College of Medicine and Dentistry, James Cook University, Townsville, Australia.
College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Australia.
PLoS One. 2019 Jun 5;14(6):e0217771. doi: 10.1371/journal.pone.0217771. eCollection 2019.
The study aimed to identify the common gaps in skills and self-efficacy for diabetes self-management and explore other factors which serve as enablers of, and barriers to, achieving optimal diabetes self-management. The information gathered could provide health professionals with valuable insights to achieving better health outcomes with self-management education and support for diabetes patients.
International online survey and telephone interviews were conducted on adults who have type 1 or type 2 diabetes. The survey inquired about their skills and self-efficacy in diabetes self-management, while the interviews assessed other enablers of, and barriers to, diabetes self-management. Surveys were analysed using descriptive and inferential statistics. Interviews were analysed using inductive thematic analysis.
Survey participants (N = 217) had type 1 diabetes (38.2%) or type 2 diabetes (61.8%), with a mean age of 44.56 SD 11.51 and were from 4 continents (Europe, Australia, Asia, America). Identified gaps in diabetes self-management skills included the ability to: recognize and manage the impact of stress on diabetes, exercise planning to avoid hypoglycemia and interpreting blood glucose pattern levels. Self-efficacy for healthy coping with stress and adjusting medications or food intake to reach ideal blood glucose levels were minimal. Sixteen participants were interviewed. Common enablers of diabetes self-management included: (i) the will to prevent the development of diabetes complications and (ii) the use of technological devices. Issues regarding: (i) frustration due to dynamic and chronic nature of diabetes (ii) financial constraints (iii) unrealistic expectations and (iv) work and environment-related factors limited patients' effective self-management of diabetes.
Educational reinforcement using technological devices such as mobile application has been highlighted as an enabler of diabetes self-management and it could be employed as an intervention to alleviate identified gaps in diabetes self-management. Furthermore, improved approaches that address financial burden, work and environment-related factors as well as diabetes distress are essential for enhancing diabetes self-management.
本研究旨在确定糖尿病自我管理技能和自我效能方面的常见差距，并探讨促进和阻碍实现最佳糖尿病自我管理的其他因素。收集到的信息可以为医疗保健专业人员提供有价值的见解，以通过自我管理教育和支持来改善糖尿病患者的健康结果。
对患有 1 型或 2 型糖尿病的成年人进行了国际在线调查和电话访谈。调查询问了他们在糖尿病自我管理方面的技能和自我效能，而访谈则评估了促进和阻碍糖尿病自我管理的其他因素。使用描述性和推断性统计方法分析调查结果。使用归纳主题分析方法分析访谈结果。
调查参与者（N=217）患有 1 型糖尿病（38.2%）或 2 型糖尿病（61.8%），平均年龄为 44.56±11.51 岁，来自 4 个大洲（欧洲、澳大利亚、亚洲、美洲）。糖尿病自我管理技能方面存在的差距包括：识别和管理压力对糖尿病的影响、避免低血糖的运动计划以及解释血糖模式水平的能力。应对压力和调整药物或饮食以达到理想血糖水平的健康应对能力不足。对 16 名参与者进行了访谈。糖尿病自我管理的常见促进因素包括：（i）预防糖尿病并发症发展的意愿，以及（ii）使用技术设备。存在一些问题，例如：（i）由于糖尿病的动态和慢性性质而产生的沮丧，（ii）财务限制，（iii）不切实际的期望，以及（iv）工作和环境相关因素，限制了患者对糖尿病的有效自我管理。
强调使用移动应用等技术设备进行教育强化是促进糖尿病自我管理的一种手段，可将其作为一种干预措施来减轻糖尿病自我管理方面的差距。此外，需要改进解决财务负担、工作和环境相关因素以及糖尿病困扰的方法，以增强糖尿病自我管理。
