Summary Of Diabetes Self-Care Activities Scale Research Articles

Gender and Ethnic Differences in Diabetes Self Care in Malaysia: An Individual Participant Meta-Analysis of Summary of Diabetes Self Care Activities Studies.

Many published studies in Malaysia have examined and assessed self care among type 2 diabetes mellitus (T2DM) patients using the Summary of Diabetes Self Care Activities (SDSCA) scale. The current paper is a meta-analysis of related studies that also examines how gender and ethnicity influence and shape T2DM self care practices in Malaysia. We undertook a bibliographic search for studies conducted and published in Malaysia on T2DM adults using the SDSCA scale. This is a two-stage individual participant meta-analysis of SDSCA which synthesised the overall and subscale score based on gender and ethnic groups as well as the correlation between SDSCA and HbA1c. We examined 11 studies that utilised SDSCA to analyse 3,720 T2DM patients. The overall SDSCA score was 33.46 (47.8% of the 7-day week). The subscale score for general diet, specific diet, exercise, blood glucose self-monitoring and foot care were 4.80, 4.09, 2.87, 1.80 and 3.21, respectively. A small but statistically significant better self care in some gender or ethnic groups was noted. The SDSCA diet subscale and HbA1c showed statistically significant correlation. The finding suggested Malaysian T2DM patients were deficient in exercise and blood glucose self-monitoring. In fact, overall self care among Malaysian adult T2DM patients appears to be suboptimal across gender and the three main ethnic groups. Greater efforts are therefore needed to educate Malaysian adult T2DM patients to improve their self care practices.

Diabetes-related distress and its impact on self-care of diabetes among people with type 2 diabetes mellitus living in a resource-limited setting: A community-based cross-sectional study

AimTo assess the a) prevalence, b) factors associated, and c) effect on self-care practices (SCP) of diabetes related distress (DRD) among patients with Type 2 Diabetes Mellitus (T2DM) in rural Punjab, India. MethodsAmongst the cohort of 700 patients, the Diabetes Distress Scale-17 (DDS-17) was used to assess DRD and the Summary of Diabetes Self Care Activities scale (SDSCA) for diabetes SCP. Multivariable logistic regression identified the factors associated with DRD. ResultsDRD was universal [severe or moderate in 391 (56%) and 309 (44%) patients, respectively]. Hypertension increased the odds of severe DRD [aOR 3.47; 95% CI:2.48–4.87, p-<0.01] whereas living in a joint family reduced the odds of severe DRD [aOR 0.68; 95% CI: 0.47–0.97, p- 0.03]. Patients with severe DRD were less likely to perform DM SCPs [aOR 0.53; 95% CI:0.32–0.85, p-0.01]. ConclusionsThe burden of DRD was alarmingly high. There is an urgent need to screen, prevent and treat DRD to improve selfcare in T2DM.

Self-care adherence and affective disorders in Barbadian adults with type 2 diabetes.

PurposeDiabetes management requires adherence to complicated self-care behaviors. Therefore, the emotional state of the individual living with diabetes, is likely to affect their ability to comply with recommendations. This study explored the relationship of self-care adherence to diabetes distress and depression in Barbadian adults with type 2 diabetes.MethodsAdults aged 20 to 80 years, with type 2 diabetes, completed self-report questionnaires comprised of a profile section consisting of demographic and clinical characteristics; and standardized questionnaires comprising, The Diabetes Distress Scale (DDS), The Patient Health Questionnaire (PQH-9), and the Summary of Diabetes Self-care Activities Scale (SDSCA). Additionally biological measures (BP and HbA1c) were collected.ResultsFor the 509 participants there were no differences in adherence for males (30.8%) and females (69.2%), high diabetes distress and depression were associated with low adherence. General diet was negatively associated with BP and HbA1c; while HbA1c was positively correlated with blood glucose testing.ConclusionSelf-care non-adherence is more than a behavioral problem; it is a multidimensional phenomenon inclusive of demographic factors, condition or disease factors, psychological and social factors.

