uu.seUppsala University Publications
Change search
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf
Self-management profiles and metabolic outcomes in type 2 diabetes
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Health Services Research. (Health Services Research)
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Health Services Research. (Health Services Research)
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Health Services Research. (Health Services Research)
2006 (English)In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 56, no 1, 44-54 p.Article in journal (Refereed) Published
Abstract [en]

Aim. This paper reports a study whose aims were (1) to examine whether it is possible to determine participants' self-management profiles using three open-ended questions about their self-perceived role in diabetes management; and (2) to analyse whether such self-management profiles have any bearing on haemoglobin A1c levels.

Background. The behavioural and educational aspects of self-management in type 2 diabetes have been the topic of a number of investigations. The individual's role in maintaining health and a satisfying everyday life with chronic conditions is increasingly becoming the focus of secondary prevention.

Method. Participants (n = 259) were recruited from those attending a year-long health educational programme for people with type 2 diabetes at Swedish pharmacies. A questionnaire was distributed 24 months after baseline. The health outcome, haemoglobin A1c was measured on four occasions. Three open-ended questions were used to explore self-management profiles based on perceived role, goal, and need of support in treatment. Data were collected during the period 1997–2002.

Findings. The following profiles of participants emerged: Disease Manager, Compliant, and Disheartened, with no initial differences in metabolic control. However, during the programme Disease Managers achieved good glycaemic control and succeeded in maintaining the reduction in their blood glucose for a longer period than those in other categories: their haemoglobin A1c level was reduced by −0·35 at 6 months (P = 0·000), −0·30 at 12 months (P = 0·001), and −0·28 at 24 months (P = 0·001) after baseline. Compliant participants had a good everyday routine and a −0·18 reduction at 6 months (P = 0·028) but no statistically significant haemoglobin A1c level reduction later. A smaller group of people, the Disheartened, reported difficulties in living with diabetes and did not succeed in decreasing their haemoglobin A1c by statistically significant amounts.

Conclusion. Healthcare professionals could use our three open-ended questions to assist in understanding people's views of their role in disease management so that health promotion and education can be tailored to individual needs.

Place, publisher, year, edition, pages
2006. Vol. 56, no 1, 44-54 p.
Keyword [en]
empirical research report, haemoglobin A1c, nursing, patient education, questionnaires, self-management, type 2 diabetes
National Category
Medical and Health Sciences
Research subject
Health Care Research
Identifiers
URN: urn:nbn:se:uu:diva-83110DOI: 10.1111/j.1365-2648.2006.03978.xISI: 000240527200007PubMedID: 16972917OAI: oai:DiVA.org:uu-83110DiVA: diva2:111017
Available from: 2006-10-17 Created: 2006-10-17 Last updated: 2017-12-14Bibliographically approved
In thesis
1. Teaching and Learning in Type 2 Diabetes: The Importance of Self-Perceived Roles in Disease Management
Open this publication in new window or tab >>Teaching and Learning in Type 2 Diabetes: The Importance of Self-Perceived Roles in Disease Management
2006 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The major part of care in type 2 diabetes is in the hands of the patient so the focus of educational interventions should be on the person behind the disease. An experience-based group education programme that actively promotes participants’ reflection and understanding has been designed and implemented in cooperation with the Swedish Pharmacy.

The regression model presented in Paper I revealed the importance of self-perceived role in diabetes management. Blood glucose control two years after baseline was improved for participants who described themselves as having an active role in their treatment, compared to those taking on a passive or a compliant role.

Paper II described the resulting categories from content analysis of three open-ended questions about participants’ role, goal and support needs in diabetes management. The people taking care of diabetes most effectively and needing least support were called Disease Managers; those following the health professionals’ orders and depending on regular controls were categorised as Compliant, whereas the Disheartened had difficulties in achieving good metabolic control and often described both medical and social obstacles. These three self-management profiles were strongly correlated to metabolic outcomes.

In Paper III perceptions of diabetes management were reassessed: perceptions were only stable in approximately half of participants, thus providing evidence for a dynamic model of learning self-management in diabetes. The three self-management profiles still correlated with metabolic outcomes.

In paper IV the long-term metabolic outcome (HbA1c) of the study population was investigated. Metabolic control was stable up to seven years following the intervention, in contrast to the metabolic deterioration often present in diabetes.

The main message of this thesis is that participants’ self-perceived role had a major influence on metabolic outcomes. Assessing self-management profiles both in diabetes and possibly other chronic conditions can help health care providers to tailor their educational efforts accordingly. Furthermore, this experience-based patient education programme outside the framework of routine diabetes care has the potential to stabilise metabolic control on the long run effectively.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2006. 66 p.
Series
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 169
Keyword
Health services research, Typ 2 diabetes, HbA(1c), Self-perception, Disease Management, Experience-based group education, Reflective learning, Hälso- och sjukvårdsforskning
Identifiers
urn:nbn:se:uu:diva-7122 (URN)91-554-6642-7 (ISBN)
Public defence
2006-09-29, Fåhraeussalen, Rudbecklaboratoriet, Dag Hammarskjölds väg 20, Uppsala Science Park, Uppsala, 13:15 (English)
Opponent
Supervisors
Available from: 2006-09-08 Created: 2006-09-08 Last updated: 2009-10-14Bibliographically approved

Open Access in DiVA

No full text

Other links

Publisher's full textPubMed

Authority records BETA

Vég, AnikóRosenqvist, UrbanSarkadi, Anna

Search in DiVA

By author/editor
Vég, AnikóRosenqvist, UrbanSarkadi, Anna
By organisation
Health Services Research
In the same journal
Journal of Advanced Nursing
Medical and Health Sciences

Search outside of DiVA

GoogleGoogle Scholar

doi
pubmed
urn-nbn

Altmetric score

doi
pubmed
urn-nbn
Total: 569 hits
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf