Pathways of emotional autonomy, problem‐solving ability, self‐efficacy, and self‐management on the glycemic control of adolescents with type 1 diabetes: A prospective study

Abstract

This prospective study tested a model to depict associations between a number of individual characteristics and 6‐month glycated hemoglobin (HbA1c) levels in adolescents with type 1 diabetes (T1D). Adolescents (N = 232) aged 10–19 years with T1D were recruited from a medical center in Taiwan. Demographic characteristics, emotional autonomy, problem‐solving ability, self‐efficacy at baseline, and self‐management information three months after baseline were collected using a self‐reported questionnaire. HbA1c levels 6 months after study commencement were obtained from medical records. Structural equation modeling was used to test the model. Higher baseline self‐efficacy and self‐management at 3 months were directly associated with lower 6‐month HbA1c levels. Higher baseline problem‐solving ability and self‐efficacy were directly associated with higher 3‐month self‐management, and higher baseline problem‐solving ability was directly associated with higher baseline self‐efficacy. Higher baseline emotional autonomy was directly associated with lower 6‐month HbA1c levels but indirectly associated with higher 6‐month HbA1c levels through the mediation of lower problem‐solving ability, self‐efficacy, and 3‐month self‐management. Findings indicate that improving self‐management is essential to improving subsequent glycemic control, which might be achieved by enhancing problem‐solving ability and self‐efficacy. Strengthening problem‐solving ability could diminish the negative impact of emotional autonomy on subsequent glycemic control in adolescents with T1D.

Diabetes self‐care behaviours among people diagnosed with serious mental illness: A cross‐sectional correlational study

“…The observed positive association between self‐efficacy and self‐care behaviours is consistent with previous findings regarding people diagnosed with T2DM alone (Lee et al., 2016). As indicated in a follow‐up study, self‐efficacy helps individuals improve their self‐care behaviours despite their frustration and the burden of living with and managing diabetes (Chen, Lo, et al., 2021). Moreover, a previous meta‐analysis revealed that self‐efficacy‐focused education substantially increased knowledge and confidence, reduced HbA1c level and improved self‐care behaviours in people diagnosed with T2DM (Jiang et al., 2019).…”

Psychometric Properties of the Revised Self-Efficacy for Diabetes Self-Management Scale among Spanish Children and Adolescents with Type 1 Diabetes

“…In addition to the construct of self-efficacy itself, its relationship with other psychosocial variables justifies the influence it may have on diabetes management. A positive relationship was found between self-efficacy and the understanding of diabetes along with its treatment [ 16 ], which improves the quality of life in the transition to adulthood [ 17 ] and may even improve glycemic control [ 18 ]. Not least, safe environments and, above all, quality social support have proven to be very important in increasing confidence in disease management [ 19 ].…”

Self-care and caregiver contribution to self-care in adolescents with type 1 diabetes mellitus: a pilot cross-sectional study

“…1,4 Thus, promoting selfcare in adolescents with type 1 diabetes is key to optimise glycaemic control. [5][6][7] Self-care is defined as the 'process of maintaining health through health promoting and managing illness', according to the middle-range theory of self-care of chronic illness, 8 and comprises self-care maintenance, self-care monitoring and self-care management. 8 Self-care maintenance concerns behaviours aimed at maintaining physical and emotional stability.…”