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Jung, Lee, Park, Park, Kim, and Choi: Self-Care and Related Factors in Young and Middle Adulthood Patients with Type 2 Diabetes
Original Article

J Korean Diabetes 2015;16(1):65-77.

Published online: 20 January 2015

DOI: https://doi.org/10.4093/jkd.2015.16.1.65

Self-Care and Related Factors in Young and Middle Adulthood Patients with Type 2 Diabetes

Kyung Mee Jung1, 2, Sook Ja Lee1, 3, Eun Sook Park1, 3, Young Joo Park1, 3, Sin Gon Kim2, 4, Dong Seop Choi2, 4,

1Korea University Major Graduate School of Education

2Diabetes Center, Korea University Anam Hospital

3Korea University College of Nursing

4Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea

Corresponding author: Dong Seop Choi Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University College of Medicine, 73 Inchon-ro, Seongbuk-gu, Seoul 136-705,

Received 8 September 2014       Revised 7 October 2014       Accepted 8 October 2014

Copyright © 2015 Korean Diabetes Association

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background

This study was designed to investigate the level of self-care and related factors such as perceived health status, family support, stress related to diabetes mellitus, self-efficacy, depression, situational influence and glycemic control level in young and middle adulthood patients with type 2 diabetes.

Methods

For this study, data were collected and individual interviews were conducted from June 1 to July 16, 2012, with 149 young and middle adulthood patients with type 2 diabetes at Korea University Anam Hospital.

Results

The mean score of self-care evaluated in terms of dietary control, medication administration, physical exercise, self-monitoring of blood glucose and general healthcare was 63.68 points (20 to 100). The mean scores of various factors related to self-care were as follows: The mean score of perceived health status was 8.90 points (3 to 15), family support was 37.75 points (12 to 48), stress related to diabetes mellitus was 44.61 points (17 to 85), self-efficacy was 26.06 points (10 to 40), depression was 10.19 points (0 to 63) and situational influence was 10.89 points (6 to 24). The most important factors related to self-care were predicted as 45% by self-efficacy and 48% added situational influence. According to age, the most important factors related to self-care were predicted as 77% by self-efficacy in the 20 to 29 age group, 52% by stress related to diabetes mellitus in the 30∼39 age group, and 43% by self-efficacy in the 40 to 49 age group.

Conclusion

To improve self-care of young and middle adulthood patients with type 2 diabetes, it is necessary to develop nursing intervention that is useful in strengthening self-efficacy, situational influence and stress related to diabetes.

Keywords: Self-care, Type 2 diabetes, Young and middle adulthood

References

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Table 1.
General characteristics of subjects(sociodemographic characteristics of subjects) (n = 149)
Characteristic Value
Gender
Male 95 (63.8)
Female 54 (36.2)
Age (y) 42.63 ± 7.16
20∼29 12 (8.1)
30∼39 31 (20.8)
40∼49 106 (71.1)
Marital status
No 31 (20.8)
Yes 111 (74.5)
Divorce 6 (4.0)
Other 1 (0.7)
Education level
High school 72 (48.3)
College level or above 74 (49.7)
Other 3 (2.0)
Occupation
Professional/administrative management 32 (21.5)
White-collar (office-work) 32 (21.5)
Manufacturing 15 (10.1)
Service jobs 33 (22.1)
Sales 7 (4.7)
House-wife 20 (13.4)
Retired/unemployed 10 (6.7)
Frequency of drinking
None 54 (36.2)
1∼2 times per a week 71 (47.7)
3∼4 times per a week 24 (16.1)
Smoking status
Yes 48 (32.2)
No 101 (67.8)

Values are presented as number (%) or mean ± standard deviation.

