Diabetes Self-management Behaviors and Influencing Factors Among Elderly Patients with Type 2 Diabetes Post-COVID-19 Pandemic in Wenzhou, China
Keywords:
Elderly, Self-efficacy, Self-management behavior, Type 2 diabetes mellitusAbstract
In the aftermath of the COVID-19 pandemic, despite healthcare recovery and digital health additions, diabetes self-management behavior (DSMB) among elderly patients in China remains poor, resulting in increased complications, mortality, and economic burden. This predictive correlational study investigated diabetes self-management behavior among elderly type 2 diabetes mellitus patients post-COVID-19 in Wenzhou, China, examining potential predictors including health literacy, perceived diabetes self-efficacy, and social support. Purposive sampling was conducted with 109 early elderly patients, aged 60-69 years, from the diabetes outpatient department at the First Affiliated Hospital of Wenzhou Medical University. Data was collected using questionnaires including the Diabetes Self-Management Behavior Scale, Health Literacy Management Scale for Chronic Diseases, Diabetes Self-efficacy Scale, and Social Support Rating Scale. Data analysis was conducted using descriptive statistics and multiple linear regression.
The findings revealed that diabetes self-management behavior in elderly patients was at a low level (M = 34.53, SD = 9.65). Perceived diabetes self-efficacy was the only factor that could significantly predict diabetes self-management behavior (β = 0.837, p < .001), explaining 65.8% of the variance in diabetes self-management behavior. Neither health literacy (β = -0.070, p = 0.377) nor social support (β = 0.045, p = 0.535) demonstrated significant predictive value.
The findings indicate that within the rapidly changing Chinese cultural context after the COVID pandemic, healthcare for elderly diabetic patients should prioritize building patients' confidence in managing their own condition.
References
American Diabetes Association. (2018). 4. Lifestyle management: Standards of medical care in diabetes-2018. Diabetes Care, 41(Suppl. 1), S38-S50. https://doi.org/10.2337/dc18-S004
American Diabetes Association. (2023). 5. Facilitating positive health behaviors and well-being to improve health outcomes: Standards of care in diabetes-2023. Diabetes Care, 46(Suppl. 1), S68-S96. https://doi.org/10.2337/dc23-S005
Chen, J., Yan, R., & Xu, K. (2024). "One old and one small" pressure highlights how to deal with the worries of a moderately aging society? 005. https://link.cnki.net/doi/10.28723/n.cnki.nsjbd.2024.003456
Chinese Diabetes Society. (2021). Guideline for the prevention and treatment of type 2 diabetes mellitus in China (2020 ed.). Chinese Journal of Diabetes Mellitus, 13(4), 315-409. https://doi.org/10.3760/cma.j.cn115791-20210221-00095
Dai, Y., Liu, W., Li, J., & Li, M. (2017). Study on the correlation between health literacy and self-management ability in type 2 diabetic patients. Journal of Guangxi University of Chinese Medicine, 20(03), 15-20.
Gray, J. R., & Grove, S. K. (2020). Burns and Grove's the practice of nursing research - e-book: Appraisal, synthesis, and generation of evidence. Elsevier Health Sciences. https://books.google.co.uk/books?id=HmbyDwAAQBAJ
Huang, M. (2019). A probe into Wenzhou special snack of Zhejiang Province and its prevailing reasons. Journal of Nanning Polytechnic, 24(6), 5-7.
Jin, D. (2024). Analysis of self-management behavior status and its influencing factors in elderly patients with hypertension comorbidity. Journal of Doctors Online, 14(10), 19-24. https://next.cnki.net/
Li, Y., Teng, D., Shi, X., Qin, G., Qin, Y., Quan, H., Shi, B., Sun, H., Ba, J., Chen, B., Du, J., He, L., Lai, X., Li, Y., Chi, H., Liao, E., Liu, C., Liu, L., Tang, X., & ... Shan, Z. (2020). Prevalence of diabetes recorded in mainland China using 2018 diagnostic criteria from the American Diabetes Association: National cross sectional study. British Medical Journal, 369, m997. https://doi.org/10.1136/bmj.m997
Liu, H., & Li, J. (2024). Application effect of nursing method based on self-efficacy theory in patients with type 2 diabetes mellitus during medication. Chinese Journal of Drug Abuse Prevention and Treatment, 30(11), 2053-2055. https://doi.org/10.15900/j.cnki.zylf1995.2024.11.026
Lu, F., & Gao, Y. (2021). Occurrence and factors affecting common complications in patients with type 2 diabetes. Chinese Journal of Public Health Engineering, 20(05), 746-747+750. https://doi.org/10.19937/j.issn.1671-4199.2021.05.013
