Self-Management Among Adults with Type 2 Diabetes in Vietnam. Authors Dao, Hanh T. T.; Anderson, Debra Jane; Chang, Anne M.

Transcription

1 The Henderson Repository is a free resource of the Honor Society of Nursing, Sigma Theta Tau International. It is dedicated to the dissemination of nursing research, researchrelated, and evidence-based nursing materials. Take credit for all your work, not just books and journal articles. To learn more, visit Item type Format Title Presentation Text-based Document Self-Management Among Adults with Type 2 Diabetes in Vietnam Authors Dao, Hanh T. T.; Anderson, Debra Jane; Chang, Anne M. Downloaded 1-May :38:33 Link to item

2 Hanh Dao, RN, BNS, MNS Debra Anderson, RN, BA, GDNS (ed), MN, PhD Anne Chang, RN, DipNEd, BEdSt, MEdSt, PhD 1

3 OUTLINE 1. Introduction 2. Brief literature review 3. Methods 4. Results 5. Discussion 6. Conclusion 2

4 INTRODUCTION Diabetes Cases (Million) T2DM (2011): 90 % # Definition Symptom Complications 4. Diagnose 5. Cause Type 2: 90-95%, risk factors References: 1. Holt, Cockram, Flyvbjerg, & Goldstein (2010) 2. Wild et al. (2004) 3. World Health Organization (2011) 4. Shaw et al. (2009) Figure 1. number of cases with diabetes in the world by year 3 Year

5 INTRODUCTION T2DM: 95% #4.75M (4) Year Incidence (2009) % - 2.5% (1) % - 4.4% (2) % % (3) 4

6 INTRODUCTION PRINCIPLES FOR DIABETES MANAGEMENT Healthy diet Regular physical activities Medication adherence Frequent blood glucose level self-monitoring Weight control, tobacco avoidance Preventive care such as foot care (1) 5

7 INTRODUCTION Self-management: patients active participation in a process to develop strategies for gaining desired goals to regulate their own actions to collaborate with healthcare providers, significant people to perform preventive, therapeutic health related activities 6

8 INTRODUCTION RESEARCH OBJECTIVES To explore frequency adults with T2DM in Vietnam perform diabetes self-management. To examine associations among demographic, healthrelated characteristics and diabetes self-management in adults with T2DM in target population. RESEARCH QUESTIONS To what extent do adults with T2DM in Vietnam perform diabetes self-management? Are there any relationships among demographic, healthrelated characteristics and diabetes self-management among adults with T2DM in target population? 7

9 BRIEF LITERATURE REVIEW When adults with T2DM received diabetes selfmanagement support, they can Improve their control of BGLs, blood pressure (1, 2, 8, 9, 12, 15) (30, 15), weight and lipid profile (2, 9, 14) (12) Improve general health status (4, 8, 10,11, 13) Reduce health distress (4, 8, 9, 10, 13), diabetes medication need (2, 14), ER visits (8, 10,11), and healthcare costs (10) References: 1. Brown, S., Garcia, A., Kouzekanani, K., & Hanis, C. (2002). 2. Deakin, T. A., McShane, C. E., Cade, J. E., & Williams, R. (2005). 3. Faridi, Z., Liberti, L., Shuval, K., Northrup, V., Ali, A., & Katz, D. (2008). 4. Foster, G., Taylor, S. J. C., Eldridge, S., Ramsay, J., & Griffiths, C. J. (2007). 5. Glasgow, R. E., Strycker, L. A., King, D. K., Toobert, D. J., Rahm, A. K., Jex, M., & Nutting, P. A. (2006). 6. Griffiths, C., Motlib, J., Azad, A., Ramsay, J., Eldridge, S., Feder, G.,... Barlow, J. (2005). 7. Harvey, P., Petkov, J., Misan, G., Fuller, J., Battersby, M., Cayetano, T.,... Holmes, P. (2008). 8. Lorig, K. R., Ritter, P., Villa, F., & Piette, J. (2008). 9. Lorig, K. R., Ritter, P. L., Laurent, D. D., Plant, K., Green, M., Jernigan, V., & Case, S. (2010). 10. Lorig, K. R., Ritter, P. L., Stewart, A., Sobel, D., William Brown, B., Bandura, A.,... Holman, H. (2001). 11. Lorig, K. R., Sobel, D., Ritter, P. L., Laurent, D. D., & Hobbs, M. (2001). 12. Norris, S., Engelgau, M., & Narayan, K. (2001). 13. Swerissen, H., Belfrage, J., Weeks, A., Jordan, L., Walker, C., Furler, J.,... Peterson, C. (2006). 14. Thoolen, B. J., De Ridder, D. T. D., Bensing, J. M., Maas, C., Griffin, S., Gorter, K., & Rutten, G. (2007) Warsi, A., Wang, P., LaValley, M., Avorn, J., & Solomon, D. (2004).

