Factors Influencing Diabetes Self-Management Among Bhutanese People with Type 2 Diabetes Mellitus
Keywords:
Diabetes self-management, health literacy, self-efficacy, social support, diabetes distressAbstract
Studies of Bhutanese people with type 2 diabetes mellitus (T2DM) show alarmingly high rates of uncontrolled DM, yet the practice of diabetes self-management is limited. The aim of the study was to examine diabetes self-management and its influencing factors among Bhutanese people with T2DM. Simple random sampling was used to recruit 105 people with T2DM who visited the diabetes clinic at Jigme Dorji Wangchuck National Referral Hospital. Research instruments included a demographic data questionnaire, the diabetes self-management questionnaire, the diabetes management self-efficacy questionnaire, the health literacy questionnaire, the chronic illness resources survey, and the diabetes distress scale. Data were analysed by descriptive statistics and standard multiple linear regression.
Results showed that participants’ mean score of diabetes self-management was 7.76 (SD = 1.03). Standard multiple linear regression analysis results indicated that self-efficacy, health literacy, social support, and diabetes distress explained 17.16% of the variance in participants’ diabetes self-management. However, only self-efficacy significantly predicted diabetes self-management (β = .277, p = .015). The findings provide evidence for health care providers to develop an intervention program focusing on improving self-efficacy in order to promote diabetes self-management activities among Bhutanese people with T2DM.
References
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Adu, M. D., Malabu, U. H., Malau-Aduli, A. E., & Malau-Aduli, B. S. (2019). Enablers and barriers to effective diabetes self-management: A multi-national investigation. PLoS One, 14(6), e0217771.
Ahmed, Z., & Yeasmeen, F. (2016). Active family participation in diabetes self-care: A commentary. Diabetes Management, 6(5), 104-107.
Baek, R. N., Tanenbaum, M. L., & Gonzalez, J. S. (2014). Diabetes burden and diabetes distress: The buffering effect of social support. Annals of Behavioral Medicine, 48(2), 145-155.
Bailay, S. C., Brega, A. G. Crutchfield, T. M., Elasy, T., Herr, H., Kaphingst, K…….Pignone, M. (2014). Update on health literacy and diabetes. The Diabetes Educator, 40(5), 581-604.
Bandura, A. (1994). Self-efficacy In V. S. Ramachandran (Ed.), Encyclopedia of Human Behaviour (Vol. 4, pp. 71-81). New York: Academic press.
Cannon, A., Handelsman, Y., Heile, M., & Shannon, M. (2018). Burden of illness in type 2 diabetes mellitus. Journal of Managed Care & Specialty Pharmacy, 24(9), S5-S13.
Dao-Tran, T.-H., Anderson, D., Chang, A., Seib, C., & Hurst, C. (2018). Factors associated with self-management among Vietnamese adults with type 2 diabetes. Nursing Open, 5(4), 507-516. doi:10.1002/nop2.158
Dorji, S., Deenan, A., & Masingboon, K. (2017). Prediction of glycated hemoglobin (HbA1c) using physical activity, eating behavior and medication adherence in bhutanese patients with type 2 diabetes. Thai Pharmaceutical and Health Science Journal, 12(4), 166–175.
Dorji, T., Lhamo, P., Tshering, T., Zangmo, L., Choden, K., Choden, D., & Namgyal, K. (2018). Glycemic control, medication adherence, and injection practices among diabetic patients treated in the 3 tertiary referral hospitals in Bhutan: A call for more action. Asian Biomedicine, 12, 27-33. doi:10.1515/abm-2018-0028
Edwards, M., Wood, F., Davies, M., & Edwards, A. (2012). The development of health literacy in patients with a long-term health condition: The health literacy pathway model. BMC Public Health, 12(1), 130. doi:10.1186/1471-2458-12-130
Glasgow, R. E., Strycker, L. A., Toobert, D. J., & Eakin, E. (2000). A social–ecologic approach to assessing support for disease self-management: The Chronic Illness Resources Survey. Journal of Behavioral Medicine, 23(6), 559-583.
Gonzalez-Zacarias, A. A., Mavarez-Martinez, A., Arias-Morales, C. E., Stoicea, N., & Rogers, B. (2016). Impact of demographic, socioeconomic, and psychological factors on glycemic self-management in adults with type 2 diabetes mellitus. Frontiers in Public Health, 4, 195.
Gonzalez, J. S., Shreck, E., Psaros, C., & Safren, S. A. (2015). Distress and type 2 diabetes-treatment adherence: A mediating role for perceived control. Health Psychology, 34(5), 505.
Gunggu, A., Thon, C. C., & Whye Lian, C. (2016). Predictors of diabetes self-management among type 2 diabetes patients. Journal of Diabetes Research, 2016, 1-7.
