Dissertations / Theses: 'Diabetes management self-efficacy'

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DeJesus, Yesenia. "Self-Efficacy and Self-Management Assessments on Hispanic Patients with Diabetes." ScholarWorks, 2016. https://scholarworks.waldenu.edu/dissertations/2967.

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Hispanics are at increased risk for diabetes and are 40% more likely to die from the condition than are non-Hispanic Caucasians. The purpose of this project was to determine the effects of diabetes education conducted in Spanish by bilingual staff on the self-management and self-efficacy of a sample of 50 volunteer adult Hispanic clinic patients with diabetes. The education intervention incorporated the American Diabetes Association's Diabetes Self-Management Education program materials. Bandura's self-efficacy theory was selected as the theoretical support for the project that relied on self-management education of the patients to improve their self-efficacy to undertake the interventions necessary to manage their disease. The Diabetes Self-Management Questionnaire measured patient understanding and self-care management of diabetes before and after the education intervention, and the Diabetes Self-Efficacy Scale measured the self-efficacy of the patients before and after the intervention. Paired sample t tests were calculated to compare the pretest to posttest scores on the full questionnaire and subscales. The full scale and the glucose monitoring control and physical activity subscales showed statistically significant improvement pretest to posttest. An increase in the pretest to posttest Diabetes Self-Efficacy Scale scores was not significant. Results indicated that the diabetes education was an effective way to improve self-reported daily blood glucose monitoring and physical activity. The project may result in positive social change from the better self-management of some diabetes control skills among Hispanic adult patients when education is delivered in Spanish.

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Pouladi, Fatemah Ali RN. "Diabets Knowledge, Self-Effecacy, Social Support, and Diabetes Self-management Affecting Type II Diabetes Outcomes In Qataris." Case Western Reserve University School of Graduate Studies / OhioLINK, 2018. http://rave.ohiolink.edu/etdc/view?acc_num=case151512792425253.

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Noll, Amanda N., and L. Lee Glenn. "Self-Efficacy and Management in Type 2 Diabetes Mellitus." Digital Commons @ East Tennessee State University, 2012. https://dc.etsu.edu/etsu-works/7493.

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Rose, Vanessa Karen Public Health &amp Community Medicine Faculty of Medicine UNSW. "Sociostructural determinants of diabetes self-management: test of a self-efficacy model." Awarded by:University of New South Wales. School of Public Health and Community Medicine, 2007. http://handle.unsw.edu.au/1959.4/31881.

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Diabetes self-management has clear benefits in reducing diabetes symptoms and complications and improving the health, wellbeing and quality of life of people with diabetes. Successful intervention programs focus on the development of diabetes self-efficacy, which promotes the capacity of people with diabetes to perform diabetes self-management even in the face of difficulty. Diabetes self-management, however, presents considerable challenges for health systems that have been structured to provide acute, rather than chronic care, and health professionals who have been trained to cure illness, rather than manage behaviour. It presents further challenges for people with diabetes who live in socioeconomically disadvantaged circumstances and have limited financial resources for diabetes care and therapies, and poor access to resources for diabetes self-management, such as clean, safe exercise areas and healthy foods at low-cost. These sociostructural determinants of diabetes self-management, defined here as GP care and socioeconomic resources, have the potential to impede the uptake and effective dissemination of diabetes self-management policy and intervention. This research thesis investigated the impact of sociostructural determinants on diabetes self-management using a model developed from self-efficacy theory. The model was empirically examined using a mixed quantitative and qualitative methodology, where qualitative data were used to illuminate the findings of quantitative data. The quantitative component comprised a random cross-sectional survey of 105 people with diabetes subjected to hierarchical multiple regression with tests for moderator effects. The qualitative component comprised three group interviews of 27 English-speaking, Vietnamese-speaking and Arabic-speaking people with diabetes, analysed using the phenomenological method. Findings provided partial support for the model. Relationships between sociostructural determinants and diabetes self-management were complex. While good quality GP care facilitated diabetes self-management, it also acted as a barrier to self-monitoring of blood glucose for people with low levels of diabetes self-efficacy. Having limited access to socioeconomic resources did not impede diabetes self-management, even for people with low levels of diabetes self-efficacy, although this may have been masked by access to public health schemes and welfare support. The findings from this small-scale exploratory study suggest that self-efficacy may exert an impact on diabetes self-management, even in the face of sociostructural determinants.

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Davis, Jo Ann. "The relationship between self-efficacy of diabetes management and health-promoting behaviors." Virtual Press, 1997. http://liblink.bsu.edu/uhtbin/catkey/1041919.

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Diabetes Mellitus is a chronic disorder that requires daily adherence to complex regimens for glucose control. The purpose of this study was to examine the relationship between the capability for self-management of diabetes and the practices of health-promoting behaviors. Instruments used were the Health Promotion Lifestyle Profile to measure health-promoting behaviors, the Insulin Management Diabetes Self-Efficacy Scale to measure self-efficacy in diabetes management, and a demographic questionnaire.Fifty participants from the outpatients of a midwestern veterans hospital responded to the questionnaires. Results showed a moderately positive significant correlation between self-efficacy in diabetes management and health-promoting behaviors (r=.52, p<001).The findings of this study point the importance of higher levels of self-efficacy and participation in health-promoting behaviors for more effective management of diabetes and improved health and well-being.
School of Nursing

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Konstantinos, Kevin. "Self-Care Management of African American Men with Type 2 Diabetes." ScholarWorks, 2018. https://scholarworks.waldenu.edu/dissertations/4930.

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African American men are disproportionately affected by type 2 diabetes and have a 3 times higher rate of 3 serious complications of diabetes, including blindness, amputations, and end-stage renal disease, compared to other groups. The purpose of this project was to address the gap-in-practice disparity that exists in care of African American men with diabetes by providing one-on-one self-care management education in an outpatient clinic setting. The behavior change theories that supported the project intervention were Orem's self-care theory and Bandura's self-efficacy theory. Employing a quasi-experimental design, 33 participants between the ages of 40 and 65 were divided into an intervention group (n = 18) and a comparison group (n = 15) by self-selection. Only participants in the intervention group received the diabetes self-care education program. Both groups completed pretest and the posttest questionnaires that collected demographic data and data from the Summary of Diabetes Self-Care Activities, the Diabetes Knowledge Test, and the Self-Efficacy for Diabetes tool. Statistically significant differences between the groups were found in the posttest scores of self-care activities, diabetes knowledge, and self-efficacy. The differences can most likely be attributed to the diabetes education intervention. This project demonstrated that diabetes self-care management education can be provided effectively in the clinic office setting, making diabetes education more available to and accessible for patients who need it most. Integrating diabetes self-care education into primary care providers' offices has the potential to address the gap-in-practice that exists for African American men with type 2 diabetes and contribute to social change by preventing disease progression.

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Emery, Karin A. "EXAMINING BIOBEHAVIORAL VARIABLES AND PREDICTORS ASSOCIATED WITH TYPE 2 DIABETES SELF- MANAGEMENT." VCU Scholars Compass, 2019. https://scholarscompass.vcu.edu/etd/5987.

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Type 2 diabetes mellitus self-management is a challenging process that brings forward a variety of emotional responses. The purpose of this work was to explore relationships between diabetes distress, self-efficacy and resilience and outcomes of glycosylated hemoglobin, quality of life and health status. A cross sectional descriptive design was used for this pilot study of 78 individuals enrolled from an Endocrine clinic in the Midwest United States and a Primary Care clinic in the southeast United States. Data were analyzed using descriptive statistics to characterize the sample and model variables. Spearman’s correlation was completed to identify relationships among variables. A stepwise building approach was used to identify significant interactions and determine predictors of the study outcomes. The results of this study confirm the presence of facilitators and barriers in type 2 diabetes mellitus self-management and their relationships with distal outcomes. The findings demonstrate that diabetes distress is a predictor of health status and quality of life. The findings of this study provide a link to other facilitator and barrier variables such as provider collaboration, diabetes self-management education, treatment regimen, ethnicity and years since diagnosis which can be incorporated into the comprehensive theoretical model. This study contributes to the understanding of the emotional aspect of diabetes as it relates to self-management of T2DM. Continuing this work will allow researchers to examine and better understand important factors of self-management. This ongoing work will hopefully lead to improved support in self-management efforts and better outcomes.

