (20 completers) with a mean age of 55.8±10.5 years (64% female, 92% born in Latin America, 39% completed high school). Class attendance averaged 82%. Small nonsignificant improvements were observed in HbA1c, DSMQ, and ITAS positive appraisal at the completion of the program. ITAS negative appraisal scores improved significantly from 43 to 38 (p=0.02). Participant feedback reported improvement in distinguishing between diabetes and prediabetes (p=0.01). Post-class focus groups revealed very high satisfaction with the program, including improved understanding of how behaviors impact health and that insulin initiation does not indicate personal failure. There were no significant changes in biometrics possibly due to the short study duration. These results demonstrate the program’s feasibility through high attendance, program approval, improved diabetes self-management knowledge and acceptance of insulin therapy. This highlights the importance of using a culturally appropriate education program taught by community health workers for higher attendance and engagement. Future research may include larger-scale evaluations of the program with long-term follow-up to detect changes in biometric data. Disclosure J. Creason: None. C. Axelrod: None. M.M. Conneely: None. C. Landeros: None. M. Diaz-Rea: None. A.D. Xi: Employee; Self; Eli Lilly and Company. R. Paczkowski: Employee; Spouse/Partner; Amgen. Employee; Self; Eli Lilly and Company. B. Reed: Employee; Self; Eli Lilly and Company. Stock/Shareholder; Self; Eli Lilly and Company. F. Gelsey: Employee; Self; Lilly Diabetes. Stock/Shareholder; Self; Lilly Diabetes. K.N. Castorino: Research Support; Self; Abbott, Dexcom, Inc., Medtronic, Mylan, Novo Nordisk Inc. Funding Eli Lilly and Company

PILOT STUDI: MANAJEMEN DIRI PASIEN DIABETES MELITUS DI RUMAH SAKIT HL. MANAMBAI ABDULKADIR

Background: The population of people with diabetes mellitus is increasing every year, furthermore included into number three of deadliest disease in Indonesia. The total number of patients with diabetes mellitus currently are 10.3 million, predicted in 2045, the population will increase to 16.7 million. The main cause population of people with diabetes mellitus are increasing due to public awareness regarding self-management is still less. No researcher has been conducted research about diabetes self-management in HL. Manambai Abdulkadir hospitals. Objectives of the Pilot Study: the main objective in this pilot study was to understand the self-management of people with diabetes mellitus in HL Manambai Abdulkadir hospitals. Methodology: The participants in this pilot study were people diabetes mellitus type 2 in HL Manambai Abdulkadir hospitals using cross sectional design by diabetes self-management, self-efficacy, diabetes self-management knowledge and diabetes distress scale questionnaire. Results: 60% of patients in HL Manambai Abdulkadir hospitals had lack of self-management. The result from measuring of distress scale, knowledge and self-efficacy of patients are related to self-management of patients with diabetes mellitus with P Value &lt;0.05. Conclusion: further research is needed with additional interventions to overcome the lack of self-management to people who suffer diabetes mellitus in HL Manambai Abdulkadir Hospital.

Adherence to diabetes care: Knowledge of biochemical processes has a high impact on glycaemic control among adolescents with type 1 diabetes.

To evaluate the impact of patients' understanding of biochemical processes involved in glucose regulation (causal-biochemical knowledge) and of diabetes self-management knowledge on adherence to treatment recommendations among adolescents with type 1 diabetes mellitus. A cross-sectional study. Adolescents with type 1 diabetes mellitus, aged 12-18years and able to read and write in Hebrew or in Arabic were eligible. Participants were recruited between August 2016 - January 2018 during routine visits to the Paediatric Diabetes Clinic; informed consent was obtained as customary. Patients completed sociodemographic, clinical and type 1 diabetes mellitus self-management and biochemical knowledge questionnaires. Adherence to treatment was assessed by patients' serum HbA1c levels, collected from medical records. Ninety-seven patients participated in the study. Mean HbA1c levels were 9.2% (1.9%) and only 24 (24.7%) patients met the recommended HbA1c≤7.5%. Lower HbA1c levels were strongly associated with higher family income, older age at diagnosis and with better type 1 diabetes mellitus self-management and causal-biochemical knowledge. A regression model showed that causal-biochemical knowledge contributed to the variance in HbA1c levels. Furthermore, causal-biochemical knowledge, but not self-management knowledge, was found to mediate the negative relationship between low family income and high HbA1c levels. Causal-biochemical knowledge is a valuable component for the adherence to diabetes care and glycaemic control. Our study suggests that causal knowledge is a valuable component that should be included in nursing and healthcare educational programmes for adolescents with type 1 diabetes mellitus.