Table 2.
General subject characteristics (characteristics related to disease of subjects) (n = 149)
Characteristic Value
Duration (y) 7.18 ± 4.97
1∼3 44 (29.6)
4∼7 37 (24.8)
8∼10 37 (24.8)
≥ 11 31 (20.8)
Educational experience for diabetes
Yes 123 (82.6)
No 26 (17.4)
Hospitalization experience for diabetes
Yes 42 (28.2)
No 106 (71.1)
No response 1 (0.7)
Treatment  
Oral hypoglycemic agent 97 (66.9)
Insulin only 5 (3.4)
Insulin + oral hypoglycemic agent 43 (29.7)
Hemoglobin A1c
Over 6.5% 100 (69.0), 8.20 ± 1.60
Less than 6.5% 45 (31.0), 6.12 ± 0.33
Total 145 (100.0), 7.56 ± 1.65

Values are presented as number (%) or mean ± standard deviation.

Table 3.
Descriptive statistics of subjects' self-care (n = 149)
Dimension Range Minimum Maximum Mean ± SD (score)
Dietary control 7∼35 7 32 19.38 ± 5.12
Medication administration 3∼15 3 15 13.04 ± 2.88
Physical exercise 2∼10 2 10 5.70 ± 2.09
Self-monitoring of blood glucose 3∼15 3 15 8.44 ± 3.35
General healthcare 5∼25 7 25 17.12 ± 4.28
Total 20∼100 24 95 63.68 ± 13.43

SD, standard deviation.

Table 4.
Descriptive statistics of factors related to self-care (n = 149)
Dimension Range Minimum Maximum Mean ± SD (score)
Perceived health status 3∼15 3 15 8.90 ± 2.28
Family support 12∼48 19 48 37.75 ± 6.08
Diabetes related stress 17∼85 19 80 44.61 ± 11.57
Self-efficacy 10∼40 15 38 26.06 ± 4.87
Depression 0∼63 0 38 10.19 ± 8.61
Situational influence 6∼24 6 20 10.89 ± 3.51

SD, standard deviation.

Table 5.
Correlations among variables between self-care and related factors (n = 149)
Variable Perceived health status Family support Diabetes −related stress Self-efficacy Depression Situational influence HbA1c Self-care
Perceived 1              
health status                
Family support 0.11 1            
Diabetes- –0.51∗∗ –0.35∗∗ 1          
related stress                
Self-efficacy 0.24∗ 0.38∗∗ –0.51∗∗ 1        
Depression –0.59∗∗ –0.28∗∗ 0.55∗∗ –0.34∗∗ 1      
Situational –0.40∗∗ –0.11 0.68∗∗ –0.37∗∗ 0.40∗∗ 1    
influence                
HbA1c 0.19 –0.02 –0.26∗∗ 0.07 –0.23∗ –0.21∗ 1  
Self-care 0.23∗ 0.33∗∗ –0.44∗∗ 0.67∗∗ –0.24∗ –0.41∗∗ 0.10 1

∗ P < 0.05,

∗∗ P < 0.01.

Table 6.
Correlations among variables between age-specific self-care and related factors (age:20∼29 years)
Variable Perceived health status Family support Diabetes-related stress Self-efficacy Depression Situational influence HbA1c Self-care
Perceived 1          
health status            
Family support –0.09 1        
Diabetes- –0.56 –0.48 1      
related stress            
Self-efficacy 0.51 0.08 –0.75∗∗ 1    
Depression –0.70∗ –0.08 0.78∗∗ –0.80∗∗ 1  
Situational –0.62∗ –0.18 0.63∗ –0.55 0.51 1
influence            
HbA1c –0.29 0.02 –0.10 0.10 0.12 0.24 1
Self-care 0.28 –0.14 –0.57 0.88∗∗ –0.74∗∗ –0.47 0.11 1

∗ P < 0.05,

∗∗ P < 0.01.

Table 7.
Correlations among variables between age-specific self-care and related factors (age: 30∼39 years)
Variable Perceived health status Family support Diabetes-related stress Self-efficacy Depression Situational influence HbA1c Self-care
Perceived 1              
health status                
Family support –0.21 1            
Diabetes- –0.45∗ –0.52∗∗ 1          
related stress                
Self-efficacy 0.10 0.42∗ –0.59∗∗ 1        
Depression –0.63∗∗∗ –0.15 0.40∗ –0.16 1      
Situational –0.52∗∗ –0.07 0.59∗∗ –0.51∗∗ 0.44∗ 1    
influence                
HbA1c Self-care 0.41∗ 0.32 –0.05 0.44∗ –0.53∗∗ –0.72∗∗ 0.22 0.63∗∗ –0.19 –0.44∗ –0.46∗ –0.60∗∗ 1 0.41∗ 1

∗ P < 0.05,

∗∗ P < 0.01.

