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Addressing stress, change in commitments may improve diabetes control
When promoting self-care understanding and diet adherence for patients with type 2 diabetes, clinicians should be aware of the negative impact the disease can have on patients, according to study findings published in The Diabetes Educator.
According to the researchers, the amount of diabetes control problems could be decreased by helping patients address the stress and changing commitments resulting from the disease.
Leonard E. Egede, MD, MS, of the Medical University of South Carolina, and colleagues evaluated 302 adults with type 2 diabetes (mean age, 66 years) recruited from primary care clinics at a Veterans Affairs medical center to determine the relationship between meaning of illness, diabetes knowledge, self-care understanding and behaviors.
Participants completed a Meaning of Illness (MIQ) questionnaire that included questions about effect of illness on day-to-day living and relationships with family members and friends; type of stress, attitude of harm/loss/threat and functional context; degrees of stress, change in commitments, and secondary appraisal of coping resources; positive attitude of challenge hope, motivation and control; and non-anticipated vulnerability/expectancy and recurrence. Outcomes of interest included diabetes knowledge, diabetes self-care understanding, diet adherence and control problems.
MIQ factors were not significantly associated with diabetes knowledge. A positive and significant association was found between diabetes self-care understanding and degree of stress/change in commitment (beta = 0.16). There was a negative and significant association found between diet adherence and little effect of illness (beta = –0.17). Little effect of illness (beta = –0.05) and degree of stress/change in commitments (beta = –0.18) were negatively and significantly associated with control problems.
After adjustment for possible confounders, little effect of illness was negatively and significantly associated with diabetes self-care understanding (beta = –0.07) and diet adherence (beta = –0.16). There also was a negative association found between control problems and degree of stress/change in commitments (beta = –0.13).
“These results point to the need for considering how a patient with diabetes views the disease and its effect on his or her day-to-day experiences,” the researchers wrote. “Based on these results, it is important to understand the negative effect diabetes could have when promoting self-care understanding and diet adherence. In addition, the results show that helping patients address the stress and changing commitments that result from diabetes may help decrease the amount of diabetes control problems, even if there is little effect on diabetes understanding. Taking these differences into account may help in creating more personalized and effective self-care education plans.” – by Amber Cox
Disclosure: The researchers report no relevant financial disclosures.