EdinburghNapier University, School of Health and Social Care, 9 Sighthill Ct, Edinburgh EH11 4BN, United Kingdom.
Glasgow Caledonian University, School of Health and Life Sciences, Cowcaddens Rd, Glasgow G4 0BA, United Kingdom.
Res Dev Disabil. 2017 Nov;70:75-84. doi: 10.1016/j.ridd.2017.09.004. Epub 2017 Sep 15.
Little is known about the successful experiences and positive perceptions of people with intellectual disabilities (ID) self-managing Type 2 Diabetes (T2D). This study sought to address this gap using Bandura's (1977) 'Four Sources of Self-Efficacy' as a framework of enquiry.
Semi-structured interviews were conducted with 10 adults with ID. Interviews were recorded, transcribed verbatim and analysed using inductive and deductive thematic analysis RESULTS: Nine sub-themes were identified following analysis of the data: 1) Mastery through knowledge; 2) Mastery through tools and strategies; 3) Mastery through autonomy; 4) Influence of social setting; 5) Positive social comparisons; 6) Positive and negative self-statements; 7) Feedback from caregivers; 8) Adjustment experiences; 9) Symptom awareness. These were mapped onto Bandura's (1977) Four Sources of efficacy enhancement model and were consistent with its proposed mechanisms.
The Four Sources model serves as a useful mode of enquiry for exploring people with ID's experiences and perceptions of self-managing diabetes. It also confirms the appropriateness of Self-efficacy as a potential intervention component for this population. However, additional support may be required for people with ID to reflect meaningfully on their experiences and thus have a sense of self-efficacy.
This paper builds upon the limited existing literature on people with ID self-managing type 2 diabetes and provides a robust, qualitative account of the participants' experiences, whilst confirming some of the existing challenges, both for people with ID and their supporters. To self-manage with autonomy and overcome the difficulties of adjustment, further strategies such as training and education needs are highlighted. In addition, the meaning and relevance of the Self-efficacy construct is evaluated in the context of people with ID self-managing T2D. This provides useful information in terms of tailoring existing mainstream T2D interventions to meet the needs of people with ID, as such programs are commonly theoretically guided by Self-efficacy. Furthermore, this evaluation provides rationale for the exploration of people with IDs' Self-efficacy in relation to other chronic diseases, such as cardiovascular disease, cancer symptoms and gastrointestinal disorders.
人们对智障人士（ID）自我管理 2 型糖尿病（T2D）的成功经验和积极看法知之甚少。本研究旨在以班杜拉（1977）的“自我效能的四个来源”为研究框架来解决这一差距。
对 10 名 ID 成人进行半结构化访谈。访谈进行了录音，逐字记录，并使用归纳和演绎主题分析进行了分析。
对数据进行分析后确定了 9 个亚主题：1）通过知识获得掌控；2）通过工具和策略获得掌控；3）通过自主获得掌控；4）社会环境的影响；5）积极的社会比较；6）积极和消极的自我评价；7）照顾者的反馈；8）调整经验；9）症状意识。这些主题被映射到班杜拉（1977）的自我效能增强模型的四个来源上，与该模型提出的机制一致。
四源模型为探索智障人士自我管理糖尿病的经验和看法提供了一种有用的研究模式。它还证实了自我效能作为这一人群潜在干预手段的适当性。然而，可能需要为 ID 提供额外的支持，以便他们能够有意义地反思自己的经验，从而获得自我效能感。
本文建立在关于智障人士自我管理 2 型糖尿病的有限文献基础上，提供了参与者经验的可靠、定性描述，同时证实了现有的一些挑战，既针对 ID 患者，也针对他们的支持者。为了实现自主管理并克服调整的困难，需要进一步制定培训和教育等策略。此外，在 ID 人群自我管理 T2D 的背景下，对自我效能结构的意义和相关性进行了评估。这为根据自我效能理论调整现有的主流 T2D 干预措施以满足 ID 患者的需求提供了有用的信息。此外，这种评估为探索 ID 患者的自我效能与其他慢性疾病（如心血管疾病、癌症症状和胃肠道疾病）的关系提供了依据。
