Glycaemic control mediates the relationships of employment status and self‐stigma with self‐care behaviours in young adults with type 2 diabetes

Abstract

Aims and objectives:To investigate the relationships of sociodemographic factors, self-stigma, glycaemic control (measured by glycated haemoglobin (A1C)) and selfcare behaviours in young adults with type 2 diabetes.Background: Young adults aged 25-44 years are in their most productive period.Once diagnosed with diabetes, this population tends to experience poor glycaemic control and perform poorly in self-care activities. Such patterns may raise perceptions of self-stigma and further decrease motivations to engage in self-care behaviours in patients with diabetes.Design: A cross-sectional, correlational research design. Methods:The STROBE guidelines for cross-sectional studies were followed. A convenience sample of 115 participants was recruited from a medical centre in southern Taiwan. Instruments included the Self-Stigma Scale-Chinese version and the Diabetes Self-Care Behaviours Scale. Data were analysed using a three-step hierarchical regression analysis and the Sobel test. Results:The average age of the participants was 36.7 years. Marital status, employment status, self-stigma and A1C were significantly associated with self-care behaviours, and these four variables explained 43.6% of the variance in self-care behaviours.However, A1C (β = −.58, p < .001) was found to be the only determinant of self-care behaviours in the last regression model. The Sobel test showed that A1C had mediating effects on self-stigma and self-care behaviours as well as employment status and self-care behaviours. Conclusion:This study supports the interactive relationship among self-stigma, employment status, glycaemic control and self-care behaviours in young adults with type 2 diabetes. Strategies aimed at optimising glycaemic control can help reduce the effects of self-stigma perceptions and employment status on the self-care behaviours of such patients.Relevance to clinical practice: More effective educational programmes should be designed to improve glycaemic control, lower the effects of employment and decrease | 583 LIN et aL.

Individualized Approaches to Diabetes Care in Nursing Homes

“…This report is attached to the patient's medical records and contains all of the findings and conclusions from the first evaluation, as well as directions for nurses and caregivers written in clear language and providing suitable monitoring schedules (dates for future consultations and tests). Strict record-keeping with the addition of any new information that is relevant, particularly any changes in treatment and test results, will serve to flag any unusual occurrences and provide an easily accessible resource for everyone involved in the patient's care, particularly those who are not familiar with the patient 61,6 . This is especially important for those who are not familiar with the patient.…”

Self-esteem mediates the relationship perceived stigma with self-efficacy for diabetes management in individuals with type 2 diabetes mellitus

“…This result supported the results of similar studies in the literature. 5,[11][12][13][14]22,28,29 Kato et al 13 reported a strong negative predictive effect of self-stigma on the self-care behaviors of people with T2DM. Brazeau et al 11 stated that in diabetic young people, stigmatization was associated with lower self-efficacy levels, higher A1c levels, severe hypoglycemia, and reduced feelings of wellbeing.…”

“…In addition, studies have shown that stigma perceived by people with diabetes affects their DM management negatively. 5,[11][12][13][14] Kato et al 5 reported that internalized stigma had a negative effect on the self-management of people with T2DM. In another study by Kato et al 13 a negative relationship was found between the self-stigma levels and self-care behaviors of people with T2DM.…”

“…In another study by Kato et al 13 a negative relationship was found between the self-stigma levels and self-care behaviors of people with T2DM. In the study carried out by Lin et al 14 with 115 people with T2DM, the authors reported that the self-stigma perceptions of the patients affected their DM-related self-care behaviors negatively.…”

Diabetes-related social stigma among university students in Saudi Arabia: A cross-sectional study

“…Psychologically, stigma lowers self-efficacy and self-esteem, and increases stress in diabetics , [10] which leads to engagement in less healthy behaviors, and as a result glycosylated hemoglobin, is found to be adversely affected by diabetes-related stigma. [7][8][9] There is urgent need for research in the area of stigma [19] that includes documenting the magnitude and nature of diabetesrelated stigma, comparing stigma in different settings, and identifying its determinants. [11] Moreover, according to our knowledge, studies investigating diabetes-related social stigma (DRSS) is explored less than the other types.…”