Self-Management of Type 2 Diabetes in Appalachina Women.

• Main Author: Magness, Melissa Joy
• Format: Others
• Published: Digital Commons @ East Tennessee State University 2007
• Subjects: Social Cognitive Theory; Self-Management; Appalachia; Women; Diabetes; Physical Sciences and Mathematics; Statistics and Probability; Vital and Health Statistics
• Online Access: https://dc.etsu.edu/etd/2156; https://dc.etsu.edu/cgi/viewcontent.cgi?article=3517&context=etd

Gender, minority, and regional-related disparities have been documented in diabetes management. Self-efficacy, the belief in one's ability to carry out the actions mandated by a task, has been identified as a key predictor in glycemic control; however, it has not been investigated in rural, female populations. This cross-sectional, correlation investigation examined the relationships among self-efficacy, depression, and diabetes self-care management in women living in Appalachia with type 2 diabetes. Using Bandura's Social Cognitive Theory, 85 women ages ≥ 21 with type 2 diabetes for a minimum of 6 months who were residents in Appalachia completed the 1) Diabetes Self-Efficacy Scale, 2) Beck Depression Inventory-II, 3)Summary of Diabetes Self-Care Activities, and a 4) Diabetes Health-Related Demographics tool. Descriptive statistics detailed the sample characteristics. ANOVA, chi-square, and independent t-tests were computed for between group differences as they related to depression, various physiologic states, presence of self-efficacy sources, and glycosylated hemoglobin. Pearson correlation coefficients were used to describe the relationships between self-efficacy, depression, and self-care management. Multiple linear regression analyses examined prediction models for glucose control while controlling for potential confounders. Eighty-four Caucasian and one African-American enrolled in the study with a mean age of 61. The mean time since diabetes diagnosis was 7 years with a mean glycosylated hemoglobin value of 6.9% (SD=1.3). Higher self-efficacy scores were associated with a lower glycosylated hemoglobin (r-.30, p=.005) and ability to choose foods best to maintain a healthy eating plan(r-.415, p=.001). The sources of self-efficacy associated with enhanced self-care management were mastery experience and vicarious experience. There were no significant relationships between self-efficacy and depression or depression and glycosylated hemoglobin. The diabetes self-care management regression model resulted in self-efficacy and education accounting for 7.5% of the variance in glycosylated hemoglobin. Study findings support the social cognitive theory and the utility of self-efficacy as a predictor of glycemic control. Depression was not found to be a significant obstacle in this Appalachian population. Comprehending the significant relationship between self-efficacy and diabetes self-care management allows providers to modify their interventions when caring for women type 2 diabetes in the region.