Effect of a Health Literacy-Considered Diabetes Self-Management Program for Older Adults in South Korea.

The current randomized controlled study evaluated the effects of a health literacy-considered diabetes self-management program on diabetes-related parameters: diabetes self-management knowledge (DSK), diabetes health beliefs (DHB), diabetes self-efficacy (DSE), diabetes self-management behavior (DSMB), and diabetes biomarkers. Fifty-one Korean older adults with diabetes completed 12 weekly sessions that were developed based on their health literacy and health-related characteristics. The results indicate significant posttest differences between groups in DSK (p = 0.046), DSE (p = 0.046), DSMB (p = 0.012), and the DSMB self-monitored blood glucose subscale (p = 0.002). Significant pre-post changes between groups were observed in the DHB benefit subscale (p = 0.043), DSE (p = 0.006), DSMB (p = 0.008), DSMB diet (p = 0.029), and the self-monitored blood glucose subscale (p < 0.001). A significant pre-post difference was observed in the intervention group's HbA1c levels (p = 0.008). The program effectively improved participants' DSK, DHB, DSE, and DSMB values, which may be helpful for improving HbA1c levels. [Res Gerontol Nurs. 2017; 10(5):215-225.].

Extension‐Delivered Diabetes Program for Rural‐residing Latinos Improves Diabetes Self‐management, Self‐efficacy and Knowledge

Rural‐residing Latinos are at high diabetes risk due to limited access to healthcare services, high rates of overweight and obesity, and acculturation. Culturally‐sensitive diabetes self‐management education programs are needed to reduce the risk and severity of Type 2 diabetes among rural‐residing Latinos. Improvements in diabetes‐related self‐efficacy and knowledge can lead to improved diabetes self‐management outcomes. Latinos Living Well (LLW) was created using the Social Marketing Theory (SMT) and the Health Belief Model (HBM). SMT ensured the content was audience‐centered and culturally‐relevant. HBM constructs were addressed through facilitative discussion, cooking practicums, and hands‐on activities. LLW is made up of four two‐hour classes with culturally‐relevant food and physical activity examples, were taught in Spanish, and delivered through Cooperative Extension. This study evaluated the impact of LLW on diabetes self‐management practices, diabetes self‐efficacy, and diabetes knowledge. A convenience sample of rural‐residing Latino adults age 18+ in a Midwest state (n=120) were recruited, regardless of diabetes status, through collaborations with established community groups serving Latinos, radio commercials and print media, and word of mouth; 76 completed the program (63.3% completion rate). Participants completed a Spanish questionnaire comprised of validated tools, sociodemographic questions, and questions regarding diabetes status at the start of Class 1 (PRE) and the end of Class 4 (POST). Descriptive statistics analyzed sociodemographic data while paired‐samples t‐tests examined changes in diabetes self‐management, diabetes self‐efficacy and diabetes knowledge from PRE to POST. The majority were females (n=73; 97.3%), between the ages of 30 and 49 years (n=34; 51.6%), who were first generation immigrants (n=63; 87.5%). Two‐thirds (n=49; 65.3%) reported some history of a diabetes diagnosis. Significant increases were detected for diabetes self‐management practices (p&lt;0.006), diabetes self‐efficacy (p&lt;0.0001), and diabetes knowledge (p&lt;0.004). These results suggest LLW is effective in improving diabetes self‐management practices, diabetes self‐efficacy, and diabetes knowledge outcomes among rural‐residing Latinos.Support or Funding InformationThis research was funded by the United States Department of Agriculture, National Institute of Food and Agriculture Rural Health and Safety Education Grant, #2014‐46100‐22349

농촌 지역 노인 당뇨병 환자의 자기관리 지식, 사회적 지지, 교육요구도에 관한 융합연구

농촌 지역 노인 당뇨병 환자의 자기관리 지식, 사회적 지지, 교육요구도에 관한 융합연구

"It Feels Good to Know That Someone Cares".

