The Influence of Self-care Behaviors, Empowerment and Social Support on Glycosylated Hemoglobin in Patients with Type 2 Diabetes

Article information

Res Community Public Health Nurs. 2017;28(2):216-225

Publication date (electronic) : 2017 June 12

doi : https://doi.org/10.12799/jkachn.2017.28.2.216

¹Hanshin Hospital, Daegu, Korea

²College of Nursing, Keimyung University, Daegu, Korea

Corresponding author: Lee, Eun Ju College of Nursing, Keimyung University, 1095 Dalgubeol-daero, Dalseo-gu, Daegu 42601, Korea. Tel: +82-53-580-3953, Fax: +82-3-580-3916, E-mail: 11578@kmu.ac.kr

Received 2017 April 23; Revised 2017 June 17; Accepted 2017 June 17.

Abstract

Purpose

The purpose of the study was to analyze the effects of self-care behavior, empowerment, and social support on glycosylated hemoglobin in patients with type 2 diabetes.

Methods

The data were collected during the period of July 1 to July 31, 2016. In total, 172 participants were recruited from outpatients who had been diagnosed with type 2 diabetes at a health care center, a health promotion center at National Health Insurance Corporation, and a tertiary hospital. Statistical data were analyzed with SPSS 20.0 using frequency analysis, t-test, ANOVA, Scheffé test, Pearson's correlation coefficients, and hierarchical regression analysis.

Results

The study results showed that self-care behavior (β=-.34, p<.001), empowerment (β=-.34, p<.001), and social support (β=-.20, p=.018) were found to be influential factors affecting glycosylated hemoglobin, with an overall descriptive power of 69%.

Conclusion

Self-care behavior, empowerment, and social support are considered to be important factors in blood glucose management for the patients with type 2 diabetes. Therefore, self-caring blood glucose programs and internal synchronizing education through social support and empowerment need to be improved.

Keywords: Self-care; Empowerment; Social support; Diabetes mellitus; Hemoglobin A; glycosylated

Table 1.

Differences in Glycated Hemoglobin according to General Characteristics and Diabetes-related Characteristics (N=172)

Table 2.

Self-care Behaviors, Empowerment, Social Support and Glycosylated Hemoglobin in Patients with Type 2 Diabetes (N=172)

Table 3.

Correlation between Self-care Behaviors, Empowerment and Social Support on Glycosylated Hemoglobin in Patients with Type 2 Diabetes (N=172)

Table 4.

The influence of Self-care Behaviors, Empowerment and Social Support on Glycosylated Hemoglobin in Patients with Type 2 Diabetes (N=172)

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Table 1.

Differences in Glycated Hemoglobin according to General Characteristics and Diabetes-related Characteristics (N=172)

