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Socio-demographic and clinical determinants of self-care in adults with type 2 diabetes: A multicentre observational study
Ausili, Davide Rossi, Emanuela Rebora, Paola Luciani, Michela Tonoli, Luca Ballerini, Enrico Androni, Silvia Vellone, Ercole Riegel, Barbara Di Mauro, Stefania
Ausili, Davide
Rossi, Emanuela
Rebora, Paola
Luciani, Michela
Tonoli, Luca
Ballerini, Enrico
Androni, Silvia
Vellone, Ercole
Riegel, Barbara
Di Mauro, Stefania
Abstract
Aims
To describe self-care as defined by the Middle Range Theory of Self-Care of Chronic Illness and to identify clinical and socio-demographic determinants in a T2DM population.
Methods
A multicentre observational cross-sectional study was conducted involving 540 adults with a confirmed diagnosis of T2DM from six outpatient diabetes services in Italy. Socio-demographic and clinical data were collected from medical records. The Self-Care of Diabetes Inventory (SCODI) was used to measure self-care maintenance, monitoring, management, and confidence dimensions. For each separate scale, scores were standardized 0–100 with higher SCODI scores indicating better self-care; a score ≥ 70 is adequate. Multiple quantile regression models were performed to identify determinants of each self-care dimension.
Results
Self-care maintenance (median = 81.3) and self-care confidence (median = 79.5) were adequate in most of the subjects. Self-care monitoring was adequate in only half of the sample (median = 70.6). Self-care management was poor (median = 59.4). Lower self-care maintenance was associated with lower self-care confidence (p < 0.001). Lower self-care monitoring was associated with being male (p < 0.001), having lower self-care confidence (p < 001), and having diabetes for < 10 years (p < 0.001). Lower self-care management was associated with being male (p = 0.002), being older (p = 0.005), having a low income (p = 0.030), being employed (p = 0.008), having missed diabetes education in the last year (p = 0.002), and lower self-care confidence (p < 0.0001). Lower self-care confidence was associated with having diabetes for < 10 years (p = 0.008), and having at least one comorbid condition (p = 0.006).
Conclusions
Determinants of self-care maintenance, monitoring, management and confidence include both clinical and socio-demographic variables. Modifiable determinants such as self-care confidence and diabetes self-care management education could be used to tailor interventions to improve diabetes self-care.
Keywords
Diabetes mellitus, Type 2 diabetes mellitus, Self-management, Chronic disease, Self-efficacy, Risk factors, Health education
Date
2018
Type
Journal article
Journal
Acta Diabetologica
Book
Volume
55
Issue
7
Page Range
691-702
Article Number
ACU Department
Mary MacKillop Institute for Health Research
Faculty of Health Sciences
Faculty of Health Sciences
Collections
Relation URI
Source URL
Event URL
Open Access Status
License
File Access
Controlled