Diabetes is the leading cause of death in Hispanic communities. Self-management is an important part of diabetes care, and diabetes self-management education (DSME) aims to teach the skills necessary for preventing and delaying complication. However, DSME is underutilized. The purpose of this study was to explore Hispanic adults' motivations for attending a DSME class to identify effective strategies for promoting class participation and retention. Nineteen adults participated in seven focus groups conducted in Spanish. Discussions were audio-recorded, transcribed, and translated. Transcripts were content coded by two coders to create a thematic coding scheme. Five main themes emerged as motivations for attendance: (1) frustration with physiological changes, (2) desire to "do better" because of family experience with death/complications from diabetes, (3) free access to information that is unattainable elsewhere, (3) a way to take control, and (4) group setting offered valued emotional and informational support as well as peer support for those who were uncomfortable discussing diabetes with family or lived with family who do not support lifestyle changes. Gaining diabetes self-management knowledge only partly explains the perceived value of classes. Culturally relevant content and appealing to the social supportive aspects of groups may encourage participation.

Validity, reliability, and acceptability of the brief version of the self-management knowledge, attitude, and behavior assessment scale for diabetes patients

To evaluate the validity, reliability, and acceptability of the brief version of the self-management knowledge, attitude, and behavior (KAB) assessment scale for diabetes patients. Diabetes patients who were managed at the Xinkaipu Community Health Service Center of Tianxin in Changsha, Hunan Province were selected for survey by cluster sampling. A total of 350 diabetes patients were surveyed using the brief scale to collect data on knowledge, attitudes, and behaviors of self-management. Content validity was evaluated by Pearson correlation coefficient between the brief scale and subscales of knowledge, attitude, and behavior. Structure validity was evaluated by factor analysis, and discrimination validity was evaluated by an independent sample t-test between the high-score and low-score groups. Reliability was tested by internal consistency reliability and split-half reliability. The evaluation indexes of internal consistency reliability were Cronbach's α coefficients, θ coefficient, and Ω coefficient. Acceptability was evaluated by valid response rate and completion time of the brief scale. A total of 346(98.9%) valid questionnaires were returned, with average survey time of (11.43±3.4) minutes. Average score of the brief scale was 78.85 ± 11.22; scores of the knowledge, attitude, and behavior subscales were 16.45 ± 4.42, 21.33 ± 2.03, and 41.07 ± 8.34, respectively. Pearson correlation coefficients between the brief scale and the knowledge, attitude, and behavior subscales were 0.92, 0.42, and 0.60, respectively; P-values were all less than 0.01, indicating that the face validity and content validity of the brief scale were achieved to a good level. The common factor cumulative variance contribution rate of the brief scale and three subscales was from 53.66% to 61.75%, which achieved more than 50% of the approved standard. There were 11 common factors; 41 of the total 42 items had factor loadings above 0.40 in their relevant common factor, indicating that the brief scale and three subscales had good construct validity. Patients were divided into a high-score group and a low-score group, then scores of the brief scale and three subscales were compared between the groups using a t-test. The results were all significant, indicating that the brief scale and three subscales had good discriminate validity. Mean scores of the brief scale and three subscales of the high-score group were 91.55±6.81, 19.51±2.17, 22.74±1.88, and 49.30±6.20, respectively; these were higher than the low-score group (65.89±5.79, 12.29±4.76, 20.22±1.88, and 33.39±6.17, respectively) with t-values 27.76, 13.31, 9.20, and 17.56 (P-values were less than 0.001). The Cronbach's α coefficient, θ coefficient, Ω coefficient, and split-half reliability of the brief scale were 0.83, 0.87, 0.96, and 0.84, respectively. These values for the three subscales were all above 0.70, except for the θ coefficient of the attitude subscale with 0.64, indicating that the brief scale and three subscales had acceptable internal consistency reliability. The brief version of the diabetes self-management knowledge, attitude, and behavior assessment scale showed good acceptability, validity, and reliability, to responsibly evaluate self-management KAB among patients with diabetes.