Variables	Categories	n (%)	M±SD	t or F	p
Age (year)	<50	31 (18.0)	6.96±0.51	0.81	.488
	50~ < 59	54 (31.4)	6.78±0.63
	≥60	87 (50.6)	6.80±0.46
Gender	Males	70 (40.7)	6.95±0.66	2.40	.018
	Females	102 (59.3)	6.73±0.56
Marriage status	Married	153 (89.0)	6.80±0.58	-0.66	.518
	Others^†	19 (11.0)	6.93±0.79
Education	≤ Elementary school	26 (15.1)	6.75±0.68	0.36	.783
	Middle school	52 (30.2)	6.86±0.61
	High school	74 (43.1)	6.84±0.58
	≥ College	20 (11.6)	6.73±0.63
Occupation	Unemployed	87 (50.6)	6.70±0.52	-2.82	.005
	Employed	85 (49.4)	6.95±0.66
Religion	Christian	32 (18.6)	6.72±0.47	0.82	.489
	Catholic	16 (9.3)	6.89±0.87
	Buddhist	39 (22.7)	6.93±0.55
	No religion	85 (49.4)	6.80±0.61
Monthly income	<100	37.8 (37.8)	6.73±0.59	2.15	.062
	100~< 200	30.8 (30.8)	6.77±0.53
	200~< 300	14.0 (14.0)	7.08±0.66
	300~<400	11 (6.4)	7.10±0.69
	400~< 500	9 (5.2)	6.60±0.76
	≥ 500	10 (5.8)	6.97±0.61
BMI	Underweight (< 18.5)^a	5 (53.0)	6.42±0.58	7.49	< .001
	Normal (18.5~<22.9)^b	107 (62.2)	6.70±0.54		a,b< d
	Overweight (23.0~ < 24.9)^c	35 (20.3)	6.95±0.67
	Obesity (>25.0)^d	25 (14.5)	7.24±0.55
Drinking (time/week)	None^a	82 (47.7)	6.68±0.56	11.76	<.001
	1~2^b	57 (33.1)	6.75±0.54		a,b< c,d
	3~4^c	26 (15.1)	7.22±0.57
	4~5^d	7 (4.1)	7.64±0.56
Smoking	No	143 (83.1)	6.77±0.59	-2.37	.019
	Yes	29 (16.9)	7.06±0.66
Duration of disease (year)	< 10	92 (53.5)	6.81±0.53	0.49	.613
	10~<20	58 (33.7)	6.87±0.66
	≥ 20	22 (12.8)	6.72±0.70
Diabetic complication	No	166 (96.5)	6.82±0.61	0.50	.615
	Yes	6 (3.5)	6.60±0.00
Diabetes education	No^a	57(33.1)	7.18±0.63	22.96	< .001
	1^b	58(33.7)	6.79±0.58		a,b>c
	≥ 2^c	57(33.2)	6.49±0.39

^{^†}

Single, divorce, separation, bereavement.

Table 2.

Self-care Behaviors, Empowerment, Social Support and Glycosylated Hemoglobin in Patients with Type 2 Diabetes (N=172)

Characteristics	Total	M±SD	Item M±SD	Min	Max
Self-care behaviors	112	75.84±15.27	4.74±0.95	2.50	6.31
Empowerment	40	22.83±5.63	2.85±0.70	1.38	4.50
Social support	80	39.73±7.21	1.99±0.36	1.35	3.25
HbA1c			6.82±0.60	5.30	8.30

Table 3.

Correlation between Self-care Behaviors, Empowerment and Social Support on Glycosylated Hemoglobin in Patients with Type 2 Diabetes (N=172)

Variable	HbA1c	Self-care behaviors	Social support	Empowerment
Variable	r (p)	r (p)	r (p)	r (p)
HbA1c	1
Self-care behaviors	-.79 (＜.001)	1
Social support	-.76 (＜.001)	.80 (＜.001)	1
Empowerment	-.80 (＜.001)	.84 (＜.001)	.85 (＜.001)	1

Table 4.

The influence of Self-care Behaviors, Empowerment and Social Support on Glycosylated Hemoglobin in Patients with Type 2 Diabetes (N=172)

Variables	Step 1				Step 2
Variables	B	β	t	p	B	β	t	p
Gender^†	0.05	03	0.37	.574	0.12	.08	1.63	.069
Occupation^‡	0.06	.05	0.65	.520	0.09	.07	1.43	.155
BMI	0.07	.26	3.60	＜.001	0.01	.02	0.17	.869
Drinking	0.22	.31	3.76	＜.001	0.06	.07	1.41	.162
Smoking§	0.05	.03	0.41	.684	-0.14	-.09	-1.72	.087
Self-care behaviors					-0.21	-.34	-3.97	＜.001
Empowerment					-0.30	-.34	-3.62	＜.001
Social support					-0.34	-.20	-2.39	.018
R²=.29, Adj. R²=.20, F=11.64, p＜.001					R²=.70, Adj. R²=.69, F=55.79, p＜.001

^{^†}

Dummy variable: Gender- Males (1), Females (0);

^{^‡}

Dummy variable: Occupation - Yes (1), No (0);

^§

Dummy variable: Smoking - Yes (1), No (0).