Ridla Akhmad Zainur, Zulfatul A'la Muhamad
Faculty of Nursing, University of Jember, East Java, Indonesia.
School of Nursing, Faculty of Science, Medicine and Health, University of Wollongong, New South Wales, Australia.
Belitung Nurs J. 2024 Oct 14;10(5):509-522. doi: 10.33546/bnj.3173. eCollection 2024.
The current model for managing type 2 diabetes mellitus (T2DM) is healthcare provider-centered rather than patient-centered. This approach may overlook individual patients' unique needs, potentially impacting the effectiveness of T2DM management goals.
This study aimed to develop a patient-centered care model based on self-efficacy to enhance self-care and improve the quality of life for individuals with T2DM.
The study employed a cross-sectional design with a sample size of 250 respondents recruited through multistage random sampling, Jember regency, East Java, Indonesia. The study variables included exogenous factors (people with T2DM, situational treatment, family, and healthcare services) and endogenous factors (self-efficacy, self-care, and quality of life). Data were collected from August to December 2022 using a questionnaire and analyzed descriptively and inferentially using SEM-PLS.
The developed model was a good fit with strong predictive relevance (SRMR = 0.065; Q2 = 0.049). All exogenous factors-people with T2DM, situational treatment, family, and healthcare services-significantly affected self-efficacy (42.2%, 37%, 8.1%, and 17.3%; <0.001). Self-efficacy had a 61.6% effect on self-care, and self-care had a 27.1% effect on quality of life ( <0.001). Only situational treatment factors had a direct effect on self-care (21.7%; <0.001). All exogenous factors also influenced the quality of life through self-efficacy and self-care (7%, 6.2%, 1.3%, and 2.9%; <0.05).
A patient-centered care model based on self-efficacy for managing T2DM can improve self-care behaviors and quality of life for individuals with T2DM. This model can be utilized by nurses in healthcare services to enhance the management of T2DM.
目前2型糖尿病（T2DM）的管理模式是以医疗服务提供者为中心，而非以患者为中心。这种方法可能会忽视个体患者的独特需求，从而可能影响T2DM管理目标的有效性。
本研究旨在开发一种基于自我效能感的以患者为中心的护理模式，以加强自我护理并改善T2DM患者的生活质量。
本研究采用横断面设计，通过多阶段随机抽样从印度尼西亚东爪哇省任抹县招募了250名受访者作为样本。研究变量包括外生因素（T2DM患者、情境治疗、家庭和医疗服务）和内生因素（自我效能感、自我护理和生活质量）。2022年8月至12月期间使用问卷收集数据，并使用结构方程模型 - 偏最小二乘法（SEM-PLS）进行描述性和推断性分析。
所开发的模型具有良好的拟合度和较强的预测相关性（标准化残差均方根（SRMR）= 0.065；交叉效度（Q2）= 0.049）。所有外生因素——T2DM患者、情境治疗、家庭和医疗服务——均对自我效能感有显著影响（分别为42.2%、37%、8.1%和17.3%；P<0.0）。自我效能感对自我护理有61.6%的影响，自我护理对生活质量有27.1%的影响（P<0.0）。只有情境治疗因素对自我护理有直接影响（21.7%；P<0.0）。所有外生因素还通过自我效能感和自我护理影响生活质量（分别为7%、6.2%、1.3%和2.9%；P<0.05）。
基于自我效能感管理T2DM的以患者为中心的护理模式可以改善T2DM患者的自我护理行为和生活质量。医疗服务中的护士可以利用该模型加强T2DM的管理。