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Gastal, Daniela Alves. "ADAPTAÇÃO PARA O PORTUGUÊS DA ESCALA DE AUTO-EFICÁCIA NO MANEJO DO DIABETES (INSULIN MANAGEMENT DIABETES SELF-EFFICACY)." Universidade Catolica de Pelotas, 2005. http://tede.ucpel.edu.br:8080/jspui/handle/tede/308.

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Made available in DSpace on 2016-03-22T17:27:10Z (GMT). No. of bitstreams: 1 DANIELA.pdf: 351154 bytes, checksum: a6b623f1c40e997f30306cdf9c2145a2 (MD5) Previous issue date: 2005-06-23
Diabetes is a public health problem. In Brazil, its prevalence is of 7,6% and it is included among the ten major mortality causes. Studies have shown that the appropriate glycemic control may either prevent or delay complications related to the disease, but the lack of adherence to treatment is high. Recently, self-efficacy has been pointed in literature as a predictor of health behaviors, especially for diabetes. Hence, there is an association between adherence to treatment and self-efficacy levels. Due to this reason, it is important to have an instrument adapted and validated for brazilian population, which was the objective of the present study: to adapt and validate IMDSES scale to brazilian reality. The original instrument is American and evaluates self-efficacy in the general management of diabetes, diet, and insulin. The sample comprised 213 patients carrying type 1 diabetes. The analysis of the major components, identified three subscales (diet, insulin and general management) which accounted for 53% of variance. Cronbach s α coefficient, used to evaluate reliability, was, respectively: diet subscale α=0,83,insulin α=0,92 and general management α=0,78. Criteria validity was investigated by two parameters: glycosilated 2 hemoglobin, through which it was possible to show a significant association with self-efficay in the insulin subscale (p=0,04), and adherence variable, that was significantly associated to self-efficacy in two subscales (p<0,05). Temporary stability of the instrument was not verified in a subscale. It was concluded that the instrument possesses appropriate psychometric properties to be used on its proposed goal.
Diabetes é um problema de saúde pública. No Brasil, tem uma prevalência de 7,6% e está entre as dez maiores causas de mortalidade. Estudos mostram que o controle glicêmico adequado, pode prevenir ou retardar complicações relacionadas à doença, mas a taxa de não adesão ao tratamento é elevada. Recentemente, a auto-eficácia vem sendo apontada na literatura, como preditora de comportamentos em saúde, especialmente em diabetes. Assim, existe uma associação entre adesão ao tratamento e os níveis de auto-eficácia. Por esse motivo é importante um instrumento adaptado e validado para a população brasileira, e este é o objetivo do presente estudo: adaptar e validar a escala IMDSES para a realidade brasileira. O instrumento original é de origem americana e avalia a auto-eficácia no manejo geral do diabetes, dieta e insulina. A amostra foi constituída de 213 pacientes portadores de diabetes mellitus tipo 1. Na análise dos componentes principais identificaram-se três subescalas (dieta, insulina e manejo geral) que explicaram 53% da variância. O coeficiente Alfa de Cronbach, utilizado para avaliar a fidedignidade, foi, respectivamente: subescala dieta α=0,83,insulina α=0,92 e manejo geral α=0,78. A validade de critério foi investigada por dois parâmetros: hemoglobina glicosilada, pela qual foi possível demonstrar associação significativa com auto-eficácia na subescala insulina (p=0,04), e a variável adesão que se associou significativamente à auto-eficácia em duas subescalas (p<0,05). A estabilidade temporal do instrumento não foi verificada em uma subescala. Concluiu-se que o instrumento possui propriedades psicométricas adequadas para ser utilizado com a finalidade à qual se propôs.

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Collier, Samuel. "Diabetes Management for Low-Income Patients: Within-Case Analyses in Primary Care." Antioch University / OhioLINK, 2019. http://rave.ohiolink.edu/etdc/view?acc_num=antioch1545175642997094.

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Sabo, Jason D. "National Print and Electronic News Coverage of Self Management Behaviors and Efficacy for Type 2 Diabetes Mellitus." Kent State University / OhioLINK, 2011. http://rave.ohiolink.edu/etdc/view?acc_num=kent1310834052.

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Shen, Huixia. "Effectiveness of a peer-led self-management program for older people with type 2 diabetes in China." Thesis, Queensland University of Technology, 2008. https://eprints.qut.edu.au/20671/1/Huixia_Shen_Thesis.pdf.

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Type 2 diabetes is a common chronic disease, which has a negative health impact and results in enormous economic burden. The prevalence of type 2 diabetes is increasing dramatically and it affects older people disproportionately. The healthcare system in China is faced with an overwhelming burden due to a large ageing population, high prevalence of diabetes and limited healthcare resources. Self-management has been widely accepted as the cornerstone of the clinical management of type 2 diabetes. Since self-management usually involves complex behaviour change and can be emotionally challenging, effective education is essential to facilitate this transition. However, there has been no existing program of type 2 diabetes self-management for older patients in China until now. Furthermore, the generalisation of any health education programs is often hampered due to limited healthcare resources in China. The primary purpose of this study was to develop a socially and culturally suitable self-management program, which addressed self-efficacy and social support to facilitate behaviour change and subsequent health improvement, for older people with type 2 diabetes living in the community in China. The secondary purpose was to test a feasible delivery model of the program through involvement of peer leaders and existing community networks. This study was conducted in three phases. Phase one gathered information about barriers related to self-management behaviours and help needed to address them, from the perspective of older people with type 2 diabetes and community health professionals, through focus group discussion. Data from Phase One, together with guidelines of the selected theoretical frame work, results from an extensive literature review, and experiences of previous relevant studies provided the basis for development of a peer-led type 2 diabetes self-management program (Phase Two). Phase Three involved a pre-test, post-test non-equivalent control group design to test the effectiveness of the self-management program on older people with type 2 diabetes in the community. The impact of the program on peer leaders was examined using a one group pre-test, post-test design. In addition, evaluation of the program from peer leaders’ and older people’s perceptions was conducted through a post-test questionnaire. Older people with type 2 diabetes and health professionals expressed broadly the same concerns, which were: social support; confidence to practice self-management behaviours; self-management behaviours; barriers to self-management behaviours; and advice for ongoing health education. However, their points of view were not always identical and different emphases were identified. The peer-led program produced significant improvement in social support, self-efficacy, self-management behaviours and depressive status in the experimental group, as compared to the non-equivalent control group. However, there was no significant effect on quality of life nor health care utilisation. Therefore, the effectiveness of the program among older people with type 2 diabetes was partially confirmed. In addition, the participants were supportive, giving positive feedback about the program. Suggestions for future improvement were provided as well. After receiving specific peer leader training and assisting in most of the delivery process of the program, the peer leaders improved, significantly, in overall self-management behaviours and in specific areas of social support and self-efficacy, though they did not improve in depressive status, quality of life and health care utlisation. In addition, these peer leaders enjoyed being peer leaders, and gave very positive feedback about the whole program. In conclusion, this study has implications for understanding and facilitating self-management behaviours for older people with type 2 diabetes in China. The peer-led self-management program was effective in improving levels of self-efficacy, social support, self-management behaviours and depressive status among older people with type 2 diabetes living in the community in China. The delivery process involving peer leaders was deemed feasible to implement within the health care system in China. The program is suitable to be used by community health professionals in their practice in China. The study also has potential wider benefit to nursing practice and global health practice.

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Shen, Huixia. "Effectiveness of a peer-led self-management program for older people with type 2 diabetes in China." Queensland University of Technology, 2008. http://eprints.qut.edu.au/20671/.