Research and application of diabetes self-management scale

Scale is the basis and quality assurance of investigation research, and a rigorous process is needed to develop a scale. The establishment of the item pool is the first step, then screening these items by using Delphi expert consultation method or statistical methods to establish the scale. At last, the acceptability, validity, reliability and sensitivity of scale should be evaluated. A scale can be widely applied only if it has a good acceptability, validity, reliability and sensitivity. China National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention have developed "the Diabetes Self-management Knowledge, Attitude, and Behavior Assessment Scale (DSKAB)" and "the brief version of Diabetes Self-management Knowledge, Attitude, and Behavior Assessment Scale (DSKAB-SF) ". These scales provide a set of scientific evaluation tools to diabetes self-management of Type 2 Diabetes with excellent reliability, validity, sensitivity and acceptability.

Social Support Groups in the Maintenance of Glycemic Control after Community-Based Intervention.

Native Hawaiians and other Pacific Islanders (NH/PI; e.g., Samoan and Chuukese) have higher type 2 diabetes prevalence compared to other groups in Hawai‘i. Partners in Care (PIC), a culturally tailored, community-based, diabetes self-management education intervention (DSME), is effective at improving participants' glycemic control and self-care behaviors. Maintenance of improvements is challenging. Diabetes-related social support groups (SSG) are a promising maintenance component for DSME. This study examined the effects of a diabetes-specific SSG component relative to a control group, after the receipt of the 3-month PIC intervention, which was delivered to 47 adult NH/PI with type 2 diabetes. Participants were then randomized to either a 3-month, 6-session SSG or a control group. Hemoglobin A1c (HbA1c), blood pressure, triglycerides, cholesterol, and diabetes self-management knowledge and behaviors were assessed at baseline, 3 months, and 6 months. Results indicated significant improvements in HbA1c, diabetes-related self-management knowledge, and behaviors from baseline to 3-month assessment. However, no differences between the SSG and control group from 3-month to 6-month assessment suggest that all participants were able to maintain initial improvements. The SSG group had a significant decrease in systolic blood pressure from 3-month to 6-month assessment while the control group did not. Study limitations and future directions are discussed.

Development on the Diabetes Self-management Knowledge, Attitude, and Behavior Assessment Scale (DSKAB)

To develop The Diabetes Self-management Knowledge, Attitude, and Behavior Scale (DSKAB) with Chinese population social culture character in a good validity and reliability after Delphi method and pilot study. This study based on former knowledge, attitude, and behavior questionnaires, an index list was established through literature search, group discussion, and expert in-depth interviews. Then we identified the core indexes and developed a primary scale through the Delphi. We selected 24 experts who specialized in the field of diabetes related clinical medicine, non-communicable diseases self-management, non-communicable diseases control and prevention, and public health. The consultation tables were delivered by EMS and Email. All the experts were asked to grade the evaluation indexes based on overall consideration finality, scientificity, importance, applicability, and to explain the extent of similarity and the basis of judgment. The core indexes of the scale were determined through the positive coefficient, the degree of concentration, the harmonious coefficient, the authoritative coefficient. We selected 27 diabetes patients from the community, and interviewed them face to face. After finishing the field survey, we organized the staff who investigated the patients to participate the panel discussion, to modify and adjust the items formed the scale knowledge attitude behavior of self-management for patients with diabetes mellitus. Two rounds of Delphi both reclaimed 20 experts(') responses, the positive coefficients were 83% and 100% respectively, the authoritative coefficients were 0.85 ± 0.10 and 0.87 ± 0.09, the harmonious coefficients were 0.16 and 0.23 (χ(2) were 283.49 and 398.00, P<0.001) respectively. We identified 75 core indexes through two-round Delphi, 86.30% (63/75) indexes had the importance of full marks than in 0.50 above, it developed the primary scale which included 100 items. Based on the pilot study, we increased 2 items, deleted 4 items, recomposed 2 items and reserved 96 items, the scale consisted of 98 items that were made of three subscales which were the knowledge subscale, the attitude subscale and the behavior subscale. For DSKAB through Delphi method and pilot study, the active coefficients, the authoritative coefficients, the harmonious coefficients fulfilled the scientific requires, it also laid the foundation for the good performance of the scale.