Loading [MathJax]/jax/output/HTML-CSS/fonts/TeX/fontdata.js

Journal List > J Korean Acad Community Health Nurs > v.28(2) > 1058462

TOOLS
Oh and Lee: The Influence of Self-care Behaviors, Empowerment and Social Support on Glycosylated Hemoglobin in Patients with Type 2 Diabetes
Original Article

J Korean Acad Community Health Nurs 2017;28(2):216-225.

Published online: 12 June 2017

DOI: https://doi.org/10.12799/jkachn.2017.28.2.216

The Influence of Self-care Behaviors, Empowerment and Social Support on Glycosylated Hemoglobin in Patients with Type 2 Diabetes

Hwa Kyung Oh1, Eun Ju Lee2

1Hanshin Hospital, Daegu, Korea

2College of Nursing, Keimyung University, Daegu, Korea

Corresponding author: Lee, Eun Ju College of Nursing, Keimyung University, 1095 Dalgubeol-daero, Dalseo-gu, Daegu 42601, Korea. Tel: +82-53-580-3953, Fax: +82-3-580-3916, E-mail: 11578@kmu.ac.kr

Received 23 April 2017       Revised 17 June 2017       Accepted 17 June 2017

Copyright © 2017 Korean Academy of Community Health Nursing

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

Purpose

The purpose of the study was to analyze the effects of self-care behavior, empowerment, and social support on glycosylated hemoglobin in patients with type 2 diabetes.

Methods

The data were collected during the period of July 1 to July 31, 2016. In total, 172 participants were recruited from outpatients who had been diagnosed with type 2 diabetes at a health care center, a health promotion center at National Health Insurance Corporation, and a tertiary hospital. Statistical data were analyzed with SPSS 20.0 using frequency analysis, t-test, ANOVA, Scheffé test, Pearson's correlation coefficients, and hierarchical regression analysis.

Results

The study results showed that self-care behavior (β=-.34, p<.001), empowerment (β=-.34, p<.001), and social support (β=-.20, p=.018) were found to be influential factors affecting glycosylated hemoglobin, with an overall descriptive power of 69%.

Conclusion

Self-care behavior, empowerment, and social support are considered to be important factors in blood glucose management for the patients with type 2 diabetes. Therefore, self-caring blood glucose programs and internal synchronizing education through social support and empowerment need to be improved.

Go to : Goto

Keywords: Self-care, Empowerment, Social support, Diabetes mellitus, Hemoglobin A, glycosylated

