Greater self-efficacy, social support boost perceived problem-solving in diabetes
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Adults with type 2 diabetes who have better self-efficacy and social support are more likely to perceive better problem-solving skills with their diabetes management, according to study data.
“Patients with type 2 diabetes need to develop comprehensive problem-solving skills in order to adequately control their condition, in which both personal and psychosocial factors play an important role in effective problem-solving, as well as diabetes management,” Meihua Ji, PhD, MSN, RN, an associate professor in the School of Nursing at Capital Medical University in Beijing, told Healio. “Researchers and clinicians should consider both personal factors and psychosocial factors, such as self-efficacy, social support and symptom distress, when examining patients’ perceived problem-solving and develop tailored interventions to improve diabetes management. In addition, health care providers should consider these important aspects when providing tailored care to this patient population.”
Researchers performed a secondary data analysis following a descriptive, cross-sectional study design using baseline data from a randomized controlled trial examining the effects of a problem-solving-based intervention on adherence to medication management by adults with type 2 diabetes and other comorbidities. The original study was conducted by a research team led by Jacqueline M. Dunbar-Jacob, PHD, RN, FAAN, at the School of Nursing, University of Pittsburgh. Participants were aged 40 years or older, had type 2 diabetes for at least 1 year, had hypertension or hyperlipidemia and were prescribed at least one oral diabetes medication.
Participants completed the Symptom Distress Scale to measure perceived symptom distress. Scores ranged from 13 to 65, with a higher score indicating more distress. The Self-Efficacy Scale for People with Type 2 Diabetes was used to measure self-confidence in diabetes management, with a higher score indicating greater confidence. The Interpersonal Support Evaluation List was used to collect social support data, with a higher score indicating greater support. The Problem-Solving Inventory was used to assess participants’ perceived level of problem-solving for diabetes management, with lower scores indicating better perceived problem-solving skills.
The findings were published in The Science of Diabetes Self-Management and Care.
The 304 participants (80.3% white; mean age, 64.1 years) had a mean Problem-Solving Inventory score of 87.5, indicating they viewed themselves as “moderately effective” problem-solvers. The mean total score for symptom distress was 23.6 of a maximum of 65 points, indicating participants likely had moderate distress with their symptoms. The mean self-efficacy scored was 143.6, indicating participants were not completely confident in their diabetes self-management. The mean social support score was 89.2, indicating adequate support. Participants had a mean HbA1c of 7.4%.
In multiple linear regression, age, sex, years of education, duration of diabetes and number of comorbidities together as a set predicted the level of problem-solving among participants (P < .001). After adding self-efficacy, social support and symptom distress to the model, the prediction model for problem-solving improved (P < .001).
“The negative associations between perceived problem-solving and self-efficacy and social support in the current study were similar to results from previous research, indicating that greater self-efficacy and social support result in better every day problem-solving,” the researchers wrote. “A positive relationship between perceived problem-solving and symptom distress was identified in the current study, suggesting that the more severe the symptom distress perceived by patients, the less effective they perceived their problem-solving skills.”
Ji said future studies should use an integrative approach to improve self-efficacy and social support while also reducing symptom distress to create problem-solving focused interventions to improve diabetes management.
For more information:
Meihua Ji, PhD, MSN, RN, can be reached at mjshouyi@ccmu.edu.cn.
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Ji M, et al. The Science of Diabetes Self-Management and Care. 2021;doi:10.1177/0145721720983222.
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