Meihua Ji, PhD, RN, is PhD Candidate, School of Nursing, University of Pittsburgh, Pennsylvania. Meihua Ji is now Associate Professor, School of Nursing, Capital Medical University, Beijing, China. Dianxu Ren, PhD, MD, is Associate Professor, School of Nursing, University of Pittsburgh, Pennsylvania. Jacqueline Dunbar-Jacob, PhD, RN, FAAN, is Dean and Distinguished Service Professor, School of Nursing, University of Pittsburgh, Pennsylvania. Tiffany L. Gary-Webb, PhD, MHS, is Associate Professor, Graduate School of Public Health, University of Pittsburgh, Pennsylvania. Judith A. Erlen, PhD, RN, FAAN, is Professor Emeritus, School of Nursing, University of Pittsburgh, Pennsylvania.
Nurs Res. 2020 Mar/Apr;69(2):E9-E17. doi: 10.1097/NNR.0000000000000401.
Diabetes self-management and glycemic control are suboptimal among Chinese patients with Type 2 diabetes with a large proportion of patients identified with metabolic syndrome.
Based on social cognitive theory, this study examines the effect of selected personal, behavioral, and environmental factors on self-management behaviors, glycemic control, metabolic syndrome and Type 2 diabetes.
A cross-sectional study was conducted among 207 Chinese with Type 2 diabetes living in a suburban area of Beijing, China. Regression models were applied to examine the effect of selected personal, behavioral, and environmental factors on self-management behaviors, glycemic control, and metabolic syndrome. The relationship among individual self-management behaviors, glycemic control, and metabolic syndrome was also examined.
Self-efficacy was significantly associated with all self-management behaviors. Social support was related to overall self-management, diabetes knowledge was related to diet, and depressive symptoms was related to self-monitoring. Problem-solving and self-management behaviors related to medication adherence and diet were significant correlates of glycemic control. Health literacy and self-management behaviors related to physical activity were correlates of metabolic syndrome.
Findings suggest that a multifactorial approach may be beneficial when providing care for Chinese with Type 2 diabetes. In addition, these findings provide support for developing and testing tailored interventions that address problem-solving, health literacy, and self-efficacy, among other factors, to help patients achieve optimal glycemic control and thereby reduce their risk for metabolic syndrome and related complications.
在中国，2 型糖尿病患者的自我管理和血糖控制不理想，其中很大一部分患者患有代谢综合征。
本研究基于社会认知理论，考察了个人、行为和环境因素对自我管理行为、血糖控制、代谢综合征和 2 型糖尿病的影响。
本研究在中国北京郊区进行了一项横断面研究，共纳入 207 名 2 型糖尿病患者。回归模型用于检验个人、行为和环境因素对自我管理行为、血糖控制和代谢综合征的影响。还检验了个体自我管理行为、血糖控制和代谢综合征之间的关系。
自我效能感与所有自我管理行为显著相关。社会支持与整体自我管理相关，糖尿病知识与饮食相关，抑郁症状与自我监测相关。解决问题和与药物依从性及饮食相关的自我管理行为是血糖控制的显著相关因素。健康素养和与身体活动相关的自我管理行为是代谢综合征的相关因素。
研究结果表明，在为 2 型糖尿病患者提供护理时，采用多因素方法可能是有益的。此外，这些发现为开发和测试针对解决问题、健康素养和自我效能等因素的定制干预措施提供了支持，以帮助患者实现最佳血糖控制，从而降低代谢综合征及相关并发症的风险。