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Type 2 diabetes is a common chronic disease, which has a negative health impact and results in enormous economic burden. The prevalence of type 2 diabetes is increasing dramatically and it affects older people disproportionately. The healthcare system in China is faced with an overwhelming burden due to a large ageing population, high prevalence of diabetes and limited healthcare resources. Self-management has been widely accepted as the cornerstone of the clinical management of type 2 diabetes. Since self-management usually involves complex behaviour change and can be emotionally challenging, effective education is essential to facilitate this transition. However, there has been no existing program of type 2 diabetes self-management for older patients in China until now. Furthermore, the generalisation of any health education programs is often hampered due to limited healthcare resources in China. The primary purpose of this study was to develop a socially and culturally suitable self-management program, which addressed self-efficacy and social support to facilitate behaviour change and subsequent health improvement, for older people with type 2 diabetes living in the community in China. The secondary purpose was to test a feasible delivery model of the program through involvement of peer leaders and existing community networks. This study was conducted in three phases. Phase one gathered information about barriers related to self-management behaviours and help needed to address them, from the perspective of older people with type 2 diabetes and community health professionals, through focus group discussion. Data from Phase One, together with guidelines of the selected theoretical frame work, results from an extensive literature review, and experiences of previous relevant studies provided the basis for development of a peer-led type 2 diabetes self-management program (Phase Two). Phase Three involved a pre-test, post-test non-equivalent control group design to test the effectiveness of the self-management program on older people with type 2 diabetes in the community. The impact of the program on peer leaders was examined using a one group pre-test, post-test design. In addition, evaluation of the program from peer leaders’ and older people’s perceptions was conducted through a post-test questionnaire. Older people with type 2 diabetes and health professionals expressed broadly the same concerns, which were: social support; confidence to practice self-management behaviours; self-management behaviours; barriers to self-management behaviours; and advice for ongoing health education. However, their points of view were not always identical and different emphases were identified. The peer-led program produced significant improvement in social support, self-efficacy, self-management behaviours and depressive status in the experimental group, as compared to the non-equivalent control group. However, there was no significant effect on quality of life nor health care utilisation. Therefore, the effectiveness of the program among older people with type 2 diabetes was partially confirmed. In addition, the participants were supportive, giving positive feedback about the program. Suggestions for future improvement were provided as well. After receiving specific peer leader training and assisting in most of the delivery process of the program, the peer leaders improved, significantly, in overall self-management behaviours and in specific areas of social support and self-efficacy, though they did not improve in depressive status, quality of life and health care utlisation. In addition, these peer leaders enjoyed being peer leaders, and gave very positive feedback about the whole program. In conclusion, this study has implications for understanding and facilitating self-management behaviours for older people with type 2 diabetes in China. The peer-led self-management program was effective in improving levels of self-efficacy, social support, self-management behaviours and depressive status among older people with type 2 diabetes living in the community in China. The delivery process involving peer leaders was deemed feasible to implement within the health care system in China. The program is suitable to be used by community health professionals in their practice in China. The study also has potential wider benefit to nursing practice and global health practice.

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Dao, Tran Tiet Hanh. "An investigation of factors influencing diabetes self-management among adults with type 2 diabetes in Vietnam." Thesis, Queensland University of Technology, 2012. https://eprints.qut.edu.au/62188/1/Tiet_Hanh_Dao_Tran_Thesis.pdf.

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Background: In diabetes care, health care professionals need to provide support for their patients. In order to provide good diabetes self-management support for adults with type 2 diabetes in Vietnam, it is important that health care professionals in Vietnam understand the factors influencing diabetes self-management among these people. However, knowledge about factors influencing diabetes self-management among adults with type 2 diabetes in Vietnam is limited. Objectives: This study aimed to investigate factors influencing diabetes self-management among adults with type 2 diabetes in Vietnam. Methodology: A cross-sectional survey with convenience sampling was conducted on 198 adults with type 2 diabetes in VietnamData collection was administeted via interview. Descriptive statistics, simple correlation statistics and structural equation modelling statistics were used for data analysis. Results: Adults with type 2 diabetes in Vietnam had limited diabetes knowledge (Median = 6.0). The majority of the study participants (72.7%) believed that performing diabetes self-management activities was very important or extremely important for controlling their blood glucose levels and for preventing complications from diabetes; about half usually received support from their family and friends’ (48.5%), and around two thirds rarely received support from their health care providers (68.2%). Many of the participants (41.4%) had limited confidence to perform diabetes management activities. The practices of diabetes self-management were limited among the study population (Mean = 96.7, SD = 19.4). Diabetes knowledge (β = 0.17, p < .001), belief in treatment effectiveness (β = 0.13, p < .01), family and friends’ support (β = 0.13, p < .001), health care providers’ support (β = 0.27, p < .001) and diabetes management self-efficacy (β = 0.43, p < .001) directly influenced their diabetes self-management. Diabetes knowledge, and family and friends’ support also indirectly influenced diabetes self-management among these people through their belief in treatment effectiveness and their diabetes management self-efficacy (p < .05). Conclusion: Findings in this study indicated that health care professionals should provide diabetes self-management support for adults with type 2 diabetes in Vietnam in the future. The adapted theory-based model of factors influencing diabetes self-management among adults with type 2 diabetes in Vietnam found in this study could be a useful framework to develop this supporting program.

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Wong, Lorrie. "Investigation into the Relationship Between Worry and Self Efficacy on Self-management in an Asian Pacific Islander Population with Type 2 Diabetes." Diss., University of Hawaii at Manoa, 2009. http://hdl.handle.net/10125/22074.

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Diabetes Mellitus is a complex chronic disease that is prevalent throughout the world (Wild, Roglic, Green, Sicree, & King, 2004). People living with this disease are confronted with lifestyle modifications that require daily attention to a myriad of self care behaviors and health practices. Adherence to these self care recommendations can prevent the devastating complications that are associated with diabetes (UKPDS Group, 1998; Stratton, Adler, Neil, et al., 2000). Though knowledge plays an important role in the self management of diabetes, education alone does not ensure adherence to life-long behavior changes (Norris, Lau, Smith, Schmid, & Engelgau, 2002; Krichbaum, Aarestad, Buethe, 2003). It is recognized that additional research is needed to understand barriers and facilitators to behavior change. Studies have identified that people with diabetes have worries about their disease and specific sources of worries include worries about being able to carry out family responsibilities in the future, worries about their financial future, worries about weight, and worries about risk for hypoglycemia (Peyrot, Rubin, Lauritzen, Snoek, Matthews, & Skovlund, 2005). Investigation into the effects of worry on health has focused primarily on worry's motivational properties and little is known about how worry impacts self management adherence in the diabetic population. The purpose of this study was to investigate the relationship between worry, self efficacy and adherence to self management recommendations in the API diabetic population. An analysis of data previously collected from a two arm randomized controlled intervention trial (ENHANCE project) was undertaken to answer the research questions. The findings of this study suggest that levels of and types of worry have an effect on self efficacy and on self management adherence. Social worries had a direct effect on self efficacy and positively moderated self efficacy's impact on self management adherence. Disease specific worries had a negative direct effect on self efficacy and negatively moderated self efficacy's effect on adherence. In addition, our study supported the understanding that worry perception and impact may differ among ethnic groups. The Hawaiian and Pacific Islanders in our study experienced less worries as measured by our social worry tools than the Asian participants.

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Wu, Shu Fang. "Effectiveness of self-management for persons with type 2 diabetes following the implementation of a self-efficacy enhancing intervention program in Taiwan." Thesis, Queensland University of Technology, 2007. https://eprints.qut.edu.au/16385/1/Shu-Fang_Wu_Thesis.pdf.

