{"title":"基于自决理论的2型糖尿病患者糖尿病自我保健活动的决定因素。","authors":"Hassan Okati-Aliabad, Athare Nazri-Panjaki, Mahdi Mohammadi, Elham Nejabat, Alireza Ansari-Moghaddam","doi":"10.1007/s00592-023-02186-w","DOIUrl":null,"url":null,"abstract":"<div><h3>Aims</h3><p>In type 2 diabetes control, self-management is an effective way to minimize the risk of developing complications and improve the quality of life. Self-determination theory (SDT) proposed a promising explanatory framework to predict self-regulated behavior which was particularly relevant for self-management. This study aimed to investigate whether SDT constructs can affect the self-management and controlling glycated hemoglobin A1c (HbA1c) levels in type 2 diabetic patients or not.</p><h3>Methods</h3><p>This cross-sectional study was conducted from August to December 2022 at two diabetes clinics in Zahedan. The study included 300 patients with type 2 diabetes. Data collection was done using a researcher-administrated questionnaire that included demographic data, diabetes self-care activities, and self-determination constructs including autonomous support, autonomous motivation, and perceived competence.</p><h3>Results</h3><p>The mean of the overall score of self-care activities was 34.62 ± 11.86 out of a maximum of 70. Patients in the fourth quarter (wealthiest) of the socioeconomic status had the highest mean self-care score (<i>P</i> = 0.003). There was a significant relationship between diet score with perceived competence (<i>P</i> = 0.009). Perceived competence (<i>P</i><0.001) and controlled self-regulation (<i>P</i><0.001) were the predictors of exercise score in diabetes patients. Independent self-regulation (<i>P</i><0.001, <i>r</i> = 0.21) and overall self-regulation (<i>P</i> = 0.001, <i>r</i> = 0.19) were significantly related to blood-glucose testing score. There was a significant relationship between foot care score with perceived competence (<i>P</i> = 0.048, <i>r</i> = 0.11) and autonomous support (<i>P</i> = 0.013, <i>r</i> = 0.14). Multiple regression showed that exercise was the predictor of HbA1c (<i>P</i> = 0.014).</p><h3>Conclusion</h3><p>Exercise is crucial for achieving good individualized glycemic control and reducing the risk of diabetes complications. The findings provided valuable insights into the determinants of self-care activities in patients with type 2 diabetes and underscore the need for interventions that address socioeconomic disparities, enhance perceived competence, and provide autonomy support to improve diabetes self-care.</p></div>","PeriodicalId":6921,"journal":{"name":"Acta Diabetologica","volume":"61 3","pages":"297 - 307"},"PeriodicalIF":3.1000,"publicationDate":"2023-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Determinants of diabetes self-care activities in patients with type 2 diabetes based on self-determination theory\",\"authors\":\"Hassan Okati-Aliabad, Athare Nazri-Panjaki, Mahdi Mohammadi, Elham Nejabat, Alireza Ansari-Moghaddam\",\"doi\":\"10.1007/s00592-023-02186-w\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Aims</h3><p>In type 2 diabetes control, self-management is an effective way to minimize the risk of developing complications and improve the quality of life. Self-determination theory (SDT) proposed a promising explanatory framework to predict self-regulated behavior which was particularly relevant for self-management. This study aimed to investigate whether SDT constructs can affect the self-management and controlling glycated hemoglobin A1c (HbA1c) levels in type 2 diabetic patients or not.</p><h3>Methods</h3><p>This cross-sectional study was conducted from August to December 2022 at two diabetes clinics in Zahedan. The study included 300 patients with type 2 diabetes. Data collection was done using a researcher-administrated questionnaire that included demographic data, diabetes self-care activities, and self-determination constructs including autonomous support, autonomous motivation, and perceived competence.</p><h3>Results</h3><p>The mean of the overall score of self-care activities was 34.62 ± 11.86 out of a maximum of 70. Patients in the fourth quarter (wealthiest) of the socioeconomic status had the highest mean self-care score (<i>P</i> = 0.003). There was a significant relationship between diet score with perceived competence (<i>P</i> = 0.009). Perceived competence (<i>P</i><0.001) and controlled self-regulation (<i>P</i><0.001) were the predictors of exercise score in diabetes patients. Independent self-regulation (<i>P</i><0.001, <i>r</i> = 0.21) and overall self-regulation (<i>P</i> = 0.001, <i>r</i> = 0.19) were significantly related to blood-glucose testing score. There was a significant relationship between foot care score with perceived competence (<i>P</i> = 0.048, <i>r</i> = 0.11) and autonomous support (<i>P</i> = 0.013, <i>r</i> = 0.14). Multiple regression showed that exercise was the predictor of HbA1c (<i>P</i> = 0.014).