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ABSTRACT: Objective
To examine the influence of diabetes psychosocial attributes and self-management on glycemic control and diabetes status change.Methods
Using data from the Health and Retirement Study, a nationally representative longitudinal study of U.S. adults >51 years, we examined cross-sectional relationships among diabetes psychosocial attributes (self-efficacy, risk awareness, care understanding, prioritization of diabetes, and emotional distress), self-management ratings, and glycemic control. We then explored whether self-management ratings and psychosocial attributes in 2003 predicted change in diabetes status in 2004.Results
In multivariate analyses (N=1834), all diabetes psychosocial attributes were associated with self-management ratings, with self-efficacy and diabetes distress having the strongest relationships (adj coeff=8.1, p<0.01 and -4.1, p<0.01, respectively). Lower self-management ratings in 2003 were associated cross-sectionally with higher hemoglobin A1C (adj coeff=0.16, p<0.01), and with perceived worsening diabetes status in 2004 (adj OR=1.36, p<0.05), with much of this latter relationship explained by diabetes distress.Conclusion
Psychosocial attributes, most notably diabetes-related emotional distress, contribute to difficulty with diabetes self-management, poor glycemic control, and worsening diabetes status over time.Practice implications
Self-management and adherence interventions should target psychosocial attributes such as disease-related emotional distress.
SUBMITTER: Zulman DM
PROVIDER: S-EPMC3229832 | biostudies-literature | 2012 Apr
REPOSITORIES: biostudies-literature
Zulman Donna M DM Rosland Ann-Marie AM Choi Hwajung H Langa Kenneth M KM Heisler Michele M
Patient education and counseling 20110815 1
<h4>Objective</h4>To examine the influence of diabetes psychosocial attributes and self-management on glycemic control and diabetes status change.<h4>Methods</h4>Using data from the Health and Retirement Study, a nationally representative longitudinal study of U.S. adults >51 years, we examined cross-sectional relationships among diabetes psychosocial attributes (self-efficacy, risk awareness, care understanding, prioritization of diabetes, and emotional distress), self-management ratings, and g ...[more]