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Objective The aim of this study firstly, was to translate and test the validity and reliability of two diabetes-specific self-efficacy instruments (the Diabetes Management Self-Efficacy Scale; DMSES and the Perceived Therapeutic Efficacy Scale; PTES) in a Taiwanese population. The main aim of this study was then to develop an intervention based on self-efficacy theory that was appropriate for the Taiwanese population and to examine the effects of a self-efficacy enhancing intervention program (SEEIP). Background In Taiwan, the prevalence, mortality rate and healthcare cost of diabetes has dramatically increased. People with diabetes have low participation rates in performing self-care activities, with some two-thirds of diabetic patients not controlling their disease appropriately. Moreover, few studies in Taiwan have conducted randomised controlled trials or had improvement in patient self-care or self-management as their primary goal and no instruments that measure self-efficacy related to the management of diabetes (especially for outcome expectations) have yet been found and appropriately used to measure the effectiveness of self-management. Therefore, there is a particular need for research on self-efficacy enhancing intervention programs for people with type 2 diabetes. Design A convenience sample survey (n=230) was used in order to test the validity and reliability of C-DMSES and C-PTES in a Taiwanese population. Moreover, a randomised controlled trial (RCT) (n=145; the intervention group (72); the control group (73)) design was conducted in the main study with pre (baseline) and post-testing (undertaken at 3 months and 6 months following baseline collection). Intervention Both the control group and intervention group received the standard diabetic educational program in the outpatient clinic. The intervention group participants received the standard diabetic educational program and the following additional interventions: (1) viewed a 10-minute DVD (2) received a "Diabetes Self-Care" booklet (3) participated in four efficacy- enhancing counselling intervention sessions, and (4) participated in telephone follow-up. The self-efficacy model was adapted from Shortridge-Baggett & van der Bijl (1996). Diabetes self-management principles were used in program development and evaluation. Main outcome measures Instruments used in data collection included 1) Self-efficacy towards management of type 2 diabetes (as measured by the Chinese version of the Diabetes Management Self-Efficacy Scale; C-DMSES and the Chinese version of the Perceived Therapeutic Efficacy Scale; C-PTES); 2) self management behavior (as measured by the Summary of Diabetes Self-Care Activities; SDSCA); 3) health-related quality of life for diabetes (as measured by the Short Form-12; SF-12); 4) psychosocial well-being (as measured by the Medical Outcomes Study (MOS), Social Support Survey (SSS) tool and the Center for Epidemiology Studies Short Depression Scale; CES-D) and 5) health care utilisation (as measured by health care utilisation self report instrument). Data analysis Data were double-entered for verification using SPSS® statistical software. Study I: Descriptive statistics, regression analysis, Pearson's correlation, Cronbach's alpha-coefficients, factor analysis and Bland-Altman plots with 95% limits of agreement (LOA) were performed to evaluate validity and reliability of C-DMSES and C-PTES. Study II: Descriptive analysis was used to examine demographic variables and outcome variables. T-tests were used to analyse differences on continuous data between mean scores for the intervention and control groups. Categorical data were analysed using Chi-square statistics to test the significance of different proportions. To assess the group differences of dependent variable changes, repeated measures ANOVA/ ANCOVA were used. Results Study I: Convergent validity showed that C-DMSES correlated well with the validated measure of the General Self-Efficacy Scale (GSE) in measuring self-efficacy. Criterion-related validity showed that the C-DMSES was a significant predictor of the Summary of Diabetes Self-Care Activities (SDSCA) scores. Factor analysis supported the C-DMSES being composed of four subscales with good internal consistency (Cronbach's alpha=.77 to .93) and stability (ICC=.82). Similarly, significant criterion-related validity was demonstrated between the C-PTES and SDSCA scores. Convergent validity was confirmed as the C-PTES converged well with the GSE Scale in measuring self-efficacy. Construct validity of the C-PTES was confirmed through factor analysis and a single subscale formed. Internal consistency with a Cronbach's alpha was .95 and the test-retest reliability (ICC) was .77 and a Bland-Altman plot showed 97% of the subjects were within 2 standard deviations of the mean. Study II: The 3- and 6-month benefits of the intervention over usual care were increases in self-efficacy, outcome expectation, self-care activities, and social support. However, the results of the health-related quality of life and depression scores indicated that the change over time was not different in the two groups. A smaller proportion of the participants significantly in the intervention group, had been hospitalised and visited the emergency room than participants who were in the control group at the 6-month period. However, health-related quality of life and depression were not significantly increased in the intervention group at the 3- and 6-month compared to the control group. Conclusion Results of Study I support the psychometric properties of C-DMSES and C-PTES in providing a measure for self-efficacy specific to persons with type 2 diabetes in Taiwan. The main study revealed that the SEEIP for type 2 diabetes based on self-efficacy theory was culturally acceptable to Taiwanese people with diabetes and that the SEEIP was effective in the self-management of people with type 2 diabetes.

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Wu, Shu Fang. "Effectiveness of self-management for persons with type 2 diabetes following the implementation of a self-efficacy enhancing intervention program in Taiwan." Queensland University of Technology, 2007. http://eprints.qut.edu.au/16385/.

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Objective The aim of this study firstly, was to translate and test the validity and reliability of two diabetes-specific self-efficacy instruments (the Diabetes Management Self-Efficacy Scale; DMSES and the Perceived Therapeutic Efficacy Scale; PTES) in a Taiwanese population. The main aim of this study was then to develop an intervention based on self-efficacy theory that was appropriate for the Taiwanese population and to examine the effects of a self-efficacy enhancing intervention program (SEEIP). Background In Taiwan, the prevalence, mortality rate and healthcare cost of diabetes has dramatically increased. People with diabetes have low participation rates in performing self-care activities, with some two-thirds of diabetic patients not controlling their disease appropriately. Moreover, few studies in Taiwan have conducted randomised controlled trials or had improvement in patient self-care or self-management as their primary goal and no instruments that measure self-efficacy related to the management of diabetes (especially for outcome expectations) have yet been found and appropriately used to measure the effectiveness of self-management. Therefore, there is a particular need for research on self-efficacy enhancing intervention programs for people with type 2 diabetes. Design A convenience sample survey (n=230) was used in order to test the validity and reliability of C-DMSES and C-PTES in a Taiwanese population. Moreover, a randomised controlled trial (RCT) (n=145; the intervention group (72); the control group (73)) design was conducted in the main study with pre (baseline) and post-testing (undertaken at 3 months and 6 months following baseline collection). Intervention Both the control group and intervention group received the standard diabetic educational program in the outpatient clinic. The intervention group participants received the standard diabetic educational program and the following additional interventions: (1) viewed a 10-minute DVD (2) received a "Diabetes Self-Care" booklet (3) participated in four efficacy- enhancing counselling intervention sessions, and (4) participated in telephone follow-up. The self-efficacy model was adapted from Shortridge-Baggett & van der Bijl (1996). Diabetes self-management principles were used in program development and evaluation. Main outcome measures Instruments used in data collection included 1) Self-efficacy towards management of type 2 diabetes (as measured by the Chinese version of the Diabetes Management Self-Efficacy Scale; C-DMSES and the Chinese version of the Perceived Therapeutic Efficacy Scale; C-PTES); 2) self management behavior (as measured by the Summary of Diabetes Self-Care Activities; SDSCA); 3) health-related quality of life for diabetes (as measured by the Short Form-12; SF-12); 4) psychosocial well-being (as measured by the Medical Outcomes Study (MOS), Social Support Survey (SSS) tool and the Center for Epidemiology Studies Short Depression Scale; CES-D) and 5) health care utilisation (as measured by health care utilisation self report instrument). Data analysis Data were double-entered for verification using SPSS® statistical software. Study I: Descriptive statistics, regression analysis, Pearson's correlation, Cronbach's alpha-coefficients, factor analysis and Bland-Altman plots with 95% limits of agreement (LOA) were performed to evaluate validity and reliability of C-DMSES and C-PTES. Study II: Descriptive analysis was used to examine demographic variables and outcome variables. T-tests were used to analyse differences on continuous data between mean scores for the intervention and control groups. Categorical data were analysed using Chi-square statistics to test the significance of different proportions. To assess the group differences of dependent variable changes, repeated measures ANOVA/ ANCOVA were used. Results Study I: Convergent validity showed that C-DMSES correlated well with the validated measure of the General Self-Efficacy Scale (GSE) in measuring self-efficacy. Criterion-related validity showed that the C-DMSES was a significant predictor of the Summary of Diabetes Self-Care Activities (SDSCA) scores. Factor analysis supported the C-DMSES being composed of four subscales with good internal consistency (Cronbach's alpha=.77 to .93) and stability (ICC=.82). Similarly, significant criterion-related validity was demonstrated between the C-PTES and SDSCA scores. Convergent validity was confirmed as the C-PTES converged well with the GSE Scale in measuring self-efficacy. Construct validity of the C-PTES was confirmed through factor analysis and a single subscale formed. Internal consistency with a Cronbach's alpha was .95 and the test-retest reliability (ICC) was .77 and a Bland-Altman plot showed 97% of the subjects were within 2 standard deviations of the mean. Study II: The 3- and 6-month benefits of the intervention over usual care were increases in self-efficacy, outcome expectation, self-care activities, and social support. However, the results of the health-related quality of life and depression scores indicated that the change over time was not different in the two groups. A smaller proportion of the participants significantly in the intervention group, had been hospitalised and visited the emergency room than participants who were in the control group at the 6-month period. However, health-related quality of life and depression were not significantly increased in the intervention group at the 3- and 6-month compared to the control group. Conclusion Results of Study I support the psychometric properties of C-DMSES and C-PTES in providing a measure for self-efficacy specific to persons with type 2 diabetes in Taiwan. The main study revealed that the SEEIP for type 2 diabetes based on self-efficacy theory was culturally acceptable to Taiwanese people with diabetes and that the SEEIP was effective in the self-management of people with type 2 diabetes.

