Predictive Factors of Self-management Behavior among Type 1 Diabetes Adolescents
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Abstract
Purpose: The purpose of this study was to examine the predictive ability of health literacy, intrinsic motivation, and depression on self-management behavior among type 1 diabetes adolescents.
Design: Correlational predictive design.
Methods: The study sample included 113 patients, aged between 13-18 years, who attended Child and Adolescent Diabetes Clinics in three tertiary care public hospitals. The subjects were recruited by convenience sampling. Data were collected using questionnaires: demographic data questionnaire, self-management of type 1 diabetes for adolescents questionnaire, health literacy of type 1 diabetes adolescents questionnaire, intrinsic motivation for diabetes management questionnaire, and children’s depression inventory. Data were analyzed by multiple linear regression.
Main findings: According to the findings, health literacy, intrinsic motivation and depression could jointly explain 13% - 48% of the variances in five aspects of self-management behavior among type 1 diabetes adolescents. Depression could significantly predict all five aspects among type 1 diabetes adolescents while intrinsic motivation could significantly predict only three aspects. Interestingly, depression could not predict any aspects of self-management behavior.
Conclusion and recommendations: The health literacy and intrinsic motivation can significantly predict self-management behavior among type 1 diabetes adolescents. Therefore, healthcare team should develop program to promote health literacy and intrinsic motivation of type 1 diabetes adolescents in order to increase more appropriate self-management behavior of these adolescents.
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References
International Diabetes Federation. IDF diabetes atlas, ninth edition 2019 [Internet]. Brussels: International Diabetes Federation; 2019 [cited 2019 Nov 12]. Available from: https://diabetesatlas.org/idfawp/resource-files/2019/07/IDF_diabetes_atlas_ninth_edition_en.pdf.
Poomthavorn P. Type 1 diabetes in children and adolescents [Internet]. Bangkok: Faculty of Medicine Ramathibodi Hospital, Mahidol University; 2017 [cited 2022 Jan 24] Available from: https://www.rama.mahidol.ac.th/atrama/issue030/health-station. (in Thai).
American Diabetes Association. Classification and diagnosis of diabetes: standards of medical care in diabetes-2019. Diabetes Care. 2019;42 Suppl 1:13-28. doi: 10.2337/dc19-S002.
Wherrett D, Huot C, Mitchell B, Pacaud D. Type 1 diabetes in children and adolescents. Can J Diabetes. 2013;37 Suppl 1:153-62. doi: 10.1016/j.jcjd.2013.01.042.
American Diabetes Association. Classification and diagnosis of diabetes: standards of medical care in diabetes-2021. Diabetes Care. 2021;44 Suppl 1:15-33. doi: 10.2337/dc21-S002.
Wisting L, Bang L, Skrivarhaug T, Dahl-Jorgensen K, Ro O. Psychological barriers to optimal insulin therapy: more concerns in adolescent females than males. BMJ Open Diabetes Res Care. 2016;4(1): e000203. doi: 10.1136/bmjdrc-2016-000203.
Grey M, Knafl K, McCorkle R. A framework for study of self- and family management of chronic conditions. Nurs Outlook. 2006;54(5):278-86. doi: 10.1016/j.outlook.2006.06.004.
Grey M, Schulman-Green D, Knafl K, Reynolds NR. A revised self- and family management framework. Nurs Outlook. 2015;63(2):162-70. doi: 10.1016/j.outlook.2014.10.003.
Delamater AM, Daigre AL, Marchante AN, Pulgaron ER, Patino-Fernandez AM, Sanchez J. Intrinsic motivation in ethnic minority youth with type 1 diabetes. Child Health Care. 2017;46(3):215-29. doi: 10.1080/02739615.2015.1124777.
Guo J, Whittemore R, Grey M, Wang J, Zhou Z-G, He G-P. Diabetes self-management, depressive symptoms, quality of life and metabolic control in youth with type 1 diabetes in China. J Clin Nurs. 2013;22(1-2):69-79. doi: 10.1111/j.1365-2702.2012.04299.x.
Rechenberg K, Whittemore R, Holland M, Grey, M. General and diabetes-specific stress in adolescents with type 1 diabetes. Diabetes Res Clin Pract. 2017;130:1-8. doi: 10.1016/j.diabres.2017.05.003.
Whittemore R, Liberti L, Jeon S, Chao A, Jaser SS, Grey, M. Self-management as a mediator of family functioning and depressive symptoms with health outcomes in youth with type 1 diabetes. West J Nurs Res. 2014;36(9):1254-71. doi: 10.1177/0193945913516546.
Ontrakrai N, Jintrawet U, Chotibang J. Factors related to self-management behaviors in adolescent with type 1 diabetes. Nursing Journal. 2021;48(2):246-58. (in Thai).
Sørensen K, Van den Broucke S, Fullam, J, Doyle G, Pelikan J, Slonska Z, et al. Health literacy and public health: a systematic review and integration of definitions and models. BMC Public Health. 2012;12:80. doi: 10.1186/1471-2458-12-80.
Riangkam C, Wattanakitkrileart D, Ketcham A, Sriwijitkamol A. Health literacy, self-efficacy, age and visual acuity predicting on self-care behaviors in patients with type 2 diabetes. Nursing Science Journal of Thailand. 2016;34(4):35-46. (in Thai).
Ryan RM, Deci EL. Intrinsic and extrinsic motivation: classic definitions and new directions. Contemp Educ Psychol. 2000;25(1):54-67. doi: 10.1006/ceps.1999.1020.
Alvarado-Martel D, Ruiz Fernandez MA, Cuadrado Vigaray M, Carrillo A, Boronat M, Exposito Montesdeoca A, et al. Identification of psychological factors associated with adherence to self-care behaviors amongst patients with type 1 diabetes. J Diabetes Res. 2019;6271591. doi: 10.1155/2019/6271591.
Kovacs M. Children's depression inventory 2nd edition (CDI 2). Toronto, ON: Multi-Health Systems; 2011. 157 p.
Cohen J. Statistical power analysis for the behavioral sciences. 2nd ed. Mahwah, NJ: Routledge; 1988. 567 p.
Schilling LS, Dixon JK, Knafl KA, Lynn MR, Murphy K, Dumser S, et al. A new self-report measure of self-management of type 1 diabetes for adolescents. Nurs Res. 2009;58(4):228-36. doi: 10.1097/NNR.0b013e3181ac142a.
Trangkasombat U, Likanapichitkul D. Depressive symptoms in children: a study using the children's depression inventory. Journal of the Psychiartist Association of Thailand. 1996;41(4):222-30. (in Thai).
Petprayoon S, Wattanakitkrileart D, Pongthavornkamol K, Peerapatdit T. The influence of perceived severity, health literacy, and family support on self-care behavior of patients with type 2 diabetes mellitus. Journal of Nursing Science Chulalongkorn University. 2014;26(1):38-51. (in Thai).