Successful daily self-management of diabetes mellitus is essential to the achievement of positive health outcomes. Basic to successful self-management of any disease is a sense of self-efficacy or the feeling of confidence in one’s self-management abilities. This study examined the association of these variables on the achievement of glycemic control, specifically glycosylated hemoglobin levels.
This study used a retrospective cohort design to evaluate the predictive relationship of self-efficacy and self-care behaviors on glycosylated hemoglobin. After Institutional Review Board approval was obtained, 60 medical records were accessed of people, eighteen years and older, with type 1 and type 2 diabetes mellitus, who were seen consecutively in a primary care practice located in an urban setting. Data analysis revealed no statistically significant relationships between global measures of self-efficacy and self-care with glycosylated hemoglobin levels. However, there were two questions from the Stanford Diabetes Self-Efficacy for Diabetes Scale found to be significantly related to glycosylated hemoglobin control (p. < .009) those well controlled were confident in: selecting appropriate foods when hungry and ability to exercise 15-30 minutes four to five times per week. Although self-efficacy and self-care influence the choices people make, some people may have a high degree of both but may still choose unhealthy behaviors. Two examples would be a physician with diabetes who does not adhere to dietary recommendations or a registered nurse with diabetes who does not take steps to decrease portion sizes. Yet, these individuals would answer that they have confidence in their ability to implement these behaviors. The findings, if replicated in future studies, may provide clinicians an opportunity to develop and test targeted self-management interventions yielding the highest probability of glycemic control.
Take Away Notes:
• Learners will be able to articulate the concepts self-management, self- efficacy and self –care and their effect on a person with diabetes’s glycemic control
• This content will enable the learner to focus on the barriers that exist for a person with diabetes related to self-care and how these can be addressed
• This research can be emulated by faculty to expand their research or teaching of those who have chronic disease, especially persons with diabetes