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Robinson, Terri E. Ph D. "An analysis of the influence of education programming type, scope of diabetes self-management education, and selected demographics on self-efficacy among adult African Americans with type 2 diabetes." Kent State University / OhioLINK, 2015. http://rave.ohiolink.edu/etdc/view?acc_num=kent1435268220.

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Beyer, Ida, and Sydow Emma von. "Patienters hanterbarhet av diabetes typ 2 : En beskrivande analys av hur kön, ålder och duration av typ 2-diabetes påverkar patienters hanterbarhet av sin sjukdom." Thesis, Ersta Sköndal högskola, Institutionen för vårdvetenskap, 2013. http://urn.kb.se/resolve?urn=urn:nbn:se:esh:diva-2183.

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Wichit, Nutchanath. "Using a Randomised Controlled Trial to Test the Effectiveness of a Family-Oriented, Theoretically Based, Diabetes Self-Management Education Program to Improve Glycaemia, Self-Management and Self-Efficacy of Individuals with Type 2 Diabetes Mellitus Living in Rural Thailand." Thesis, Australian Catholic University, 2018. https://acuresearchbank.acu.edu.au/download/03bd0306c4a116a7a82c15b10eb68c51666051d4858ebe06822d21f152e856d9/7549634/WICHIT_2018_Using_a_randomised_controlled_trial_to.pdf.

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Introduction Diabetes is increasing in prevalence throughout the world. This increase is also of concern to upper-middle-income countries such as Thailand. Diabetes mellitus develops gradually and is often undetected in the early stages, leading to long-term damage of several organs in the body with related complications. Diabetes self-management education (DSME) has been found to improve knowledge, self-care behaviours, glycaemic control, and quality of life for Thai individuals with type 2 diabetes mellitus (T2DM). Thailand is a country in which family members have a fundamental role in assisting other family members in sickness and in health. Family-oriented interventions, therefore, have the potential to enhance health outcomes for individuals with T2DM. Randomised controlled trials conducted on family-carers of individuals with diabetes in Thailand are limited and none has investigated the potential benefit of a family-oriented DSME program, which includes the family-carer in the intervention. Aims The primary aim of this study was to test the effectiveness of a family-oriented, theoretically derived (based on self-efficacy) DSME for Thai individuals living with T2DM. The specific objectives of this research are to develop and deliver a family-oriented DSME for Thai individuals with T2DM and carers; to evaluate the effectiveness of a family-oriented DSME in improving diabetes knowledge, glycaemic control, self-efficacy, self-management, and quality of life among Thai individuals with T2DM; to develop and test the validity and reliability of the family-carer diabetes management self-efficacy scale (F-DMSES) that measures diabetes management self-efficacy among family-carers of Thai individuals with T2DM; and, finally, to measure and compare diabetes management self-efficacy between individuals with T2DM and their carers. Methods After developing a family-oriented DSME program, a single-blinded randomised controlled trial was conducted in rural Thailand to examine the effectiveness of the program. One hundred and forty Thai individuals with T2DM (and their carers) were randomly allocated to intervention and control arms. Those in the intervention group received routine care plus the family-oriented program that included education classes, group discussions, a home visit, and a telephone follow-up. Participants within the control group only received the routine usual care. The sample size was estimated based on a known effect size (effect size = 0.58) from the primary outcome of diabetes self-management score (Mean difference = 8.35, SD = 14.28) (Wu et al., 2011). The level of significance was set at 0.05 (probability of type 1 error) and a power of 0.90 (1- probability of type 2 error), and a sample of 140 people (70 per group) was required. The primary study outcome was diabetes self-management evaluated by the Summary of Diabetes Self-Care Activities measure. The secondary outcomes were diabetes knowledge evaluated by the Diabetes Knowledge Questionnaire, diabetes self-efficacy (efficacy expectation and outcome expectation) evaluated by the Diabetes Management Self-Efficacy Scale and the Perceived Therapeutic Efficacy Scale, quality of life evaluated by the 12-item Short-Form Health Survey, and glycaemic control as shown by HbA1C levels. Outcome assessments were made overtime (baseline, week 5 and week 13 following intervention) and were evaluated using generalised estimating equations multivariable analyses. The family-carer diabetes management self-efficacy scale (F-DMSES) was developed using forward and backward translations from and to English and Thai languages and its construct and content validity, together with the internal consistency, were tested. Results One hundred and forty participants were actually recruited and randomized to the intervention but 134 individuals have completed the three time points in data collection. Intention to-treat analyses were conducted in this study. Except for age, no between-group significant differences were found in all other baseline characteristics. Diabetes self-efficacy, self-management, and quality of life improved in the intervention group but no improvement was observed in the controls. In the risk-adjusted multivariable models, compared to the controls, participants in the intervention group had significantly better self-efficacy, self-management, outcome expectations, and diabetes knowledge (p < 0.001 for all outcomes). Participation in the intervention increased the diabetes self-management score by 14.3 points (β = 14.3, (95% CI 10.7 – 17.9), p < 0.001). Self-management improved in individuals with lower BMIs and in females. No between-group differences were observed in quality of life or glycaemic control. The F-DMSES retained 14 items within 4 factors (general diet and blood glucose monitoring, medications and complications, diet in differing situations, and weight control and physical activities), and explained 72.2% of the total variance in the overarching construct. Internal consistency was high (α = 0.89). The F-DMSES was also able to measure change over time following the intervention, with an effect size of 0.9. Diabetes knowledge and management self-efficacy in family-carers improved over time. These aspects were also improved in individuals with T2DM when compared to their carers. Conclusions The family-oriented DSME program improved self-efficacy, self-management and quality of life, which in turn could decrease HbA1c levels. The F-DMSES is a valid and reliable self-administered instrument that measures the diabetes management self-efficacy of family-carers of individuals with T2DM, which can be used in clinical and research situations. Better carer diabetes knowledge improved the self-management of individuals with T2DM and greater family-carer diabetes management self-efficacy increased the diabetes management self-efficacy of individuals with T2DM. Family-carers can play an important role in supporting individuals with T2DM living in Thailand and should be formally included within educational programs. Family-carers also have the potential to provide compensatory care when required.

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Wu, Chiung-Jung. "Promoting self-management for patients with type 2 diabetes following a critical cardiac event." Thesis, Queensland University of Technology, 2007. https://eprints.qut.edu.au/16465/1/Chiung-Jung_Wu_Thesis.pdf.

