Browsing by Subject "Self-management"

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    Analysis Of The Relationship Between Psychosocial Factors And Self-Efficacy On Self-Management Behaviors In Adult Patients With Type 2 Diabetes
    (2013-11) McClernon, Susan
    Objectives Only 20% of patients with type 2 diabetes implement recommended self-management behaviors (DAWN study) (Funnell, 2006). In this research, psychosocial factors significantly influenced self-management behaviors and A1c, having more influence than SES factors. The integrated conceptual model illuminated complex relationships between psychosocial factors, self-management(SM) and A1c levels. It posited self-efficacy (SE) as mediator between self-management and other psychosocial factors. Method This study explored direct and indirect relationships between diabetes social support (DSS), knowledge, affect, self-efficacy and dependent variables including diet, exercise, competency in adult patients with type 2 diabetes with suboptimal glycemic control (A1c <&ge> 7%) using cross sectional data from the IDEA study using structural equation modeling. Results The conceptual model fit test statistics are <&chi>;a1c2= 379 (df = 112; n=564, <&rho>-value = 000). The RSMEA estimate was .043 (.037 - .051 CI), SRMR was .045, and GFI was .94. The direct effects for knowledge (<&beta> = .647, <&rho> value ≤ .001) influenced SE and SE indirectly influenced A1c (<&beta> = .253, <&rho> value ≤ .001). DSS directly influenced knowledge (<&beta> = .579, <&rho> value ≤ .001) and SE (<&beta> range = .482, <&rho> value ≤ .001). Affect directly influenced knowledge (<&beta> range = .296, <&rho> value ≤ .05) and indirectly influenced SE (<&beta> = .192, <&rho> value ≤ .05). A second hypothesis found SE mediated SM and A1c only for knowledge, not for DSS or affect. DSS, knowledge, and affect indirectly influenced SM behaviors and A1c significantly (affect only for exercise and A1c). Knowledge was a mediator for DSS to SE. Conclusions The theoretically integrated conceptual model has merit. Affect and DSS (mediates) are directly influencing knowledge, with is significantly linked with SE. SE mediates SM and A1c. This new knowledge of relationships between psychosocial factors may assist caregivers in better engaging their patients with diabetes in improving SM behaviors and outcomes.
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    Self-management patient education and weight loss.
    (2010-11) Stombaugh, Angela M.
    Self-management of a disease is defined as "having or being able to obtain, the skills and resources necessary to best accommodate to the chronic disease and its consequences" (Holman & Lorig, 1992, p. 309). Self-management has been used in the management of several chronic conditions and this model may be useful in the management of weight loss. This research explored the relationships amongst participation in a self-management weight loss program and weight change, patient activation, health distress, and behavioral change. The purpose of this study was to evaluate a self-management weight loss program and provide some insight into factors that may need to be addressed when designing a weight loss program. Participants completed a six-week weight loss program that consisted of three components: exercise, nutrition classes, and self-management classes. Weight, patient activation, health distress and goal setting behaviors were collected at the beginning of the program and at completion of the program. Participation in the program was statistically significant associated for weight loss, change in health distress, and change in patient activation. Although the self-management model has been useful in other chronic diseases, further exploration is needed to understand the role of the model in weight loss programs.