Lan Xuefen, Ji Xiaozhen, Zheng Xiaojia, Ding Xiaoyu, Mou Hongyi, Lu Shunfei, Ye Bin
Nursing Department, Medicine College, Lishui University, Lishui, Zhejiang, China.
Department of Endocrinology, Lishui People's Hospital, Lishui, Zhejiang, China.
BMC Public Health. 2025 Jan 31;25(1):397. doi: 10.1186/s12889-025-21622-w.
Self-care, a process of maintaining health through health-promoting practices and managing illness, is pivotal for the management of type 2 diabetes. This study aimed to explore the self-care level and investigate its socio-demographic and clinical determinants among Chinese adults with type 2 diabetes.
In this multicenter cross-sectional study, we enrolled 495 Chinese adults with type 2 diabetes from the outpatient departments of three tertiary hospitals in Zhejiang province, China. The Self-Care of Diabetes Inventory (SCODI) was used to measure self-care maintenance, self-care monitoring, and self-care management as three critical components of the dynamic self-care process. Self-care self-efficacy is a critical factor affecting the self-care process, which was measured by the SCODI. Multiple quantile regression models were employed to identify the determinants of each self-care component and self-care self-efficacy.
Participants had a median age of 62 years, of whom 55.4% were male. The median scores for self-care maintenance, self-care monitoring, and self-care management were 66.67 (50.00-85.42), 47.06 (32.35-58.82), and 53.13 (34.38-68.75), respectively, whereas the median score for self-care self-efficacy was 70.45 (52.27-84.09). Living in the southwest of Zhejiang province and having lower self-care self-efficacy were associated with lower self-care maintenance. Female gender, belonging to minorities, having complications, not attending diabetes self-management education in the last year, living in the southwest of Zhejiang province, and having lower self-care self-efficacy were associated with lower self-care monitoring. Having complications, using insulin, living in the southwest of Zhejiang province, and having lower self-care self-efficacy were associated with a lower level of self-care management. Living in the southwest of Zhejiang province was associated with lower self-care self-efficacy.
CONCLUSIONS/INTERPRETATION: The findings of this study provide invaluable insights into the factors affecting self-care among Chinese adults with type 2 diabetes. By enhancing self-care self-efficacy and participating in diabetes self-management education, healthcare providers can develop tailored self-care interventions to improve diabetes care, particularly for adults with type 2 diabetes who are female, belong to minority groups, have complications, use insulin, or reside in the southwest of Zhejiang province.
自我护理是通过促进健康的行为和管理疾病来维持健康的过程，对2型糖尿病的管理至关重要。本研究旨在探讨中国2型糖尿病成年人的自我护理水平，并调查其社会人口学和临床决定因素。
在这项多中心横断面研究中，我们从中国浙江省三家三级医院的门诊招募了495名中国2型糖尿病成年人。糖尿病自我护理量表（SCODI）用于测量自我护理维持、自我护理监测和自我护理管理，作为动态自我护理过程的三个关键组成部分。自我护理自我效能感是影响自我护理过程的一个关键因素，通过SCODI进行测量。采用多个分位数回归模型来确定每个自我护理组成部分和自我护理自我效能感的决定因素。
参与者的中位年龄为62岁，其中55.4%为男性。自我护理维持、自我护理监测和自我护理管理的中位得分分别为66.67（50.00 - 85.42）、47.06（32.35 - 58.82）和53.13（34.38 - 68.75），而自我护理自我效能感的中位得分为70.45（52.27 - 84.09）。居住在浙江省西南部且自我护理自我效能感较低与自我护理维持水平较低有关。女性、属于少数民族、有并发症、去年未参加糖尿病自我管理教育、居住在浙江省西南部以及自我护理自我效能感较低与自我护理监测水平较低有关。有并发症、使用胰岛素、居住在浙江省西南部以及自我护理自我效能感较低与自我护理管理水平较低有关。居住在浙江省西南部与自我护理自我效能感较低有关。
结论/解读：本研究结果为影响中国2型糖尿病成年人自我护理的因素提供了宝贵的见解。通过提高自我护理自我效能感并参与糖尿病自我管理教育，医疗保健提供者可以制定量身定制的自我护理干预措施，以改善糖尿病护理，特别是对于女性、属于少数民族群体、有并发症、使用胰岛素或居住在浙江省西南部的2型糖尿病成年人。