References

1. Minister of Health and Welfare. Korea national health and nutrition examination survey [Internet]. Seoul: Minister of Health and Welfare;2014. [cited 2016 August 31]. Available from:. https://knhanes.cdc.go.kr/knhanes/index.do.
2. Statistics Korea. Cause of death statistics of Korea [Internet]. Seoul: Statistics Korea;2014. [cited 2016 August 31]. Available from:. http://kostat.go.kr/portal/index/statistics.action.
3. Park LB, Baik SH. Epidemiologic characteristics of diabetes mellitus in Korea: Current status of diabetic patients using Korean health insurance database. Korean Diabetes Journal. 2009; 33(5):357–362. https://doi.org/10.4093/kdj.2009.33.5.357.
crossref
4. Korea National Diabetes Program. Clinical practice guideline for the prevention and management of diabetes in Korea. Seoul: Medbook;2015. p. 389.
5. American Diabetes Association. Standards of medical care in diabetes -2011. Diabetes Care. 2011; 34(Supplement 1):S11–S61. https://doi.org/10.2337/dc11-S011.
6. Lee YR, Kang MA, Kim PG. The effects of an admission-education program on knowledge, self-efficacy, self-care and glucose control in type 2 diabetes patients. Journal of Korean Academic Society of Nursing Education. 2008; 14(1):12–19. https://doi.org/10.5977/JKASNE.2008.14.1.012.
crossref
7. Kim SH, Kang HS. The relationship between depression, self-care activity and HbA1c in clients with type 2 diabetes mellitus. Journal of Korean Academy of Fundamentals of Nursing. 2008; 15(2):178–185.
8. Park JY. A study on self management, HbA1c, and perceived health status for the type II diabetes patients. Journal of Korean Biological Nursing Science. 2010; 12(2):106–113.
9. Gu MO. A structural model for self care behavior and metabolic control in diabetic patient [dissertation]. [Seoul]: Seoul National University;1992. p. 135.
10. Choi EO. Development of empowerment program for the diabetes patients and the experiences of diabetes patient's empowerment process. The Journal of Korean Community Nursing. 2001; 12(2):317–328.
11. Tsay SL, Hung LO. Empowerment of patients with end-stage renal disease-a randomized controlled trial. International Journal of Nursing Studies. 2004; 41(1):59–65. https://doi.org/10.1016/S0020-7489(03)00095-6.
crossref
12. Park IH. Effects of empowerment education program for the patients having rheumatoid arthritis on empowerment, health status and self-care activities [dissertation]. [Seoul]: Chung-Ang University;2001. p. 130.
13. Langford CPH, Bowsher J, Maloney JP, Lillis PP. Social support: A conceptual analysis. Journal of Advanced Nursing. 1997; 25(1):95–100. https://doi.org/10.1046/j.1365-2648.1997.1997025095.x.
crossref
14. Kang YJ. The association between social support and impaired fasting glucose, and type 2 diabetes [dissertation]. [Yongin]: Dankook University;2015. p. 82.
15. Choi Y. Correlationships between family support, self-care be- haviors and quality of life in middle aged adults with diabetes mellitus [master's thesis]. [Seoul]: Ewha Womans University;2002. p. 71.
16. Kim YJ. Correlation between family support and self-care behavior in patients with type 2 diabetes [master's thesis]. [Seoul]: Kyunghee University;2000. p. 58.
17. Toobert DJ, Hampson SE, Glasgow RE. The summary of diabetes self-care activities measure: Results from 7 studies and a revised scale. Diabetes Care. 2000; 23(7):943–950.
crossref
18. Chang SJ, Song MS. The validity and reliability of a Korean version of the summary of diabetes self-care activities questionnaire for older patients with type 2 Diabetes. Journal of Korean Academy of Adult Nursing. 2009; 21(2):235–244.
19. Keum HS, Suh SR. HbA1c, self-efficacy and self-care activities depending on the disease duration of type 2 diabetes mellitus patients. Journal of the Korea Contents Association. 2014; 14(12):303–312. https://doi.org/10.5392/JKCA.2014.14.12.303.
20. Anderson RM, Fitzgerald JT, Gruppen LD, Funnell MM, Oh MS. The diabetes empowerment scale-short form (DES-SF). Diabetes Care. 2003; 26(5):1641–1642. https://doi.org/10.2337/diacare.26.5.1641-a.
crossref
21. Song MS. Construction of a functional status prediction model for the elderly [dissertation]. [Seoul]: Seoul National University;1991. p. 141.
22. Singh R, Press M. Can we predict future improvement in gly-caemic control? Diabetic Medicine. 2008; 25(2):170–173. https://doi.org/10.1111/j.1464-5491.2007.02309.x.
crossref
23. Yu HY. Correlation between eating habits, exercise habits, stress, and glycosylated hemoglobin in patients with type 2 diabetes [master's thesis]. [Seoul]: Yonsei University;2003. p. 69.
24. De Groot M, Anderson R, Freedland KE, Clouse RE, Lustman PJ. Association of depression and diabetes complications: A meta-analysis. Psychosomatic Medicine. 2001; 63(4):619–630.
crossref
25. Scheel MJ, Rieckmann T. An empirically derived description of self-efficacy and empowerment for parents of children identified as psychologically disordered. American Journal of Family Therapy. 1998; 26(1):15–27. https://doi.org/10.1080/01926189808251083.
crossref
26. Park CR, Song MS, Cho BL, Lim JY, Song W, Chang HK, et al. Effects of a multi-disciplinary approached, empowerment theory based self- management intervention in older adults with chronic illness. Journal of Korean Academy of Nursing. 2015; 45(2):192–201. https://doi.org/10.4040/jkan.2015.45.2.192.
27. Yeom JH. Depression, illness perception, and social support of older adults before discharge from a general hospital [master's thesis]. [Seoul]: Hanyang University;2016. p. 80.
28. Cho WJ, Choi MN, Kim SS, Cho EH. Effect of social support and depression on self-care of older adults receiving percutaneous coronary intervention. The Journal of Korean Gerontological Nursing. 2010; 12(2):119–130.
29. Lee JK. Self-management and its predictors for patients with poorly controlled type 2 diabetes. The Korean Academic Society of Adult Nursing. 2009; 21(5):447–457.
30. Schiøtz ML, Bøgelund M, Almdal T, Jensen BB, Willaing I. Social support and self management behaviour among patients with type 2 diabetes. Diabetic Medicine. 2012; 29(5):654–661. https://doi.org/10.1111/j.1464-5491.2011.03485.x.
Go to : Goto