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.e6. https://doi.org/10.1016/j.outlook.2008.10.004
Sun, H., Peng, H., & Fu, H. (2012). The reliability and consistency of health literacy scale for chronic patients. Fudan University Journal of Medical Sciences, 39(3), 268-272. https://doi.org/10.3969/j.issn.1672-8467.2012.03.009
Sun, X., Shi, F., Ma, J., Yang, M., Liu, W., Wang, L., & Liu, W. (2020). Study on glycemic profiles and emotional scales in diabetic patients after the outbreak of COVID-19. Chinese Journal of Endocrinology and Metabolism, 36(8), 673-677. https://doi.org/10.3760/cma.j.cn311282-20200611-00431
Tang, J., Yang, Q., Li, X., Wu, W. W., Li, Q., Niu, D., Bao, X., Ding, P., & Xu, L. (2019). Study on guiding effect of mental health of elderly patients with type 2 diabetes in community Chinese. Journal of General Practice, 17(3), 433-435+507. https://doi.org/10.16766/j.cnki.issn.1674-4152.000701
Wan, Q., & Shang, S. (2009). Study on reliability and validity of self-efficacy scale for diabetes mellitus patients. Chinese Nursing Research, 23(17), 1589-1590. https://caod.oriprobe.com/articles/16688196/Study_on_reliability_and_validity_of_self_efficacy.htm
Wan, Q., Shang, S., Lai, X., & Pan, J. (2008). A study on the reliability and validity of the self-management behaviour scale for patients with type 2 diabetes. Chinese Journal of Practical Nursing, 24(7), 26-27. https://caod.oriprobe.com/articles/13385028/Study_on_the_reliability_and_validity_of_summary_o.htm
Wang, Y., & Zhao, Y. (2022). Analysis of the status quo of self-efficacy and health knowledge cognition among diabetic patients in Shaoxing City and the influencing factors. Chinese Journal of Public Health Management, 38(5), 647-650. https://doi.org/10.19568/j.cnki.23-1318.2022.05.0019
Xia, Z., Jiang, Y., Mao, F., Dong, W., Zhang, W., & Dong, J. (2022). Quality of life and its influencing factors among diabetic patients two years after a self-management intervention in six Provinces and cities in China: A follow-up study. Chinese Journal of Public Health, 38(3), 285-290. https://doi.org/10.11847/zgggws1131688
Xiao, S. Y. (1994). The theoretical basis and research application of social support rating scale. Journal of Clinical Psychiatry, 4, 98-100.
Yang, J. (2024). Social support and health self-management in older patients with diabetes mellitus type 2 mellitus Relationship and mediation role studies. https://link.cnki.net/doi/10.26980/d.cnki.gcczc.2024.000275
Ying, J., Ran, X., & Zhong, L. (2020). Reflections on the diagnosis and treatment of diabetes during COVID-19 pandemic. Journal of Chengdu Medical College, 15(3), 293-296. https://link.cnki.net/urlid/51.1705.R.20200324.1056.004
Yu, Y., Duan, X., Yang, L., & Xie, H. (2018). A correlation between self-efficacy, self-management behavior and quality of life in elderly diabetic patients in the community. Journal of Mudanjiang Medical University, 39(1), 123-126. https://doi.org/10.13799/j.cnki.mdjyxyxb.2018.01.042
Zhang, X., Feng, S., Zeng, S., Zhao, X., Zhang, B., Zhao, X., Huang, Y., Chen, X., & Wan, B. (2022). Status quo and correlation analysis of electronic health literacy, self-efficacy and self-management behavior in patients with type 2 diabetes. Journal of Modern Clinical Medicine, 48(3), 170-174. https://doi.org/10.11851/j.issn.1673-1557.2022.03.003
Zhang, X., Lin, Y., Jiang, Y., Zhang, L., Dong, M., Chi, H., Dong, H., Ma, L., Li, Z., & Chang, C. (2023). Mediating effect of self-efficacy on self-management ability and self-management behavior in patients with type 2 diabetes mellitus. Journal of Peking University (Health Sciences), 55(3), 450-455. https://doi.org/10.19723/j.issn.1671-167X.2023.03.010
Zhu, R., & Zhou, L. (2022). Progress in health literacy in patients with type 2 diabetes. Progress in Health Literacy in Patients with Type 2 Diabetes, 19(10), 188-192. https://doi.org/10.11986/j.issn.1673-873X.2022.010.045
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2025 Nursing Journal CMU
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
บทความที่ได้รับการตีพิมพ์เป็นลิขสิทธิ์ของวารสารพยาบาลสาร
ข้อความที่ปรากฏในบทความแต่ละเรื่องในวารสารวิชาการเล่มนี้เป็นความคิดเห็นส่วนตัวของผู้เขียนแต่ละท่านไม่เกี่ยวข้องกับมหาวิทยาลัยเชียงใหม่ และคณาจารย์ท่านอื่นๆในมหาวิทยาลัยฯ แต่อย่างใด ความรับผิดชอบองค์ประกอบทั้งหมดของบทความแต่ละเรื่องเป็นของผู้เขียนแต่ละท่าน หากมีความผิดพลาดใด ๆ ผู้เขียนแต่ละท่านจะรับผิดชอบบทความของตนเองแต่ผู้เดียว