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Type 2 diabetes is a global health problem. Evidence indicates that type 2 diabetes can lead to serious complications, such as a cardiac event, which usually require critical nursing care. Patients with type 2 diabetes and with a history of cardiac disease are at greater risk of a further cardiac event requiring readmission to hospital. Evidence indicates that improved diabetes management assists patients with type 2 diabetes to manage their condition efficiently, reduces risks of a further cardiac event, and therefore reduces hospitalisations. However, there is limited information found regarding a diabetes management program specifically for patients who have already had cardiac complications. Difficulties in developing patients' skills in managing and modifying their daily lives also present a challenge to coronary care staff. Therefore, there is a real need to develop a special diabetes management program for patients with diabetes who have experienced a critical cardiac event, which will be commenced in the Coronary Care Unit (CCU). The aim of this research is to gain a greater understanding of the characteristics, secondly to obtain in-depth understanding of needs and experiences of patients with type 2 diabetes hospitalised for a critical cardiac event. A further aim is to develop and pilot test a diabetes management program, specific to the patients with diabetes in the context of the CCU. The design of this research employed three studies: Study I was an exploratory study, which obtained patients' demographic and disease characteristics from the hospital records of all patients with diabetes admitted to the CCU of one public hospital between 1 January 2000 to 31 December 2003. Study II used a qualitative interpretative approach and aimed to gain an in-depth understanding of the perspectives of patients with type 2 diabetes who have experienced a critical cardiac event in managing their everyday lives with both diabetes and cardiac conditions. Study III included two parts. The first utilised the information from the first two studies and the literature (self-efficacy theory) to develop a diabetes self-management program specifically for patients with diabetes who have had a critical cardiac event. The second part pilot tested the newly-developed diabetes self-management program for patients with diabetes admitted to CCU following a critical cardiac event. The pilot study used a randomised controlled trial research design to evaluate the efficacy of the program. Study I collected data from one hospital's records retrospectively from 2000 to 2003. The results of Study I showed there were 233 (14.7%) patients admitted to CCU that had diabetes out of the total 1589 CCU admissions during the study period. More than 22% of CCU patients with diabetes were readmitted to hospital within 28 days, compared to 6% of CCU patients without diabetes. Patients with diabetes who had a longer CCU stay were more likely to be readmitted. These results indicate that a significant proportion of a CCU population had type 2 diabetes and is more likely to be readmitted to hospital. Study II used an interpretive approach comprising open-ended interviews to collect data from patients with type 2 diabetes experiencing a cardiac event who had a CCU admission in 2000-2003. The findings revealed that patients with diabetes who had a critical cardiac event experienced considerable feelings of hopelessness and fatigue. Patients also had concerns in the areas of self-confidence and confidence in health professionals. Patients indicated that greater self-confidence and confidence in health professionals would help their ability to manage their daily lives. Therefore, it is very important that intervention programs for these at-risk patients need to improve patients' confidence levels, and reduce their feelings of hopelessness and fatigue. The information gathered from Study I and Study II provided important insight into the development of an effective diabetes self-management specifically designed for patients with type 2 diabetes following a critical cardiac event, which is presented in Study III in this thesis. Study III also provided a preliminary evaluation of the newly developed program. The evaluation used a randomised controlled trial research design for the new program and the current educational program provided in the CCU. The results of the program indicate the feasibility of commencing the new diabetes self-management program in the CCU, and to be continued in wards or at home. The results also showed significant improvements in patients' knowledge in the experimental group, but not in other outcome variables (self-efficacy, vitality and mental health levels). However, as a small sample size was used in this pilot study, a larger study is needed to ensure adequate testing of the intervention. Future research is also recommended to incorporate the new diabetes self-management program into the current cardiac education program. Staff's further professional development in providing such a program also needs to be examined. Improvements in quality of care, and patients' quality of life are expected in the future.

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Wu, Chiung-Jung. "Promoting self-management for patients with type 2 diabetes following a critical cardiac event." Queensland University of Technology, 2007. http://eprints.qut.edu.au/16465/.

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Type 2 diabetes is a global health problem. Evidence indicates that type 2 diabetes can lead to serious complications, such as a cardiac event, which usually require critical nursing care. Patients with type 2 diabetes and with a history of cardiac disease are at greater risk of a further cardiac event requiring readmission to hospital. Evidence indicates that improved diabetes management assists patients with type 2 diabetes to manage their condition efficiently, reduces risks of a further cardiac event, and therefore reduces hospitalisations. However, there is limited information found regarding a diabetes management program specifically for patients who have already had cardiac complications. Difficulties in developing patients' skills in managing and modifying their daily lives also present a challenge to coronary care staff. Therefore, there is a real need to develop a special diabetes management program for patients with diabetes who have experienced a critical cardiac event, which will be commenced in the Coronary Care Unit (CCU). The aim of this research is to gain a greater understanding of the characteristics, secondly to obtain in-depth understanding of needs and experiences of patients with type 2 diabetes hospitalised for a critical cardiac event. A further aim is to develop and pilot test a diabetes management program, specific to the patients with diabetes in the context of the CCU. The design of this research employed three studies: Study I was an exploratory study, which obtained patients' demographic and disease characteristics from the hospital records of all patients with diabetes admitted to the CCU of one public hospital between 1 January 2000 to 31 December 2003. Study II used a qualitative interpretative approach and aimed to gain an in-depth understanding of the perspectives of patients with type 2 diabetes who have experienced a critical cardiac event in managing their everyday lives with both diabetes and cardiac conditions. Study III included two parts. The first utilised the information from the first two studies and the literature (self-efficacy theory) to develop a diabetes self-management program specifically for patients with diabetes who have had a critical cardiac event. The second part pilot tested the newly-developed diabetes self-management program for patients with diabetes admitted to CCU following a critical cardiac event. The pilot study used a randomised controlled trial research design to evaluate the efficacy of the program. Study I collected data from one hospital's records retrospectively from 2000 to 2003. The results of Study I showed there were 233 (14.7%) patients admitted to CCU that had diabetes out of the total 1589 CCU admissions during the study period. More than 22% of CCU patients with diabetes were readmitted to hospital within 28 days, compared to 6% of CCU patients without diabetes. Patients with diabetes who had a longer CCU stay were more likely to be readmitted. These results indicate that a significant proportion of a CCU population had type 2 diabetes and is more likely to be readmitted to hospital. Study II used an interpretive approach comprising open-ended interviews to collect data from patients with type 2 diabetes experiencing a cardiac event who had a CCU admission in 2000-2003. The findings revealed that patients with diabetes who had a critical cardiac event experienced considerable feelings of hopelessness and fatigue. Patients also had concerns in the areas of self-confidence and confidence in health professionals. Patients indicated that greater self-confidence and confidence in health professionals would help their ability to manage their daily lives. Therefore, it is very important that intervention programs for these at-risk patients need to improve patients' confidence levels, and reduce their feelings of hopelessness and fatigue. The information gathered from Study I and Study II provided important insight into the development of an effective diabetes self-management specifically designed for patients with type 2 diabetes following a critical cardiac event, which is presented in Study III in this thesis. Study III also provided a preliminary evaluation of the newly developed program. The evaluation used a randomised controlled trial research design for the new program and the current educational program provided in the CCU. The results of the program indicate the feasibility of commencing the new diabetes self-management program in the CCU, and to be continued in wards or at home. The results also showed significant improvements in patients' knowledge in the experimental group, but not in other outcome variables (self-efficacy, vitality and mental health levels). However, as a small sample size was used in this pilot study, a larger study is needed to ensure adequate testing of the intervention. Future research is also recommended to incorporate the new diabetes self-management program into the current cardiac education program. Staff's further professional development in providing such a program also needs to be examined. Improvements in quality of care, and patients' quality of life are expected in the future.

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Obaid, Balsam. "Youth with type 1 diabetes: A study of their epidemiological and clinical characteristics, glycaemic control and psychosocial predictors, and an evaluation of the efficacy of Motivational Interviewing in improving diabetes management." Thesis, University of Canterbury. School of Health Sciences, 2015. http://hdl.handle.net/10092/11078.

