Resilience plays an important role in the health of the elderly. The 10-item Connor-Davidson Resilience Scale (CD-RISC-10) is widely used to evaluate resilience, but its factorial invariance has not been evaluated in the Chinese elders. In the current study, 1,238 Chinese elders aged 60 years and above completed the Chinese CD-RISC-10, yielding good reliability (Cronbach’s
α
= 0.936, Omega coefficient = 0.83, and test-retest reliability coefficient of 0.665 after 6 months). Confirmatory factor analysis indicated that a single-factor model fitted our CD-RISC-10 data well, both for the total sample and for each gender group. Furthermore, factorial invariance across genders was supported by multigroup confirmatory factor analysis. Finally, the current study revealed greater resilience levels in Chinese elderly women than in Chinese elderly men.
Aim. This systematic review aimed at investigating the effectiveness of structured education (SE) in improving glycemic control and psychological outcomes in adolescent and adult patients with type 1 diabetes. Methods. Electronic databases (EMBASE, Medline, PubMed, and the Cochrane Library) and the reference lists of included studies were searched from the beginning of the database through April 2019. Randomized controlled trials comparing SE with a control condition and reporting a change in glycosylated hemoglobin (HbA1c) level were included. The primary outcome was glycemic control measured by HbA1c. Secondary outcomes were diabetes-related distress, well-being, depression, and quality of life. Results. Eighteen studies representing 2759 patients were included. Twelve studies targeted adolescents and six targeted adults. Adolescent patients who were randomized to the intervention group did not show significant improvement of HbA1c in the short (SMD = −0.04; 95% CI: −0.14 to 0.06; P=0.41), medium (SMD = −0.03; 95% CI: −0.13 to 0.07; P=0.55), and long term (SMD = 0.04; 95% CI: −0.16 to 0.25; P=0.66) or of diabetes self-efficacy (SMD = −0.17; 95% CI: −0.33 to 0.00; overall effect P=0.05). However, SE was effective in reducing HbA1c levels in adult patients with inadequate baseline control (HbA1c higher than 7.5%) (SMD = −0.52; 95% CI: −0.86 to −0.17; P=0.003). SE significantly improved the well-being and psychological distress of adult patients but had no effect on the extent of depression. Conclusions. Development of more efficient SE programs according to the patients’ personal characteristics is needed.
Objective Self-management is beneficial for improving health outcomes in adults with type 1 diabetes. However, there are no validated instruments to assess self-management in Chinese adults with type 1 diabetes. The aim of this study was to develop and validate the Self-Management of Type 1 Diabetes for Chinese Adults (SMOD-CA) scale. Methods Qualitative and quantitative methods were used to develop the SMOD-CA. We conducted a literature review and semi-structured interviews to generate an initial item pool. An expert panel examined the content validity. We conducted a cross-sectional survey to evaluate scale reliability and validity. A total of 243 participants were recruited. Exploratory factor analyses were used to test the construct validity, and internal consistency and test-retest reliability were assessed. Results The expert panel determined that the SMOD-CA content validity index was satisfactory. The final 30-item scale consisted of four factors explaining 49.50% of the total variance in the data. Cronbach’s α was 0.901 for the total scale and 0.911 for test–retest reliability. Conclusions The SMOD-CA demonstrated good reliability and validity. The scale is a credible and effective instrument that can be used by social workers and health care professionals to assess self-management in Chinese adults with type 1 diabetes. Trial registration number NCT03610984
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