</p><h3>Conclusion</h3><p>Exercise is crucial for achieving good individualized glycemic control and reducing the risk of diabetes complications. The findings provided valuable insights into the determinants of self-care activities in patients with type 2 diabetes and underscore the need for interventions that address socioeconomic disparities, enhance perceived competence, and provide autonomy support to improve diabetes self-care.</p></div>\",\"PeriodicalId\":6921,\"journal\":{\"name\":\"Acta Diabetologica\",\"volume\":\"61 3\",\"pages\":\"297 - 307\"},\"PeriodicalIF\":3.1000,\"publicationDate\":\"2023-10-19\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Acta Diabetologica\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://link.springer.com/article/10.1007/s00592-023-02186-w\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"ENDOCRINOLOGY & METABOLISM\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Acta Diabetologica","FirstCategoryId":"3","ListUrlMain":"https://link.springer.com/article/10.1007/s00592-023-02186-w","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"ENDOCRINOLOGY & METABOLISM","Score":null,"Total":0}
Determinants of diabetes self-care activities in patients with type 2 diabetes based on self-determination theory
Aims
In type 2 diabetes control, self-management is an effective way to minimize the risk of developing complications and improve the quality of life. Self-determination theory (SDT) proposed a promising explanatory framework to predict self-regulated behavior which was particularly relevant for self-management. This study aimed to investigate whether SDT constructs can affect the self-management and controlling glycated hemoglobin A1c (HbA1c) levels in type 2 diabetic patients or not.
Methods
This cross-sectional study was conducted from August to December 2022 at two diabetes clinics in Zahedan. The study included 300 patients with type 2 diabetes. Data collection was done using a researcher-administrated questionnaire that included demographic data, diabetes self-care activities, and self-determination constructs including autonomous support, autonomous motivation, and perceived competence.
Results
The mean of the overall score of self-care activities was 34.62 ± 11.86 out of a maximum of 70. Patients in the fourth quarter (wealthiest) of the socioeconomic status had the highest mean self-care score (P = 0.003). There was a significant relationship between diet score with perceived competence (P = 0.009). Perceived competence (P<0.001) and controlled self-regulation (P<0.001) were the predictors of exercise score in diabetes patients. Independent self-regulation (P<0.001, r = 0.21) and overall self-regulation (P = 0.001, r = 0.19) were significantly related to blood-glucose testing score. There was a significant relationship between foot care score with perceived competence (P = 0.048, r = 0.11) and autonomous support (P = 0.013, r = 0.14). Multiple regression showed that exercise was the predictor of HbA1c (P = 0.014).
Conclusion
Exercise is crucial for achieving good individualized glycemic control and reducing the risk of diabetes complications. The findings provided valuable insights into the determinants of self-care activities in patients with type 2 diabetes and underscore the need for interventions that address socioeconomic disparities, enhance perceived competence, and provide autonomy support to improve diabetes self-care.
期刊介绍：
Acta Diabetologica is a journal that publishes reports of experimental and clinical research on diabetes mellitus and related metabolic diseases. Original contributions on biochemical, physiological, pathophysiological and clinical aspects of research on diabetes and metabolic diseases are welcome. Reports are published in the form of original articles, short communications and letters to the editor. Invited reviews and editorials are also published. A Methodology forum, which publishes contributions on methodological aspects of diabetes in vivo and in vitro, is also available. The Editor-in-chief will be pleased to consider articles describing new techniques (e.g., new transplantation methods, metabolic models), of innovative importance in the field of diabetes/metabolism. Finally, workshop reports are also welcome in Acta Diabetologica.
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