Self-management activities in type 2 diabetes: a structural equation modeling analysis

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dc.contributor.advisorDobson, Keith S.
dc.contributor.authorHarvey, Natasha R.
dc.date.accessioned2017-12-18T21:16:13Z
dc.date.available2017-12-18T21:16:13Z
dc.date.issued2006
dc.descriptionBibliography: p. 142-165en
dc.description.abstractBackground: A plethora of psychosocial predictors of Type 2 diabetes self-management adherence have been identified, yet these variables generally fail to account for more than about 25% of the variance in measures of diabetes adherence. The predominance of the Type 2 diabetes adherence literature represents behaviour change (intrapersonal) and social support (interpersonal) models. Few studies have examined the roles of empirically supported diabetes adherence predictors within a social-ecological model framework. Purpose: To use structural equation modeling to increase our understanding of the associations among social-ecological support resources, perceived locus of control of diabetes, negative affect (anxiety, depression, and alexithymia), and Type 2 diabetes self-care activities. Methods: This cross-sectional study utilized a convenience sample of 235 participants (54% male, 46% female) aged 25 to 87 (Mage= 56, SD = 11) with Type 2 diabetes from Calgary's Regional Diabetes Education Centre. Self-report measures were distributed for home completion and returned by post. Primary measures included (1) Chronic Illness Resources Survey, (2) Perceived Control of Diabetes Scales, (3) Twenty-Item Toronto Alexithymia Que tionnaire, (4) Well-Being Questionnaire anxiety and depression subscales, and (5) ummary of Diabetes Self-Care Activities Questionnaire, with an appended foot-care measure. Structural equation modeling was used to assess measurement and structural models. Results: Social-ecological support resources emerged as the sole direct predictor of diabetes self-care activity, accounting for 45% of the variance in diabetes self-care activity. Intraindividual variables ( decreased emotional well-being, perceived personal and situational control) had indirect effects on diabetes self-care activity primarily through their direct influence on social- 111 ecological support resources. Conclusions: The present study suggests that previous emphasis on the direct influence of intrapersonal variables measured in this study is likely an oversimplification of the complex interaction among variables influencing Type 2 diabetes self-care activities. Further, the results support a strong positive direct influence of utilization of social-ecological support resources on diabetes self-care activity, while the measured intrapersonal variables had only a very modest indirect relationship with diabetes self-care activity. Results point to the importance of considering social-ecological models of Type 2 diabetes adherence and ensuring sufficient availability and personal utilization of social-ecological support resources in clinical practice.
dc.format.extentxiii, 192 leaves : ill. ; 30 cm.en
dc.identifier.citationHarvey, N. R. (2006). Self-management activities in type 2 diabetes: a structural equation modeling analysis (Doctoral thesis, University of Calgary, Calgary, Canada). Retrieved from https://prism.ucalgary.ca. doi:10.11575/PRISM/825en_US
dc.identifier.doihttp://dx.doi.org/10.11575/PRISM/825
dc.identifier.urihttp://hdl.handle.net/1880/101826
dc.language.isoeng
dc.publisher.institutionUniversity of Calgaryen
dc.publisher.placeCalgaryen
dc.rightsUniversity of Calgary graduate students retain copyright ownership and moral rights for their thesis. You may use this material in any way that is permitted by the Copyright Act or through licensing that has been assigned to the document. For uses that are not allowable under copyright legislation or licensing, you are required to seek permission.
dc.titleSelf-management activities in type 2 diabetes: a structural equation modeling analysis
dc.typedoctoral thesis
thesis.degree.disciplineClinical Psychology
thesis.degree.grantorUniversity of Calgary
thesis.degree.nameDoctor of Philosophy (PhD)
ucalgary.item.requestcopytrue
ucalgary.thesis.accessionTheses Collection 58.002:Box 1649 520492166
ucalgary.thesis.notesUARCen
ucalgary.thesis.uarcreleaseyen
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