Assessment of Self-Care Practices among Type 2 Diabetic Patients in a Secondary Care Teaching Hospital

Background: Diabetes is one of the major health problems worldwide that can be effectively managed by good self-care activities like medication adherence, exercise, monitoring of blood glucose, foot care and diet. Objectives: The study assessed the self-care activities of diabetic patients using summary of diabetes self-care activities scale (SDSCA) and the variables (Age, gender, educational level, socioeconomic status (SES)) associated with it. Methods: A cross-sectional descriptive study was undertaken in 400 Type 2 diabetic patients. Self-care practices of the patients were evaluated by using SDSCA and correlation with variables were determined statistically. Results: Among 400 diabetic patients about 215 (53.75%) had an average score of self-care. Self-care was poor in 184 (46%) subjects, and only 1 subject (0.25%) scored good. Blood sugar monitoring was the highest (100%) followed by medication adherence (92.75%) whereas inadequate levels of self-care were reported in foot care (1.5%), and physical activity (31.5%) domains. A significant positive correlation was found between self-care practices and socio-demographic variables such as age (r=0.298, p=0.000), income (r=0.490, p=0.000) occupation (r=0.433, p=0.000), education (r=0.582, p=0.000), and Socio-Economic status (r=0.599, p=0.000). Conclusion: The study revealed higher level of adherence to self-care activities in terms of blood sugar monitoring and medication taking behaviour in the current setting, but self-care in other domains such as foot care is critically low. Age, education and Socio-Economic status seems to affect the self-care practice by the patients.&#x0D; Keywords: Diabetes, Diabetes self- care, Diabetic foot care, Summary of diabetes self-care activities (SDSCA) score.

The relation of alexithymia and attachment with type 1 diabetes management in adolescents: a gender-specific analysis

BackgroundSeveral studies indicate the role of psychosocial factors in the management and control of chronic diseases in adolescents. In this regard, the roles of attachment and alexithymia in the management of type 1 diabetes in adolescents and related gender-specific patterns have rarely been the focus of empirical research. In this study we investigate the gender-specific relationship of alexithymia and attachment with self-care and blood glucose level in adolescents with type1 diabetes.MethodsThis is a cross-sectional study conducted on adolescents aged 12–18 years, with type 1 diabetes. Participants were recruited from diabetes clinics and the Iranian Diabetes Society. Data were collected using the Farsi versions of the Toronto Alexithymia Scale (FTAS-20), the Inventory of Parent and Peer Attachment (IPPA) and the Summary of Diabetes Self-Care Activities Scale (SDSCA). Blood glucose levels were measured by determining HbA1c which were abstracted from medical records. Data were analyzed using SPSS21 software.ResultsParticipants were 150 adolescents (57% female), mean age 14.97 ± 2.30. Alexithymia (β = 0.10, P = 0.01), difficulty identifying feelings (β = 0.15, P = 0.03) and communication with mothers (β = − 0.08, P = 0.03) predicted HbA1c in girls, whereas no significant relationships were observed for HbA1c with alexithymia and attachment in boys. Factors that predicted self-care in girls were alexithymia (β = − 0.04, P = 0.02), difficulty identifying feelings (β = − 0.06, P = 0.04); in boys however in addition to these two factors predicting self-care [alexithymia (β = − 0.07, P = 0.01) and difficulty identifying feelings (β = − 0.11, P = 0.01)], we also found difficulty describing feelings (β = − 0.16, P = 0.02), communication with mother (β = 0.04, P = 0.04), alienation to mother (β = − 0.06, P = 0.03), to father (β = − 0.06, P = 0.01) and to peers (β = − 0.09, P = 0.03).ConclusionsOur results suggest that, in a gender-specific pattern, alexithymia and attachment could affect self-care and blood glucose level in adolescents with type 1 diabetes; findings that can be used to facilitate more effective treatment strategies and interventions in this age group.