IDF. (2019). IDF Diabetes Atlas. Retrieved from Brussels, Belgium: http://www.diabetesatlas.org
Ishikawa, H., Takeuchi, T., & Yano, E. (2008). Measuring functional, communicative, and critical health literacy among diabetic patients. Diabetes Care, 31(5), 874. doi:10.2337/dc07-1932
Khalooei, A., & Benrazavy, L. (2019). Diabetes Self-management and Its Related Factors among Type 2 Diabetes Patients in Primary Health Care Settings of Kerman, Southeast Iran. Journal of Pharmaceutical Research International, 1-9.
Kurnia, A. D., Amatayakul, A., & Karuncharernpanit, S. (2017). Predictors of diabetes self-management among type 2 diabetics in Indonesia: Application theory of the health promotion model. International Journal of Nursing Sciences, 4(3), 260-265.
Maneze, D., Everett, B., Astorga, C., Yogendran, D., & Salamonson, Y. (2016). The influence of health literacy and depression on diabetes self-management: A cross-sectional study. Journal of Diabetes Research, 2016.
Miller, T. A. (2013). Importance of family/social support and impact on adherence to diabetic therapy. Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy, 6, 421-426.
Polonsky, W. H., Fisher, L., Earles, J., Dudl, R. J., Lees, J., Mullan, J., & Jackson, R. A. (2005). Assessing psychosocial distress in diabetes. Diabetes Care, 28(3), 626. doi:10.2337/diacare.28.3.626
Ryan, P., & Sawin, K. J. (2009). The individual and family self-management theory: Background and perspectives on context, process, and outcomes. Nursing Outlook, 57(4), 217-225.
Schinckus, L., Dangoisse, F., Van den Broucke, S., & Mikolajczak, M. (2018). When knowing is not enough: Emotional distress and depression reduce the positive effects of health literacy on diabetes self-management. Patient Education and Counseling, 101(2), 324-330.
Schmitt, A., Gahr, A., Hermanns, N., Kulzer, B., Huber, J., & Haak, T. (2013). The Diabetes Self-Management Questionnaire (DSMQ): Development and evaluation of an instrument to assess diabetes self-care activities associated with glycaemic control. Health and Quality of Life Outcomes, 11(1), 138.
Strom, J. L., & Egede, L. E. (2012). The impact of social support on outcomes in adult patients with type 2 diabetes: A systematic review. Current Diabetes Reports, 12(6), 769-781. doi:10.1007/s11892-012-0317-0
Sturt, J., Hearnshaw, H., & Wakelin, M. (2010). Validity and reliability of the DMSES UK: A measure of self-efficacy for type 2 diabetes self-management. Primary Health Care Research & Development, 11(4), 374-381.
Van der Heide, I., Uiters, E., Rademakers, J., Struijs, J. N., Schuit, A. J., & Baan, C. A. (2014). Associations among health literacy, diabetes knowledge, and self-management behavior in adults with diabetes: Results of a Dutch cross-sectional study. Journal of Health Communication, 19(sup2), 115-131. doi:10.1080/10810730.2014.936989
Weinger, K., Beverly, E. A., & Smaldone, A. (2014). Diabetes self-care and the older adult. Western Journal of Nursing Research, 36(9), 1272-1298.
Adu, M. D., Malabu, U. H., Malau-Aduli, A. E., & Malau-Aduli, B. S. (2019). Enablers and barriers to effective diabetes self-management: A multi-national investigation. PLoS One, 14(6), e0217771.
Ahmed, Z., & Yeasmeen, F. (2016). Active family participation in diabetes self-care: A commentary. Diabetes Management, 6(5), 104-107.
Baek, R. N., Tanenbaum, M. L., & Gonzalez, J. S. (2014). Diabetes burden and diabetes distress: The buffering effect of social support. Annals of Behavioral Medicine, 48(2), 145-155.
Bailay, S. C., Brega, A. G. Crutchfield, T. M., Elasy, T., Herr, H., Kaphingst, K…….Pignone, M. (2014). Update on health literacy and diabetes. The Diabetes Educator, 40(5), 581-604.
Bandura, A. (1994). Self-efficacy In V. S. Ramachandran (Ed.), Encyclopedia of Human Behaviour (Vol. 4, pp. 71-81). New York: Academic press.
Cannon, A., Handelsman, Y., Heile, M., & Shannon, M. (2018). Burden of illness in type 2 diabetes mellitus. Journal of Managed Care & Specialty Pharmacy, 24(9), S5-S13.
Dao-Tran, T.-H., Anderson, D., Chang, A., Seib, C., & Hurst, C. (2018). Factors associated with self-management among Vietnamese adults with type 2 diabetes. Nursing Open, 5(4), 507-516. doi:10.1002/nop2.158
Dorji, S., Deenan, A., & Masingboon, K. (2017). Prediction of glycated hemoglobin (HbA1c) using physical activity, eating behavior and medication adherence in bhutanese patients with type 2 diabetes. Thai Pharmaceutical and Health Science Journal, 12(4), 166–175.
