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DIABETES SELF-MANAGEMENT AND HEALTH OUTCOMES AMONG CHINESE PATIENTS WITH TYPE 2 DIABETES

JI, MEIHUA (2018) DIABETES SELF-MANAGEMENT AND HEALTH OUTCOMES AMONG CHINESE PATIENTS WITH TYPE 2 DIABETES. Doctoral Dissertation, University of Pittsburgh. (Unpublished)

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Abstract

There is limited evidence on theory-based research conducted in China and little is known about the relationships of personal, behavioral, and environmental factors, self-management behaviors, glycemic control, and metabolic syndrome among Chinese patients with type 2 diabetes (T2DM), especially among those who live in suburban areas. Using Social Cognitive Theory this cross-sectional study was conducted among patients with T2DM recruited from an outpatient clinic in a suburban area of Beijing, China. The aims of the study were to describe patient characteristics in selected personal, behavioral and environmental factors, self-management behaviors, and health outcomes; examine the association and impact of modifiable study variables on self-management behaviors and health outcomes (HbA1c and existence of metabolic syndrome); and explore the mediation role of self-management behaviors among study variables and glycemic control. A convenience sample of 207 patients provided informed consent; self-reported questionnaires were completed during a patient’s clinic appointment. A clinic nurse retrieved clinical information from the medical record. The results showed that 40.1% had optimal glycemic control, 16.4% had an adequate level in performing self-management behaviors, and 89.4% were identified to have metabolic syndrome. Compared to men, women in this sample demonstrated poorer health literacy and problem-solving, received less social support and had more depressive symptoms (p<0.05). Multiple regression analysis showed that self-efficacy was a significant correlate of all self-management behaviors (p<0.05). Social support was related to overall self-management, diabetes knowledge was related to diet, and depressive symptoms was related to self-monitoring (p<0.05). Problem-solving, self-management behaviors related to medication and diet were significant correlates for glycemic control (p<0.05). Health literacy (OR =0.77) and self-management behaviors related to physical activity (OR=0.84) were protective factors for metabolic syndrome (p<0.05). There was no mediation of self-management behaviors between the study variables and glycemic control. Patients’ overall glycemic control and self-management behaviors were suboptimal and a large proportion were at risk for developing cardiovascular disease. Gender differences should be considered when targeting strategies to improve health outcomes. Findings suggest that future research needs to consider designing and testing an intervention using a multifactorial approach to improve health outcomes among Chinese patients with T2DM.


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Details

Item Type: University of Pittsburgh ETD
Status: Unpublished
Creators/Authors:
CreatorsEmailPitt UsernameORCID
JI, MEIHUAmej61@pitt.eduMEJ61
ETD Committee:
TitleMemberEmail AddressPitt UsernameORCID
Committee ChairERLEN, JUDITHJAE001@PITT.EDU
Committee MemberDUNBAR-JACOB, JACQUELINEDUNBAR@PITT.EDU
Committee MemberREN, DIANXUDIR8@PITT.EDU
Committee MemberGARY-WEBB, TIFFANYTGARY@PITT.EDU
Date: 14 August 2018
Date Type: Publication
Defense Date: 21 June 2018
Approval Date: 14 August 2018
Submission Date: 10 August 2018
Access Restriction: 1 year -- Restrict access to University of Pittsburgh for a period of 1 year.
Number of Pages: 215
Institution: University of Pittsburgh
Schools and Programs: School of Nursing > Nursing
Degree: PhD - Doctor of Philosophy
Thesis Type: Doctoral Dissertation
Refereed: Yes
Uncontrolled Keywords: Chinese patients with type 2 diabetes; self-management; glycemic control; metabolic syndrome; health outcomes; associated factors
Date Deposited: 15 Aug 2018 00:27
Last Modified: 15 Aug 2018 00:27
URI: http://d-scholarship.pitt.edu/id/eprint/35151

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