Do supportive family behaviors promote diabetes self-management in resource limited urban settings? A cross sectional study

BackgroundSelf-management is an essential component of prevention and treatment of type 2 diabetes. Social and family support has been shown to influence self-management behaviors as well as glycemic control and complications. This study was conducted to assess whether diabetes family support improves diabetes self-management and glycemic control in a typical urban population in India.MethodsA cross-sectional study using a questionnaire that had items from the Summary of Diabetes Self Care Activities Scale (SDSCA), the Diabetes Family Behavior Checklist (DFBC) and some sociodemographic and diabetes related clinical data was conducted. The participants were consecutively sampled from the diabetes outpatient department in a tertiary care hospital in Chennai, south India.ResultsA total of 200 consecutive patients from the diabetes outpatient department were interviewed. Diabetes self-management practices were good with respect to avoiding fatty foods and carbohydrates and undergoing regular blood testing for glucose. But the self-management with respect to exercise and foot related care was rare. It was observed that a vast majority of the patients did not report receiving any support from their families. However, in the small proportion who did receive good family support, there is an association between diabetes self-management and diabetes family support (β = 0.527; p = 0.015). Further, the path model showed that there is a positive statistically significant association between family support score and the diabetes self-management score (β = 0.254, p < 0.001). However, the negative association between the diabetes self-management score and the mean plasma glucose did not reach statistical significance (β = − 46.378, p = 0.082).ConclusionsIn the urban south Indian setting, family support was significantly associated with better self-management activities, but better self-management did not reflect as better glycaemic control.

Impact of Certified Diabetes Educators following Preapproved Protocols on Diabetes Self-Care Behaviors—Results of the REMEDIES 4D Trial

Diabetes self-care behaviors (DSCBs) play a significant role in controlling risk factors for diabetes-related complications when practiced consistently. Our objective was to evaluate changes in DSCBs in people with type 2 diabetes from primary care practices participating in the REMEDIES 4D study. REMEDIES 4D was a clustered, randomized trial in which certified diabetes educators (CDEs) implemented standardized treatment protocols to intensify treatment for glucose, lipid or blood pressure control. Fifteen practices and their patients were randomized to the intervention (n=175) or usual care (n=65). Eligible participants had uncontrolled HbA1c, blood pressure, or LDLc. The intervention group received diabetes self-management education in addition to treatment intensification, while the usual care group participated in monthly support groups for one year. DSCBs were measured via the Summary of Diabetes Self-Care Activities scale (SDSCA). Two-sample t-tests were conducted to examine differences in adherence to recommended daily diabetes self-care behaviors between the intervention and usual care groups. The population was 49% male with a mean age of 61 years. The main results of the trial demonstrated a significant 1% decline in HbA1c in the intervention group and no significant change in the usual care group. At baseline, intervention participants tested blood glucose (BG) an average of 4.3 days compared with usual care 3.0 days (P=0.232). At follow-up, intervention participants tested BG an average of was 4.9 days, 1.3 days more frequently than the control group (P=0.004). There was no significant difference between groups for adherence to the self-care behaviors of general diet, specific diet, exercise, or foot care. These findings suggest that CDEs following standardized treatment protocols will improve adherence to recommendations for daily blood glucose testing which may enable patients to maintain better glycemic control. Disclosure K.M. Johnson: None. M. Malmi: None. S. Kuo: None. J.C. Zgibor: None.

Effects of Mindfulness on Psychological Distress and HbA1c in People with Diabetes

Type 2 diabetes mellitus (T2DM) is a prevalent chronic condition that is associated with a high degree of psychological distress. The aim of this study was to evaluate the effectiveness of a novel approach to delivering an intervention of mindfulness practice (IMP) to a patient population with a demonstrated need for psychological support. The novel approach utilised a self-directed audio compact disc (CD) recording of mindfulness practice. In this randomised controlled trial, 67 participants with T2DM (mean age = 59.4, standard deviation = 12.4), attending outpatient clinics, were randomised to an IMP (n = 31) or a control (n = 36) group. Participants completed written questionnaires at baseline and again at 8- and 12-week follow-ups. Primary outcome measures included depression, anxiety and stress (21-item Depression, Anxiety and Stress Scale) and diabetes-specific emotional problems (Problem Areas in Diabetes Survey (PAID)). Secondary outcome measures included diabetes self-management using the Summary of Diabetes Self-Care Activities Scale (SDSCA), systolic and diastolic blood pressure and HbA1c. Participants receiving the IMP reported significant reductions in depression (p = 0.02) and stress (p = 0.03) when compared with the control group. At the 12-week follow-up, there was an overall reduction in depression by 4.1 units and stress by 3.4 units in the IMP group relative to the control group. There was an overall improvement in blood glucose monitoring; however, this was not significant (p = 0.06). HbA1c measures decreased significantly over the 12-week follow-up by 0.48 units (time × group interaction: p = 0.02). The current study has shown that an easily accessible self-directed IMP was effective in improving psychological symptoms of depression and stress, blood glucose monitoring and HbA1c.

