Self-Management as a Mediator of the Relationship between Social Support Dimensions and Health Outcomes of African American Adults with Type 2 Diabetes

Al‐Dwaikat, Tariq; Chlebowy, Diane Orr; Hall, Lynne A.; Crawford, Timothy N.; Yankeelov, Pamela

doi:10.1177/0193945919867294

Cited by 10 publications

(10 citation statements)

References 51 publications

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“…Mediation analysis results indicate that self-management behavior played a mediation role in the influence of social support on quality of life (SS → SM → QOL). Al-Dwaikat et al claimed that self-management did not mediate the relationships between social support dimensions and their health outcomes [ 87 ], which is not consistent with the results in this study. The findings in this study suggested that self-management behaviors were a significant mediator in the association between social support and quality of life, which highlight the importance of implementing necessary social support to promote effective diabetes self-management behavior to achieve better health outcomes among elderly patients with type 2 diabetes.…”

Section: Discussioncontrasting

confidence: 96%

Self-management behavior and fasting plasma glucose control in patients with type 2 diabetes mellitus over 60 years old: multiple effects of social support on quality of life

Chen

et al. 2021

Health Qual Life Outcomes

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Objective Elderly patients with type 2 diabetes mellitus are highly vulnerable due to severe complications. However, there is a contradiction in the relationship between social support and quality of life, which warrants further exploration of the internal mechanism. This study assessed the quality of life and its interfering factors in this patient population. Methods In total, 571 patients with type 2 diabetes mellitus over 60 years old were recruited from two community clinics in Heilongjiang Province, China. We collected data on health status, quality of life, self-management behavior, fasting plasma glucose (FPG) level, and social support. Structural equation modeling and the bootstrap method were used to analyze the data. Results The average quality of life score was − 29.25 ± 24.41. Poorly scored domains of quality of life were “Psychological feeling” (− 8.67), “Activity” (− 6.36), and “Emotion” (− 6.12). Of the 571 patients, 65.32% had normal FPG, 9.8% had high-risk FPG, 15.94% had good self-management behavior, and 22.07% had poor social support. Significant correlations among social support, self-management behavior, FPG level, and quality of life were noted. A multiple mediator model revealed that social support influenced quality of life in three ways: (1) directly (c′ = 0.6831); (2) indirectly through self-management behavior (a1*b1 = 0.1773); and (3) indirectly through FPG control (a2*b2 = 0.1929). Self-management behavior influenced the quality of life directly and indirectly through FPG control. Conclusion Improving self-management behavior and monitoring hypoglycemia should become priority targets for future intervention. Scheduled social support to self-management projects should be put into the standardized management procedure. Physicians should provide substantial and individualized support to the elderly patients with type 2 diabetes mellitus regarding medication, blood glucose monitoring, and physical exercise.

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Section: Discussioncontrasting

confidence: 96%

Self-management behavior and fasting plasma glucose control in patients with type 2 diabetes mellitus over 60 years old: multiple effects of social support on quality of life

Chen

et al. 2021

Health Qual Life Outcomes

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“…The results of this study showed that social support had a positive impact on psychological outcomes in the study population and that participants who reported higher levels of social support had less depression, anxiety, and stress when compared to their counterparts who reported lower levels of social support. Similarly, Al-Dwaikat et al (2019) found that social support was positively associ-ated with physical and psychological outcomes in African-American adults with T2D. Few studies have examined the relationship between social support and psychological outcomes in adults with T2D (Strom & Egede, 2012).…”

Section: Discussionmentioning

confidence: 99%

“…Social support is directly associated with improved T2D health outcomes (Al-Dwaikat et al, 2019) and indirectly by improving self-efficacy and self-management behaviors (Osborn et al, 2010). Social support is a multidimensional concept (Gottlieb & Bergen, 2010), that includes: support function, support quality, and support structure.…”

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confidence: 99%

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Social Support, Self-Efficacy, and Psychological Wellbeing of Adults with Type 2 Diabetes

et al. 2020

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Social support improves self-efficacy, which in turns enhances self-management that lead to better psychological outcomes of persons with type 2 diabetes (T2D). The purpose of this study was to examine the relationship between social support and psychological outcomes of adults with T2D. A cross-sectional design was used to recruit a sample of 339 participants from a diabetes clinic. The participants responded to a series of questionnaires on demographics, social support dimensions, and self-management; self-efficacy; and psychological outcomes. The function and quality of social support were positively associated with self-efficacy. Self-efficacy was significantly associated with both self-management and psychological outcomes. In addition, self-efficacy demonstrated successful mediation role in the relationship between social support and psychological outcomes of T2D, however, self-management failed to mediate this relationship. The quality and functionality of social support are distinctive variables that should be recognized to promote social support interventions to reduce or prevent T2D-related psychological outcomes.

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“…Diabetes fatalism has been defined as a psychological pattern involving components of distress, religious and spiritual coping, and perceived self-efficacy [ 24 ]. Social support has a positive influence on diabetes self-management, weight control, and health outcomes [ 26 , 27 , 28 , 29 ], and it enhances resilience [ 30 ] and plays a role in diabetes prevention [ 31 , 32 ]. Self-efficacy for managing diabetes can either be positively or negatively related to diabetes self-care activities such as diet, exercise, and taking medications [ 33 ].…”

Section: Introductionmentioning

confidence: 99%

Fatalism, Social Support and Self-Management Perceptions among Rural African Americans Living with Diabetes and Pre-Diabetes

et al. 2021

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Diabetes is a public health problem and a major risk factor for cardiovascular disease, the leading cause of death in the United States. Diabetes is prevalent among underserved rural populations. The purposes of this study were to perform secondary analyses of existing clinical trial data to determine whether a diabetes health promotion and disease risk reduction intervention had an effect on diabetes fatalism, social support, and perceived diabetes self-management and to provide precise estimates of the mean levels of these variables in an understudied population. Data were collected during a cluster randomized trial implemented among African American participants (n = 146) in a rural, southern area and analyzed using a linear mixed model. The results indicated that the intervention had no significant effect on perceived diabetes management (p = 0.8), diabetes fatalism (p = 0.3), or social support (p = 0.4). However, the estimates showed that, in the population, diabetes fatalism levels were moderate (95% CI = (27.6, 31.3)), and levels of social support (CI = (4.0, 4.4)) and perceived diabetes self-management (CI = (27.7, 29.3)) were high. These findings suggest that diabetes fatalism, social support, and self-management perceptions influence diabetes self-care and rural health outcomes and should be addressed in diabetes interventions.

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Self-Management as a Mediator of the Relationship between Social Support Dimensions and Health Outcomes of African American Adults with Type 2 Diabetes

Cited by 10 publications

References 51 publications

Self-management behavior and fasting plasma glucose control in patients with type 2 diabetes mellitus over 60 years old: multiple effects of social support on quality of life

Self-management behavior and fasting plasma glucose control in patients with type 2 diabetes mellitus over 60 years old: multiple effects of social support on quality of life

Social Support, Self-Efficacy, and Psychological Wellbeing of Adults with Type 2 Diabetes

Fatalism, Social Support and Self-Management Perceptions among Rural African Americans Living with Diabetes and Pre-Diabetes

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