Clinical School Johor Bahru, Monash University Malaysia, No. 8, Masjid Sultan Abu Bakar, 80100, Johor Bahru, Johor, Malaysia.
BMC Health Serv Res. 2022 Mar 21;22(1):370. doi: 10.1186/s12913-022-07731-x.
Type 2 diabetes mellitus (T2D) is slowly turning into an international health emergency, evidenced by accelerated growth in prevalence rates worldwide. Experts have now called for greater integration of self-management interventions in clinical practice in light of these worrisome trends, supplanting the prevailing notion of a "glucocentric" approach. In this pilot study designed to complement a novel assessment program currently in development, we describe a concise screening tool designed to stratify the intention to follow through on self-management practices in people with T2D.
A cross-sectional survey was conducted at 3 regional primary care clinics. Individuals with T2D having the following characteristics were recruited into the study: (i) individuals with T2D between 18 and 65 years, (ii) fluent in English and, and iii) having been diagnosed with T2D for at least 2 years. We assessed the relevance of components in the Theory of Planned Behaviour (TPB) within the context of self-management behaviour in T2D. Participants were requested to complete a questionnaire containing questions related to intention, attitudes subjective norm and perceived behavioural control. Based on their responses, the psychometric properties of the scale were then evaluated using both reliability and validity analysis.
The Cronbach α value for all direct measures of TPB was excellent: intention to adhere to self-management practices (0.98), attitude towards self-management behaviour (0.87), subjective norm (0.83), and perceived behaviour control (0.66). The correlation between intentions and all 3 constructs of TPB was excellent (p < 0.01). Structural equation modeling helped determine attitudes and subjective norms as important predictors of intentions to follow through self-management practices.
By first understanding the dimensions that influence intentions associated with self-management behaviour, clinicians have the opportunity to "triage" individuals with T2D who require greater involvement to bring about better self-care practices. Thus, our research attempts to bridge this gap by devising a psychometric tool suited to a regional setting which allows for an improved person-centered communication between clinicians and patients.
2 型糖尿病（T2D）正在慢慢演变成一场国际卫生紧急事件，全球患病率的加速增长就是明证。鉴于这些令人担忧的趋势，专家们现在呼吁在临床实践中更加强化自我管理干预措施的整合，取代目前流行的“以血糖为中心”的方法。在这项旨在补充目前正在开发的新型评估计划的试点研究中，我们描述了一种简洁的筛选工具，旨在对 T2D 患者的自我管理实践意愿进行分层。
在 3 个区域初级保健诊所进行了横断面调查。符合以下特征的 T2D 个体被招募入组研究：（i）18-65 岁的 T2D 个体，（ii）英语流利，且（iii）确诊 T2D 至少 2 年。我们评估了计划行为理论（TPB）中的组成部分在 T2D 自我管理行为中的相关性。要求参与者完成一份包含与意图、态度、主观规范和感知行为控制相关问题的问卷。根据他们的回答，使用可靠性和有效性分析评估了量表的心理测量特性。
TPB 的所有直接测量的克朗巴赫α值都非常好：坚持自我管理实践的意图（0.98）、对自我管理行为的态度（0.87）、主观规范（0.83）和感知行为控制（0.66）。意图与 TPB 的所有 3 个构念之间的相关性都非常好（p<0.01）。结构方程模型有助于确定态度和主观规范是影响遵循自我管理实践意图的重要预测因素。
通过首先了解影响自我管理行为意图的维度，临床医生有机会“分诊”需要更多参与以带来更好自我护理实践的 T2D 个体。因此，我们的研究试图通过设计一种适合区域环境的心理计量工具来弥合这一差距，从而在临床医生和患者之间实现更好的以患者为中心的沟通。
