Relationships of illness representation, diabetes knowledge, and self-care behaviour to glycemic control in incarcerated persons with diabetes

Abstract

Purpose The purpose of this paper is to examine relationships of self-care behavior, illness representation and diabetes knowledge with A1C (level of glycemic control) in 124 incarcerated persons. Design/methodology/approach Using a cross-sectional design, summary scores and items from the self-care inventory revised, brief illness perception questionnaire and the spoken knowledge for low literacy in diabetes were evaluated using linear regression to assess their relationship to A1C. Findings Metabolic control was suboptimal for the majority of inmates with diabetes. The final regression model was statistically significant ( F (3, 120)=9.51, p=0.001, R(2)=19.2 percent). Higher log10 HbA1C (A1C) was associated with lower personal control beliefs ( B=-0.007, t (122)=-2.42, p=<0.02), higher self-report of diabetes understanding ( B=0.009, t (122)=3.12, p=0.00) and using insulin ( B=0.062, t (122)=2.45, p=0.02). Research limitations/implications Similar to findings with community dwelling participants, enhancing diabetes personal control beliefs among inmates may lead to lower A1C. Social implications Highly structured environments with limited options for self-care, personal choices and readily available health care may give some incarcerated persons with diabetes no motivation to improve diabetes control even if they have an understanding of what to do. Originality/value While there is abundant research in the community describing how these factors influence A1C levels, research of this nature with incarcerated persons with diabetes is limited. Findings will inform diabetes programming during incarceration to better prepare inmates for reentry.

<p>The Association of Health Literacy Level with Self-Care Behaviors and Glycemic Control in a Low Education Population with Type 2 Diabetes Mellitus: A Cross-Sectional Study in Iran</p>

“…8,9 Previous studies' findings recommend that self-care behaviors, 10 increased diabetes knowledge, 11 and greater medication adherence 12 are related to better glycemic control. 13 In several studies, it is found that the main determinant of regulated HbA1c is the better self-care behaviors. 14,15 Self-care for diabetes includes healthy diet, regular exercise, adherence to the medical treatment system, blood glucose regulation and tracking, as well as skills to promote health.…”

Illness perceptions among patients with type 2 diabetes mellitus: A cross‐sectional study

“…Evidence indicates that illness perceptions can predict adherence to recommended self‐management behaviours, as well as objective clinical outcomes, especially glycaemic control among individuals with diabetes (Abubakari, Cousins, Thomas, Sharma, & Naderali, ; Mc Sharry, Moss‐ Morris, & Kendrick, ; Reagan, Walsh, & Shelton, ; van Puffelen et al, ). Patients who perceived that they had the ability to control their diabetes reported being more physically active and adhering to the general guidelines for healthy eating and diet more often (van Puffelen et al, ).…”

“…Patients who perceived that they had the ability to control their diabetes reported being more physically active and adhering to the general guidelines for healthy eating and diet more often (van Puffelen et al, ). Diabetic patients with lower personal control beliefs and perceptions of diabetes as a cyclical disease had a higher level of haemoglobin A1c (HbA1c) (Mc Sharry et al, ; Reagan et al, ). Moreover, Mc Sharry et al (2011) found that illness perceptions may be changed by targeted intervention, and these changes may also impact glycaemic control.…”

Diagnosed diabetes and optimal disease control of prisoners in Catalonia

“…Es posible también que la reclusión incida notablemente en la actitud frente a la DM, ya que es habitual que la población reclusa durante el internamiento priorice en su escala de valores la concesión de libertad u otros aspectos relacionados con la excarcelación sobre el concepto de salud y las necesidades sanitarias y terapéuticas 28,29 . Reagan et al 30 consideran que la fácil accesibilidad a la atención sanitaria tampoco es un elemento que eduque en el esfuerzo personal necesario para mejorar el control de la enfermedad, y que el control de la DM en los presos suele ser subóptimo, debido también a que los internos presentan opciones limitadas para el autocuidado y a las condiciones propias del entorno penitenciario, no favorables al control óptimo de la enfermedad 31 . En este trabajo, solo una variable (el tratamiento con ADO) se asoció al control óptimo de la DM.…”

“…A pesar de las dificultades, el manejo de la DM en estos pacientes debería ser similar al de la población no presa 23 , y el proceso educativo, primordial en el tratamiento de estos pacientes. En prisiones, el hecho de modificar el estilo de vida adquiere elevada importancia, porque además de la limitación del autocuidado 23,33 , puede haber también menor motivación para el control de la enfermedad 23,30 . Por otro lado, los reclusos están expuestos también a múltiples factores psicosociales, físicos y ambientales que los hacen más vulnerables, lo que debe tenerse en cuenta en el abordaje educativo 30 .…”