Dorji, T., Lhamo, P., Tshering, T., Zangmo, L., Choden, K., Choden, D., & Namgyal, K. (2018). Glycemic control, medication adherence, and injection practices among diabetic patients treated in the 3 tertiary referral hospitals in Bhutan: A call for more action. Asian Biomedicine, 12, 27-33. doi:10.1515/abm-2018-0028
Edwards, M., Wood, F., Davies, M., & Edwards, A. (2012). The development of health literacy in patients with a long-term health condition: The health literacy pathway model. BMC Public Health, 12(1), 130. doi:10.1186/1471-2458-12-130
Glasgow, R. E., Strycker, L. A., Toobert, D. J., & Eakin, E. (2000). A social–ecologic approach to assessing support for disease self-management: The Chronic Illness Resources Survey. Journal of Behavioral Medicine, 23(6), 559-583.
Gonzalez-Zacarias, A. A., Mavarez-Martinez, A., Arias-Morales, C. E., Stoicea, N., & Rogers, B. (2016). Impact of demographic, socioeconomic, and psychological factors on glycemic self-management in adults with type 2 diabetes mellitus. Frontiers in Public Health, 4, 195.
Gonzalez, J. S., Shreck, E., Psaros, C., & Safren, S. A. (2015). Distress and type 2 diabetes-treatment adherence: A mediating role for perceived control. Health Psychology, 34(5), 505.
Gunggu, A., Thon, C. C., & Whye Lian, C. (2016). Predictors of diabetes self-management among type 2 diabetes patients. Journal of Diabetes Research, 2016, 1-7.
IDF. (2019). IDF Diabetes Atlas. Retrieved from Brussels, Belgium: http://www.diabetesatlas.org
Ishikawa, H., Takeuchi, T., & Yano, E. (2008). Measuring functional, communicative, and critical health literacy among diabetic patients. Diabetes Care, 31(5), 874. doi:10.2337/dc07-1932
Khalooei, A., & Benrazavy, L. (2019). Diabetes Self-management and Its Related Factors among Type 2 Diabetes Patients in Primary Health Care Settings of Kerman, Southeast Iran. Journal of Pharmaceutical Research International, 1-9.
Kurnia, A. D., Amatayakul, A., & Karuncharernpanit, S. (2017). Predictors of diabetes self-management among type 2 diabetics in Indonesia: Application theory of the health promotion model. International Journal of Nursing Sciences, 4(3), 260-265.
Maneze, D., Everett, B., Astorga, C., Yogendran, D., & Salamonson, Y. (2016). The influence of health literacy and depression on diabetes self-management: A cross-sectional study. Journal of Diabetes Research, 2016.
Miller, T. A. (2013). Importance of family/social support and impact on adherence to diabetic therapy. Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy, 6, 421-426.
Polonsky, W. H., Fisher, L., Earles, J., Dudl, R. J., Lees, J., Mullan, J., & Jackson, R. A. (2005). Assessing psychosocial distress in diabetes. Diabetes Care, 28(3), 626. doi:10.2337/diacare.28.3.626
Ryan, P., & Sawin, K. J. (2009). The individual and family self-management theory: Background and perspectives on context, process, and outcomes. Nursing Outlook, 57(4), 217-225.
Schinckus, L., Dangoisse, F., Van den Broucke, S., & Mikolajczak, M. (2018). When knowing is not enough: Emotional distress and depression reduce the positive effects of health literacy on diabetes self-management. Patient Education and Counseling, 101(2), 324-330.
Schmitt, A., Gahr, A., Hermanns, N., Kulzer, B., Huber, J., & Haak, T. (2013). The Diabetes Self-Management Questionnaire (DSMQ): Development and evaluation of an instrument to assess diabetes self-care activities associated with glycaemic control. Health and Quality of Life Outcomes, 11(1), 138.
Strom, J. L., & Egede, L. E. (2012). The impact of social support on outcomes in adult patients with type 2 diabetes: A systematic review. Current Diabetes Reports, 12(6), 769-781. doi:10.1007/s11892-012-0317-0
Sturt, J., Hearnshaw, H., & Wakelin, M. (2010). Validity and reliability of the DMSES UK: A measure of self-efficacy for type 2 diabetes self-management. Primary Health Care Research & Development, 11(4), 374-381.
Van der Heide, I., Uiters, E., Rademakers, J., Struijs, J. N., Schuit, A. J., & Baan, C. A. (2014). Associations among health literacy, diabetes knowledge, and self-management behavior in adults with diabetes: Results of a Dutch cross-sectional study. Journal of Health Communication, 19(sup2), 115-131. doi:10.1080/10810730.2014.936989
Weinger, K., Beverly, E. A., & Smaldone, A. (2014). Diabetes self-care and the older adult. Western Journal of Nursing Research, 36(9), 1272-1298.
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Published
2020-12-28
How to Cite
Yangdon, K. ., Masingboon , K. ., & Samarkit, N. . (2020). Factors Influencing Diabetes Self-Management Among Bhutanese People with Type 2 Diabetes Mellitus. The Journal of Faculty of Nursing Burapha University, 28(4), 75–86. retrieved from https://he02.tci-thaijo.org/index.php/Nubuu/article/view/248302
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