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Poorly controlled diabetes is common among the majority of youth with type 1 diabetes and can lead to adverse health outcomes at an early age. There is a need to change this to minimise the risk of negative long-term consequences. The onset of complications from diabetes can be prevented or delayed with good management as demonstrated by blood glucose being kept close to or within the normal range. Diabetes control is challenging for young people due to a combination of physiological and psychological factors. Diabetes control needs to be monitored both at an individual level and also at a population level, in order to optimise health outcomes and provide important information for health service provision. There are gaps in knowledge relating to the current level of diabetes control at a population level and of the epidemiological characteristics of youth with type 1 diabetes in the Canterbury region in New Zealand. There has been no research of this nature in the Canterbury region since 2003. There are also gaps in knowledge and a lack of national and international research that investigates psychosocial characteristics of youth with type 1 diabetes and the impact these may have on diabetes control. There is a potentially promising intervention, namely, Motivational Interviewing (MI), that although previous research investigating it with diabetes has shown some promise, methodological problems have limited the conclusions that can be drawn. This thesis, within the New Zealand context, addresses some of these gaps and adds to the body of knowledge of research concerning diabetes control and youth with type 1 diabetes, and investigates MI intervention for youth with poorly controlled diabetes. The thesis encompasses three studies. The first study is an audit that provides up-to-date information on epidemiological characteristics and clinical outcomes for the youth population with type 1 diabetes residing in the Canterbury region. The second study is a cross-sectional study that investigates the relationship between glycaemic control and key psychosocial characteristics: illness beliefs, self-efficacy, and quality of life in youth with type 1 diabetes in Canterbury. The third study is a longitudinal study that investigates the efficacy of MI as an intervention for youth with poorly controlled type 1 diabetes, and explores its impact on diabetes outcomes using statistical and clinical analyses. The first study showed that from 2003 to 2010 the prevalence of adolescents and young adults with type 1 diabetes in Canterbury has increased; there is therefore an increased demand on health resources. In addition, in 2010 glycaemic control at a population level was in the poorly controlled diabetes range and this had remained unchanged since 2003. This suggests the need for more intensive interventions. The second study found that poor diabetes control in youth with type 1 diabetes is influenced by a number of factors, including negative views on diabetes, lower perceived personal control, higher diabetes-related concerns, and lower levels of worry about complications. These findings provide a new understanding of the importance of balancing worries about diabetes complications and the perception of diabetes as a threatening condition. The third study showed that the MI intervention was generally successful in improving diabetes outcomes – clinical, psychosocial, and behavioural changes were observed. Statistically and clinically significant positive changes were found across multiple variables: glycated haemoglobin (HbA1c), glycaemic variability, adherence, and psychosocial functioning. Taken together, the findings of the three studies indicate that majority of youth with type 1 diabetes in the Canterbury region had poor glycaemic control, which suggests that additional interventions may be required to improve management of their condition, especially interventions targeting psychosocial functioning (e.g., illness perceptions) and diabetes self-management. Motivational Interviewing may be a viable option, and therefore further research into this approach is recommended.

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Yamonn, Nyo. "Examination of the Association between Patient Empowerment and Diabetes Management among an Urban African American Population by Gender, Age, Socioeconomic Status and Education Level." Digital Archive @ GSU, 2010. http://digitalarchive.gsu.edu/iph_theses/83.

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Diabetes mellitus is a significant problem in the United States with the burden being greater in the African American population. Because diabetes is complex and costly, the importance of self-care management changes the disease management paradigm from “provider-centered” to patient-centered”. Empowerment is a possible solution for barriers to better diabetes management. Patient empowerment is helping patients discover and develop the inherent capacity to be responsible for their own life. Although patient empowerment is a valuable philosophy, there are gaps between the philosophy and actual practice. There are limited studies addressing the effectiveness of patient empowerment at improving diabetes management. Therefore, this study examined the association of patient empowerment and diabetes management by gender, age, socioeconomic status and education level by using the data from the Patient Empowerment to Improve Diabetes Care intervention conducted in the Diabetes Clinic of the Grady Health System (GHS). In this study, diabetes management was measured by glycated hemoglobin (HbA1c) level which shows the average blood glucose level over the past two to three months. Patient empowerment was measured by two standardized tools which were the Diabetes Empowerment Scale-Short Form and Patient Activation Measure. In this study, patient empowerment scores measured by these tools were not associated with HbA1c level in African American diabetes patients of the Diabetes Clinic of the GHS. Further study is necessary to understand the association between patient empowerment and diabetes disease management by using different measures of patient empowerment, different levels of disease management, and measurement in different settings.

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Dommers, Eric. "Social cognitive theory and type ii diabetes education: A case study." Thesis, Queensland University of Technology, 2003. https://eprints.qut.edu.au/36681/1/36681_Digitised%20Thesis.pdf.

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Type II diabetes is one of Australia's six national health priority areas, and typically afflicts overweight adults who are over forty years of age. Although type II diabetes can be controlled through lifestyle modifications such as diet and exercise, many diabetic patients find these changes difficult to make, and to sustain. Even when patients attend diabetes education programs which include medical information and skills training designed to facilitate changes in patient self-management behaviour, many fail to improve or control their condition. Although the research literature has identified that health education programs which are based on Social Cognitive Theory (Bandura, 1997; 1986), and which are designed to increase participants' self-efficacy and outcome expectations, can produce changes in self-management behaviour - the research outcomes for group diabetes education programs (DEPs) have nonetheless yielded inconsistent results. While there are numerous factors which have the potential to influence the educational process, this study explored the impact of a group diabetes education program based on Social Cognitive Theory on the cognitive processes (psycho-social skills) which are believed to support self-efficacy and outcome expectations. Using a case study design, data was collected through structured interviews and surveys from participants in a group diabetes education program conducted in Brisbane. The broad findings of the current study were that: 1. outcome expectation beliefs changed substantially for most participants (as anticipated by the study), although the extent of biomedical knowledge acquisition was highly variable across the group. 2. cognitive change with respect to the knowledge of psycho-social processes was highly variable, with some participants manifesting no real change. This finding was (only) in partial correspondence with the anticipated changes. 3. several factors appeared to have impacted significantly on the DEP outcomes. These factors included: the level of diabetes educator skill and self confidence; the DEP participants' existing belief systems and cognitive flexibility with respect to psycho-social theories about motivation and confidence; the impact of group dynamics on 'learning to live' with diabetes; and contingent health issues influencing learning and learning transfer.

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Andrae, Daniela. ""Diabetes? I can live with it" : a qualitative evaluation of a diabetes self-management programme : a thesis presented in partial fulfilment of the requirements for the degree of Master of Arts in Psychology at Massey University, Palmerston North, New Zealand." Massey University, 2009. http://hdl.handle.net/10179/1199.

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Self-management programmes provide one form of education for people with diabetes. Evaluations of these programmes allow for a better understanding in regard to their impact and whether outcomes are met. Very little research has used qualitative methods to capture participants’ experiences of these programmes and their perception of psychological outcomes. This is the first qualitative evaluation of the Type 2 Diabetes Self-Management Programme in Whangarei. It has adopted an interpretative-phenomenological approach to explore participants’ experiences of the programme and participants’ perceptions in regard to their self-efficacy and quality of life after attending a course. A sample of 7 participants with diabetes provided data via interviews 4 weeks and 3 months after attending the course. The themes that emerged from the initial interview were separated into three evaluation components. In “6 weeks sounded very long but it was worth the time”, participants discussed enrolment, benefits of the course and suggestions for future participants. In “I know what I need to do and I’m confident to do it”, participants linked the gained knowledge from the course to improvements in their self-efficacy regarding self-management behaviours, education and control of own life. In “Life is good, diabetes is just another thing to handle”, participants reflected on the impact of living with diabetes and changes to their life. An overarching theme of settling into a comfortable routine emerged from the follow-up interview. Participants reflected positively on their course and research participation. The programme was perceived to be beneficial to participants, impacting positively on increasing knowledge, self-efficacy development, behaviour changes and quality of life. The participants maintained these benefits in the short-term. These results are discussed in terms of the need for further research to evaluate if benefits are maintained in the long-term, referral process to the programme, decision-making process in regard to enrolment and impact of a support person attending the programme. Practice implications for the programme are discussed in regard to incorporating a follow-up phone call to participants after they attended a course and offering follow-up sessions with the latest information on diabetes care.

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Britt, Eileen F. "Enhancing diabetes self-management : motivational enhancement therapy : a thesis submitted in partial fulfilment of the requirements for the degree of Doctor of Philosophy in the Department of Psychology University of Canterbury /." 2008. http://library.canterbury.ac.nz/etd/adt-NZCU20080314.124830.

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Chang, Meiyen, and 張美燕. "Self-Efficacy, Perceived Health Status, Blood Sugar Management, And Health Examination In Adults With Diabetes Mellitus." Thesis, 2012. http://ndltd.ncl.edu.tw/handle/75816492078594602206.