10 BRIEF LITERATURE REVIEW Definition of self-management patients compliance to health care providers recommendations patients adherence to their health care plan aimed at managing the impacts of diabetes on physical health. patients participation in managing the impacts of diabetes on their physical as well as on their psychosocial health an active, flexible process in which patients developed strategies for achieving desired goals by regulating their own actions, collaborating their healthcare providers and significant people and performing preventive and therapeutic health related activities 9

11 METHODS Setting: Endocrine OPC, Cho Ray hospital Design: A cross-sectional survey Sample size: 198 Sampling method: Convenience sampling Data collection: Face to face interview Instruments: Self-report questionnaire (demographic, health related characteristics, diabetes self-management instrument) Ethical approvals: QUT, UMP, hospital acceptance 10

12 Inclusion criteria METHODS Criteria for participation Vietnamese, aged 18 years Diagnosed with T2DM for at least 6 months Had more than one outpatient visit related to T2DM Able to communicate in Vietnamese Able to give informed consent and willing to participate in study. Exclusion criteria Cognitive impairment Too sick to participate. 11

13 RESULTS 12

14 Demographic characteristics 13

15 Health-related characteristics 14

16 Diabetes self-management 15

17 Relationships between demographic, health-related characteristics and diabetes self-management Diabetes self-management and age (βo=117.32, β1= -0.35, R2=0.03, p<0.05) religion (F3.194=6.51, p<0.001) marital status (F2.195=3.42, p<0.05) education level (F7.190=8.257, p<0.001) occupation (F3.194=8.11, p<0.001) workload (F3.194=6.46, p<0.001) income (βo= 85.26, β1=3.66, R2=0.08, p<0.001) attendance to diabetic patients' clubs (t196=3.62, p<0.001). 16

18 DISCUSSION Practice of self-management was limited in study population. usually self-integrated and self-regulated their diabetes management in daily life: reporting bias? Reports of rarely working with their healthcare providers are a concern low frequency of self-monitoring blood glucose level: fear of pain related to injections, financial constraints, and limited access to the facilities?!. Depend on healthcare providers to monitor BGLs, low self-efficacy about selfmonitoring BGLs => in-depth investigation Usually adhered to the treatment regime => consistent with literature 17

19 DISCUSSION Those who were younger, had no religion, were married or live with their partners, had higher education, jobs with light or normal workload, higher incomes and attended diabetic patients clubs were more likely to self-manage better than others => target self-management support Strengths: an unstudied population, a tertiary hospital, concept measurement, valid instrument with a good translation equivalence and high internal consistency values, interview. Limitations: self-report, convenience sampling, crosssectional design 18

20 DISCUSSION Recommendations for future research: Instruments validation Bigger sample size, M-plus for a comprehensive model Longitudinal study, RCT for causal relationship exploration, epidemiological study for investigation in whole Vietnamese population. Measuring behavioural outcomes to test the application of SCT in Vietnamese adults with T2DM population. In-depth interview for comprehensive understanding factors influencing diabetes self-management in target population u

21 CONCLUSION Diabetes self-management support should be provided for adults with type 2 diabetes in the target population. An adapted theory based model could be a useful framework to develop the diabetes self-management support program for the target population. 20

22 ACKNOWLEDMENT Many thanks to 1. The Atlantic Philanthropies 2. Cho Ray Hospital and the adults with T2DM participating in the study 3. Translation team 4. Experts panel 5. The study research assistants 21