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Metabolic control, self-management and psychosocial adjustment in women with type 2 diabetes
Robin Whittemore1, Gail D'Eramo Melkus, Margaret Grey
1Yale School of Nursing, New Haven, Connecticut 06536-0740, USA. robin.whittemore@yale.edu
Aims:
To examine factors associated with metabolic control, self-management (diet and exercise behaviour), and psychosocial adjustment (diabetes-related distress) in women with type 2 diabetes.
Design:
Cross-sectional design using baseline data of women with type 2 diabetes enrolled to participate in a pilot study of a nurse coaching intervention (n = 53).
Ethical Issues:
Appropriate ethical review and approval was completed. Informed consent from participants was obtained.
Outcome Measures:
Physiological measures included body mass index and glycosylated haemoglobin (HbA1c). Self-management measures included the Dietary Subscale of the Summary of Diabetes Self-Care Activities Questionnaire and a modified Paffenbarger Physical Activity Questionnaire. Psychosocial measures included the Problem Areas in Diabetes Survey (diabetes-related distress), the Diabetes Questionnaire, the Diabetes Self-Management Assessment Tool Support and Confidence Subscale, and the Social Functioning Scale. Descriptive, bivariate, and multivariate analyses were completed.
Results:
The most consistent predictor of metabolic control, dietary self-management, and diabetes-related distress was support and confidence in living with diabetes. Additionally, women had difficulty meeting optimal goals for exercise, yet reported higher levels of other physical activity.
Limitations:
This study was an exploratory analysis with a homogeneous sample of women with type 2 diabetes enrolled in an intervention study and measurements included multiple self-report instruments.
Conclusions:
Interventions to increase women's perceived self-confidence and support may contribute to positive health outcomes in women with type 2 diabetes.
Relevance To Clinical Practice:
Assessment of social support and self-confidence in diabetes self-management in women with type 2 diabetes may assist in determining individualized goals and strategies. Enhanced social support and self-confidence in diabetes self-management may subsequently improve metabolic control, self-management and psychosocial adjustment to diabetes.
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