The influence of diabetes psychosocial attributes and self-management practices on change in diabetes status

Patient Educ Couns. 2012 Apr;87(1):74-80. doi: 10.1016/j.pec.2011.07.013. Epub 2011 Aug 15.

Abstract

Objective: To examine the influence of diabetes psychosocial attributes and self-management on glycemic control and diabetes status change.

Methods: Using data from the Health and Retirement Study, a nationally representative longitudinal study of U.S. adults >51 years, we examined cross-sectional relationships among diabetes psychosocial attributes (self-efficacy, risk awareness, care understanding, prioritization of diabetes, and emotional distress), self-management ratings, and glycemic control. We then explored whether self-management ratings and psychosocial attributes in 2003 predicted change in diabetes status in 2004.

Results: In multivariate analyses (N=1834), all diabetes psychosocial attributes were associated with self-management ratings, with self-efficacy and diabetes distress having the strongest relationships (adj coeff=8.1, p<0.01 and -4.1, p<0.01, respectively). Lower self-management ratings in 2003 were associated cross-sectionally with higher hemoglobin A1C (adj coeff=0.16, p<0.01), and with perceived worsening diabetes status in 2004 (adj OR=1.36, p<0.05), with much of this latter relationship explained by diabetes distress.

Conclusion: Psychosocial attributes, most notably diabetes-related emotional distress, contribute to difficulty with diabetes self-management, poor glycemic control, and worsening diabetes status over time.

Practice implications: Self-management and adherence interventions should target psychosocial attributes such as disease-related emotional distress.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Aged
  • Blood Glucose Self-Monitoring
  • Cross-Sectional Studies
  • Diabetes Mellitus, Type 1 / psychology*
  • Diabetes Mellitus, Type 1 / therapy
  • Diabetes Mellitus, Type 2 / psychology*
  • Diabetes Mellitus, Type 2 / therapy
  • Disease Management
  • Female
  • Glycated Hemoglobin A / analysis
  • Health Knowledge, Attitudes, Practice*
  • Health Status
  • Humans
  • Interviews as Topic
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Risk Factors
  • Self Care* / methods
  • Self Care* / psychology
  • Self Efficacy
  • Severity of Illness Index
  • Social Support
  • Stress, Psychological*
  • Surveys and Questionnaires
  • Treatment Outcome

Substances

  • Glycated Hemoglobin A