Factors Influencing Diabetes Self-Management Behaviors among Patients with T2DM in Rural Thailand

Factors Influencing Diabetes Self-Management Behaviors among Patients with T2DM in Rural Thailand Boontuan Wattanakul, PhD, RN Department of Biobehavioral Health Science University of Illinois at Chicago Chicago, Illinois (2012) Dissertation Chairperson: Lauretta T. Quinn, PhD, RN, FAAN Diabetes self-management strategies help individuals maintain optimal blood glucose levels and postpone complications of diabetes. These include insulin and medication adjustments; blood glucose monitoring; alterations in the timing, frequency, and content of meals; changes in exercise patterns; and foot care. This exploratory study conducted in 197 Thai adults (30-79) with type 2 diabetes mellitus (T2DM) in rural Thailand explored relationships of patients with T2DM self-management behaviors and cultural belief of Buddhist values, psychosocial factors (social support) and social cognitive factors (self-efficacy, general diabetes knowledge, risk perception of developing complications), and optimal glycemic control (A1C). Participants completed the following self-report surveys: Summary of Diabetes Self-Care Activities (SDSCA), brief Chronic Illness Resources Survey (CIRS), Risk Perception Survey for Diabetes (RPS-DM), Buddhist Value Survey, Diabetes Self-Efficacy (DSE), Diabetes Knowledge Questionnaires (Thai), and personal factors. Subjects had capillary blood taken for A1C measurement. Self-management behaviors were moderate by self-report. Risk knowledge related to developing diabetes complications was high. Scores on optimistic bias, personal control, worry of developing DM complications were higher than scores on personal disease risk. Social support, self-efficacy, diabetes knowledge, and Buddhist values were moderate to high. Optimal glycemic control rate was low (20.3%). Self-management behaviors were significantly positively associated with perceived social support, diabetes self-efficacy, general diabetes knowledge, and Buddhist values, but negatively significantly related to risk perception. Buddhist values, diabetes self-efficacy, and risk perception accounted for approximately 21% of the variance in self-management behavior. Duration of diabetes and age explained 6% of the variance in A1C. Findings from this study support the relationship between self-management behaviors and Buddhist values, self-efficacy, and risk perception. Self-management programs designed to improve diabetes self-management skills should consider including strategies of Buddhist teachings and practices, self-efficacy, and understanding of risk perception for developing complications.