Larger self-efficacy, social assist increase perceived problem-solving in diabetes

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April 20, 2021

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Adults with type 2 diabetes who have better self-efficacy and social support are more likely to experience better problem-solving skills in their diabetes management, according to study data.

Meihua Ji

“Patients with type 2 diabetes need to develop comprehensive problem-solving skills to adequately control their condition. Both personal and psychosocial factors play an important role in effective problem-solving and diabetes management.” Meihua Ji, PhD, MSN, RN, Healio said, an associate professor in the School of Nursing at Capital Medical University in Beijing. “Researchers and clinicians should consider both personal and psychosocial factors such as self-efficacy, social support, and symptom distress when examining patient perceived problem solving, and develop tailored interventions to improve diabetes management. In addition, healthcare providers should consider these important aspects when providing tailored care for this patient population. “

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Researchers performed a secondary data analysis based on a descriptive cross-sectional study design that used baseline data from a randomized controlled trial examining the effects of a problem-solving intervention on drug management adherence in adults with type 2 diabetes and other comorbidities . The original study was carried out by a research team led by Jacqueline M. Dunbar-Jacob, PHD, RN, FAANat the School of Nursing at the University of Pittsburgh. Participants were 40 years or older, had type 2 diabetes for at least 1 year, had high blood pressure or hyperlipidemia, and were receiving at least one oral diabetes drug.

Participants completed the symptom distress scale to measure their perceived symptom distress. The score ranged from 13 to 65, with a higher score indicating more distress. The self-efficacy scale for people with type 2 diabetes was used to measure self-confidence in treating diabetes, with a higher value indicating higher confidence. The interpersonal support rating list was used to collect social support data, with a higher score indicating greater support. The problem-solving inventory was used to rate participants’ perceived level of problem-solving for diabetes management, with lower scores indicating better perceived problem-solving skills.

The results were published in The Science of Diabetes Self-Management and Care.

The 304 participants (80.3% white; mean age 64.1 years) had an average problem-solving inventory value of 87.5, indicating that they viewed themselves as “moderately effective” problem-solvers. The mean total score for symptom distress was 23.6 out of a maximum of 65, indicating that participants were likely to have had moderate distress with their symptoms. The mean self-efficacy was 143.6, indicating that participants were not fully convinced of their diabetes self-management. The average social support score was 89.2, which indicates adequate support. The participants had a mean HbA1c of 7.4%.

In the multiple linear regression, age, gender, years of education, duration of diabetes, and number of comorbidities together as a set predicted the degree of problem solving among participants (P <0.001). After self-efficacy, social support, and symptom distress were added to the model, the problem-solving predictive model improved (P <0.001).

“The negative associations between perceived problem solving and self-efficacy and social support in the current study were similar to previous research, suggesting that greater self-efficacy and social support lead to better day-to-day problem solving,” the researchers wrote. “The current study found a positive association between perceived problem-solving and symptom distress. This suggests that the more severe the symptom distress felt by patients, the less effective they were in perceiving their problem-solving skills.”

Ji said future studies should use an integrative approach to improve self-efficacy and social support while reducing symptom burden to create problem-solving interventions to improve diabetes management.

For more informations:

Meihua Ji, PhD, MSN, RNcan be reached at mjshouyi@ccmu.edu.cn.

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