Self-care assessment in type-2 diabetes: the Italian translation and validation of the Summary of Diabetes Self-Care Activities

Self-care represents a key factor for diabetes patients to maintain quality of life and to prevent serious disease complications. Self-care standardized assessment tools are needed to evaluate and to promote self-care in diabetes patients. The Summary of Diabetes Self-Care Activities Scale (SDSCA) has been widely used in clinical and research settings and has been translated in many languages. Validity and reliability of this self-report scale were reported by several studies. However, SDSCA has not yet been translated, culturally adapted and tested in the Italian context. The aim of this methodological research was to translate and to provide a first validation study of the Italian SDSCA - 11 item Version. A process of translation, back-translation and semantic concordance evaluation has been performed in order to translate the SDSCA into Italian language in collaboration with the original authors. A cross-sectional survey has been planned to test internal consistency and test -retest reliability on a convenience sample of 80 type 2 diabetes patients. As secondary objective, SDSCA criterion validity has been explored referring to a range of clinical outcomes as glicated emoglobin and presence of complications. A description of respondents' self-care abilities is provided for the whole sample and for sub-groups by gender, age, instruction and income levels. Cronbach's Alfa and Intraclass Correlation Coefficient showed acceptable values considering the multidimensionality of SDSCA. High values were obtained in 3 out of 5 sub-classes of items. As in previous studies, specific diet and physical exercise sub-classes showed limited internal consistency. Cohen's Kappa Concordance Correlation Coefficient and t-test demonstrated high test-retest reliability of SDSCA. Overall SDSCA score did not show significant correlations with selected clinical outcomes; however 3 SDSCA single items significantly correlated with glicated emoglobin, complications and the clinical judgment of the diabetes case manager nurse. Further researches involving larger samples are needed to integrate data about Italian SDSCA performances, especially concerning construct and criterion validity. However, based on these preliminary results, SDSCA could find relevant applications in clinical settings to systematically evaluate, to compare over time and to improve specific self-care abilities of diabetes patients.

Psychometric evaluation of the Problem Areas in Diabetes (PAID) survey in Southern, rural African American women with Type 2 diabetes

BackgroundThe Problem Areas in Diabetes (PAID) survey is a measure of diabetes-related stress for which reported use has been in largely Caucasian populations. Our purpose was to assess the psychometric properties of the PAID in Southern rural African American women with Type 2 diabetes.MethodsA convenience sample of African American women (N = 131) ranging from 21–50 years of age and diagnosed with Type 2 diabetes were recruited for a survey study from two rural Southern community health centers. Participants completed the PAID, Center for Epidemiological Studies-Depression Scale (CES-D), and the Summary of Diabetes Self-Care Activities Scale (SDSCA). Factor analysis, Cronbach's coefficient alpha, and construct validation facilitated psychometric evaluation.ResultsA principle component factor analysis of the PAID yielded two factors, 1) a lack of confidence subscale, and 2) a negative emotional consequences subscale. The Lack of Confidence and Negative Emotional Consequences subscales, but not the overall PAID scale, were associated with glycemic control and body mass index, respectively. Relationships with measures of depression and diabetes self-care supported construct validity of both subscales. Both subscales had acceptable (alpha = 0.85 and 0.94) internal consistency measures.ConclusionA psychometrically sound two-factor solution to the PAID survey is identified in Southern, rural African American women with Type 2 diabetes. Lack of confidence in and negative emotional consequences of diabetes self-care implementation provide a better understanding of determinants of glycemic control and weight than an aggregate of the two scales.