Self-care, social support, and quality of life in Asians and Pacific Islanders with type 2 diabetes

Abstract

Self-care is an important concept for individuals with diabetes because of necessary lifestyle changes. Diabetes, a chronic condition, must be managed by proper diet, exercise, medication or a combination of the three. There are 25.8 million people diagnosed with diabetes in the United States and was the seventh leading cause of death in 2007 (National Diabetes Information Clearinghouse, 2011). This study aimed to determine if 1) differences exist in the perception of self-care (SC), social support (SS), and quality of life (QOL) among Asian and Pacific Islanders (PIs), and 2) if SC and SS are predictors of QOL in these populations with diabetes. This is a descriptive study of SC, SS, and QOL with previously collected data from an experimental, randomized control study of self-management of type 2 diabetes, the Study of Cognitive Behavioral Interventions in Diabetes Self-Management. 207 Asians and PIs ages 18 to 76 years old participated in this study. Subscales of the Summary of Diabetes SC Activities, Multidimensional Diabetes Questionnaire and Diabetes QOL Measures were analyzed using the t-test, General Linear Model (GLM) and Structural Equation Model (SEM). These instruments have limited use among the Asian and PI populations. Results of the study found that significant differences exist between Asians and PIs in their SS and QOL. PIs scored their spouse/significant other higher in giving both positive reinforcement and misguided support than Asian. Asians also rated their lives as being impacted more by their diabetes than PIs. A path analysis was completed with positive reinforcement influencing both exercise and footcare, which both in turn influenced satisfaction in life. SS and general diet directly affected the impact of diabetes. SS also affected general diet. In this analysis, impact and satisfaction were significantly correlated. General diet was found only to be a partially mediating variable. The results from this study could assist in directing nurses and health care professionals to provide culturally specific care to Asians and PIs based on their SS needs, calling specific attention to how SS needs affect an individual‟s QOL and success in managing diabetes.