Table 8.
Correlations among variables between age-specific self-care and related factors (age: 40∼49 years)
Variable Perceived health status Family support Diabetes-related stress Self-efficacy Depression Situational influence HbA1c Self-care
Perceived 1              
health status                
Family support 0.23 1            
Diabetes- –0.50∗∗ –0.34∗∗ 1          
related stress                
Self-efficacy 0.24∗ 0.39∗∗ –0.47∗∗ 1        
Depression –0.55∗∗ –0.36∗∗ 0.55∗∗ –0.34∗∗ 1      
Situational –0.35∗∗ –0.16 0.70∗∗ –0.32∗∗ 0.38∗∗ 1    
influence                
HbA1c 0.16 0.03 –0.16 0.01 –0.28∗ –0.13 1  
Self-care 0.19 0.35∗∗ –0.35∗∗ 0.66∗∗ –0.07 –0.37∗∗ –0.01 1

∗ P < 0.05,

∗∗ P < 0.01.

Table 9.
Stepwise multiple regression analysis of self-care (n = 149)
Variable B SE β t P R2
  1.43 0.37   3.91 0.000  
Self-efficacy 0.08 0.01 0.60 7.82∗∗ 0.000 0.45
Situational influence –0.22 0.09 –0.19 –2.50∗ 0.014 0.48

Confounding variables: occupation, frequency of drinking, smoking status. SE, standard error.

∗ P < 0.05,

∗∗ P < 0.0001.

Table 10.
Stepwise multiple regression analysis of self-care (n = 149)
Age (y) Variable B SE β t P R2
20∼29   –14.74 14.39   –1.03 0.332  
  Self-efficacy 2.96 0.53 0.88 5.54∗∗∗ 0.000 0.77
30∼39   102.83 8.65   11.89 0.000  
  Diabetes related stress –0.94 0.19 –0.72 –4.98∗∗∗ 0.000 0.52
40∼49   15.56 6.89   2.26 0.027  
  Self-efficacy 1.81 0.26 0.66 7.01∗∗∗ 0.000 0.43

Confounding variables: occupation, frequency of drinking, smoking status. SE, standard error.

∗∗∗ P < 0.001.

Table 11.
Self-care score according to socio-demographic related characteristics (n = 149)
Characteristic Frequency (n) Self-care
Mean ± SD t/F P
Sex     –1.74 0.084
Male 95 62.25 ± 12.23    
Female 54 66.20 ± 15.11    
Age (y)     0.54 0.583
20–29 12 63.92 ± 15.22    
30–39 31 61.45 ± 13.28    
40–49 106 64.31 ± 13.33    
Marital status     0.47 0.702
Not married 31 62.90 ± 14.58    
Married 111 64.24 ± 13.17    
Divorced 6 58.17 ± 13.96    
Other 1 59.00    
Education level     0.71 0.496
High school 72 62.33 ± 14.88    
College level or above 74 64.97 ± 12.03    
Other 3 64.33 ± 9.02    
Occupation     2.31∗ 0.037
Professional/administrative management 32 66.66 ± 10.66    
White-collar (office work) 32 65.53 ± 10.20    
Manufacturing 15 61.87 ± 10.72    
Service jobs 33 58.21 ± 13.29    
Sales 7 67.29 ± 10.52    
House wife 20 68.35 ± 19.73    
Retired/unemployed 10 57.20 ± 15.87    
Frequency of drinking     7.76∗∗∗ 0.001
None 54 67.28 ± 13.87    
1∼2 per a week 71 63.93 ± 11.65    
3∼4 per a week 24 54.88 ± 13.90    
Smoking status     –2.76∗∗ 0.007
Yes 48 59.44 ± 12.24    
No 101 65.70 ± 13.56    

SD, standard deviation.

∗ P < 0.05,

∗∗ P < 0.01,

∗∗∗ P < 0.001.

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