Table 1.
Differences in Glycated Hemoglobin according to General Characteristics and Diabetes-related Characteristics (N=172)
Variables Categories n (%) M±SD t or F p
Age (year) <50 31 (18.0) 6.96±0.51 0.81 .488
50~ < 59 54 (31.4) 6.78±0.63
≥60 87 (50.6) 6.80±0.46
Gender Males 70 (40.7) 6.95±0.66 2.40 .018
Females 102 (59.3) 6.73±0.56
Marriage status Married 153 (89.0) 6.80±0.58 -0.66 .518
Others† 19 (11.0) 6.93±0.79
Education ≤ Elementary school 26 (15.1) 6.75±0.68 0.36 .783
Middle school 52 (30.2) 6.86±0.61
High school 74 (43.1) 6.84±0.58
≥ College 20 (11.6) 6.73±0.63
Occupation Unemployed 87 (50.6) 6.70±0.52 -2.82 .005
Employed 85 (49.4) 6.95±0.66
Religion Christian 32 (18.6) 6.72±0.47 0.82 .489
Catholic 16 (9.3) 6.89±0.87
Buddhist 39 (22.7) 6.93±0.55
No religion 85 (49.4) 6.80±0.61
Monthly income <100 37.8 (37.8) 6.73±0.59 2.15 .062
100~< 200 30.8 (30.8) 6.77±0.53
200~< 300 14.0 (14.0) 7.08±0.66
300~<400 11 (6.4) 7.10±0.69
400~< 500 9 (5.2) 6.60±0.76
≥ 500 10 (5.8) 6.97±0.61
BMI Underweight (< 18.5)a 5 (53.0) 6.42±0.58 7.49 < .001
Normal (18.5~<22.9)b 107 (62.2) 6.70±0.54 a,b< d
Overweight (23.0~ < 24.9)c 35 (20.3) 6.95±0.67
Obesity (>25.0)d 25 (14.5) 7.24±0.55
Drinking (time/week) Nonea 82 (47.7) 6.68±0.56 11.76 <.001
1~2b 57 (33.1) 6.75±0.54 a,b< c,d
3~4c 26 (15.1) 7.22±0.57
4~5d 7 (4.1) 7.64±0.56
Smoking No 143 (83.1) 6.77±0.59 -2.37 .019
Yes 29 (16.9) 7.06±0.66
Duration of disease (year) < 10 92 (53.5) 6.81±0.53 0.49 .613
10~<20 58 (33.7) 6.87±0.66
≥ 20 22 (12.8) 6.72±0.70
Diabetic complication No 166 (96.5) 6.82±0.61 0.50 .615
Yes 6 (3.5) 6.60±0.00
Diabetes education Noa 57(33.1) 7.18±0.63 22.96 < .001
1b 58(33.7) 6.79±0.58 a,b>c
≥ 2c 57(33.2) 6.49±0.39

† Single, divorce, separation, bereavement.

Table 2.
Self-care Behaviors, Empowerment, Social Support and Glycosylated Hemoglobin in Patients with Type 2 Diabetes (N=172)
Characteristics Total M±SD Item M±SD Min Max
Self-care behaviors 112 75.84±15.27 4.74±0.95 2.50 6.31
Empowerment 40 22.83±5.63 2.85±0.70 1.38 4.50
Social support 80 39.73±7.21 1.99±0.36 1.35 3.25
HbA1c 6.82±0.60 5.30 8.30
Table 3.
Correlation between Self-care Behaviors, Empowerment and Social Support on Glycosylated Hemoglobin in Patients with Type 2 Diabetes (N=172)
Variable HbA1c Self-care behaviors Social support Empowerment
r (p) r (p) r (p) r (p)
HbA1c 1
Self-care behaviors -.79 (＜.001) 1
Social support -.76 (＜.001) .80 (＜.001) 1
Empowerment -.80 (＜.001) .84 (＜.001) .85 (＜.001) 1
Table 4.
The influence of Self-care Behaviors, Empowerment and Social Support on Glycosylated Hemoglobin in Patients with Type 2 Diabetes (N=172)
Variables Step 1 Step 2
B β t p B β t p
Gender† 0.05 03 0.37 .574 0.12 .08 1.63 .069
Occupation‡ 0.06 .05 0.65 .520 0.09 .07 1.43 .155
BMI 0.07 .26 3.60 ＜.001 0.01 .02 0.17 .869
Drinking 0.22 .31 3.76 ＜.001 0.06 .07 1.41 .162
Smoking§ 0.05 .03 0.41 .684 -0.14 -.09 -1.72 .087
Self-care behaviors -0.21 -.34 -3.97 ＜.001
Empowerment -0.30 -.34 -3.62 ＜.001
Social support -0.34 -.20 -2.39 .018
R2=.29, Adj. R2=.20, F=11.64, p＜.001 R2=.70, Adj. R2=.69, F=55.79, p＜.001

† Dummy variable: Gender- Males (1), Females (0);

‡ Dummy variable: Occupation - Yes (1), No (0);

§ Dummy variable: Smoking - Yes (1), No (0).

TOOLS
Similar articles