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碩士
義守大學
管理學院管理碩士在職專班
100
Purpose: The purpose of the current study was to exam the correlations among self-efficacy, perceived health status, blood-sugar controlling, and adult preventive health exam in patients with diabetes. Methods: This was a cross-sectional study with convenient sample of patients with diabetes in an out-patient department of a regional teaching hospital in southern Taiwan. Self-reported questionnaires which include three sets of information: demographic data, Self-Efficacy of Health Behavior Questionnaire, and Perceived Health Status Questionnaire, were used to collect data. Statistical analysis includedT-test, Chi-square, and correlationt by using statistical package SPSS 12.0. Results: The number of effective samples is 131. Their average age was 65 years old; there were 68 men (51.9%) and 63 women (48.1%); the education degree of the majority was junior high school or less (N=48, 44.3%); and most of them were married (N=102, 77.9%) and had children (N=122, 93.1%). The range of subjects with diabetes was between 0.5 - 40 years, with a mean duration of 9.8 years (SD=7.7), and the average of their HbA1C was 8.08%. Sixty-six subjects (50.4%) did have an adult preventive health exam, while 65 (49.6%) did not. Of 40-64 year old group, majority did not receive an adult preventive health exam (65.08%); on the other hand, of subjects with 65 years old or older, majority received an adult preventive health exam (64.71%). Results showed that subjects who had an adult preventive health exam had good HbA1C control (HbA1C<7%) than those who did not (19.8% vs. 9.9%，χ2 = 5.89，P < .02). In health self-efficacy, there is significant difference between men and women; male had a higher score than women (90.18 vs. 76.40，t=4.91，P<0.01). In perceived health status, subjects with good HbA1C control (HbA1C<7%) had better perceived health status than those with poor HbA1C control (HbA1C≥7%) (18.10 vs. 16.48，t=2.13，P<0.04). In additional, subjects had additional chronic illness had worse perceived health status than those did not have other chronic illness (16.41 vs. 18.07，t= -2.26，P<0.03). Finally, self-efficacy of health behavior and perceived health status had a correlation coefficient 0.38, (P<0.01). Recommendation: In conclusion, older people were more likely to have an adult preventive health exam and there is a correlation between health behavior (receiving an adult preventive health exam) and health status (HbA1c). We expect our study in preventive health can be applied to other chronic illness. In this way, achieve early detection and early treatment and lower expenditure of public health insurance.

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LEE, PEI-FEN, and 李佩芬. "Effects of a Self-Efficacy Program in the Control of Blood Glucose, Self-Management and Social Support in Type 2 Diabetes Patients with Insulin Treatment." Thesis, 2018. http://ndltd.ncl.edu.tw/handle/9762q4.

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碩士
國立臺北護理健康大學
護理研究所
106
ABSTRACT Background: Diabetes is a global disease and the number of patients is increasing with appalling rapidity. In Taiwan, the total number of people with diabetes increased by 70% from 2000 to 2009, and diabetes was the fifth leading cause of death in 2015 that caused 9,530 deaths reached. In the current research field of type 2 diabetes care, more emphasis is still placed on developing or constructing the self-efficacy scale, and even on the relationship between self-efficacy and other psychological constructs and clinical outcomes. The lack of Type 2 In view of this, this study hopes to provide self-efficacy management program of type 2 diabetes insulin therapy patients as the research object, by self-efficacy management programs to provide peer-to-peer, self-efficacy, self-management, Support and motivation to explore the effectiveness of self-management programs on self-efficacy OBJECTIVES: The purpose of this study was to explore the impact of self-management insulin-centered self-management interventions on type 2 diabetes patients by using self-management interventions to understand the effects of insulin therapy on type 2 diabetes insulin therapies Physiological (clinical control index), psychological (self-efficacy), self-management and social support effectiveness. Methods: Patients with type 2 diabetes and treated with insulin were recruited from the metabolic clinic in a northern teaching hospital. They were randomly assigned into two groups. The experimental group was endled in the Insulin Treatment Self-Efficacy Management Program (ITSEMP) for 4 weeks. The course of ITSEMP was performed for 100 minutes a week. Control group participated in the conventional health education program for insulin treatment. All patients were evaluated by a structured questionnaire, which contains demographic characteristics (demographics and medical related data), insulin self-efficacy scale, diabetes self-efficacy management scale and social support scale. There were 4 periods for data collection that included before the intervention, 1, 3, and 6 months after the intervention. Conclusion: 88 patients finished the determination of ITSEMP, including 43 in the experimental group and 45 in the control grouop. The data was analyzed by Generalized Estimation Equation. Results showed that compared with the control group, the LDL-C expression of experimental group was reduced significantly at 3 months after the intervention. It shows the intervention with ITSEMP might decrease LDL-C level in clinical cardiovascular atherosclerosis, microvascular disease (p <0.05). The self-efficacy of insulin treatment in the experimental group was significantly increased by 0.54 points at 6 months after intervention (B = 0.54, SE = 0.11, p <0.001). The self-management efficacy of diabetes mellitus significantly increased the self-management efficacy of diabetic patients by 1.13 points (B = 1.13, SE = 0.27, p <0.001). Through intervention, experimental groups could significantly improve the efficacy of diabetes self-management effect than the control group at 6 months. The performance of social support was not significantly different in group, time, and interaction of time and group. Therefore, the intervention of ITSEMP could not affect the effectiveness of social support.

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Lien, Ru-Yu, and 連如玉. "Analysis of self management , Self-efficacy and treatment Compliance in after CABG under diabetic mellitus." Thesis, 2011. http://ndltd.ncl.edu.tw/handle/88125848286345092065.

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Abstract:

碩士
國立臺北護理健康大學
護理研究所
99
Objectives：The purpose of this study is to understand the diabetes after coronary artery bypass graf and view their health needs to enhance self-management, Self-efficacy and treatment Compliance of associated with impact predictors factor. and to understandof self-management factor between Mediation effect. Background：Cardiovascular disease is the first cause of death worldwide, accounting for 29% of all deaths. Coronary artery heart disease is the second leading of cardiovascular disease in Taiwan. Diabetes after coronary artery bypass graf patients prone to complications and poor prognosis, control Related factors can reduce complications, to understand their disease self-management for control of such long-term care patients is important issues. However, no researches for self-management, self-efficacy and treatment compliance analysis of the relationship in diabetes after coronary artery bypass graf. Study Design：A Integrated cross-sectional study method and convenience sampling in the study. Quantitative component:Three instrument were self-management scale, self-efficacy scale and the treatment compliance scale related investigations, and a demographic questionnaire,. Investigate the two medical centers, one regional teaching hospital in northern, 166 patient diabetic coronary artery bypass graf surgery. Qualitative component :semi-structured interviews in which seven patients with the most concerned about health problems and health needs. The data analyzed by Content analysis for group of health problems and needs, Quantitative parts by descriptive statistics shows the basic attributes and patient self-management, self-efficacy, Treatment compliance situation, using the Pearson correlation, independent samples T test, one way ANOVA analyzed of relevance, Regression analysis for predictors of self-management , and the Multiple mediation script to detect the variables mediating influence. Findings：The results showed that patients with an average of 67.5 years, and 80.1% males, patient age, gender and education et al variables are reaches significant meaning with self-management, self-efficacy or treatment compliance. self-efficacy and treatment compliance showed a significant negative correlation in self-management (r =-. 618, p = <.001; r =-. 549, p = <.001), the stepwise regression analysis showed that age, education, carers, professional level, smoking, drug side effects, other diseases, systolic blood pressure, and self-efficacy and treatment compliance have 67.4% explained, are important predictors factors of self-management, while the mediating effect, treatment compliance was statistically significant 18.5% significance (95% CI = -. 0472 ~ -. 0115) in self-efficacy on the explanatory power of self-management. Qualitative analysis found that patients with health problems and needs, may affect in self-management, self-efficacy and compliance of treatment. Conclusion：The results of this study can provide nurses to understand patients with diabetes after coronary artery bypass graft in the self-management, Self-efficacy and treatment compliance of the case, as well as the continuity between them, in order to enhance the patients discharged as a self-management, self-efficacy and treatment compliance, to enhance the continued relevance of health behavior and control the disease relevant factors and reduce the complication, improve long-term quality of life.

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