Investigation into the Relationship Between Worry and Self Efficacy on Self-management in an Asian Pacific Islander Population with Type 2 Diabetes

Wong, Lorrie
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University of Hawaii at Manoa
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Diabetes Mellitus is a complex chronic disease that is prevalent throughout the world (Wild, Roglic, Green, Sicree, & King, 2004). People living with this disease are confronted with lifestyle modifications that require daily attention to a myriad of self care behaviors and health practices. Adherence to these self care recommendations can prevent the devastating complications that are associated with diabetes (UKPDS Group, 1998; Stratton, Adler, Neil, et al., 2000). Though knowledge plays an important role in the self management of diabetes, education alone does not ensure adherence to life-long behavior changes (Norris, Lau, Smith, Schmid, & Engelgau, 2002; Krichbaum, Aarestad, Buethe, 2003). It is recognized that additional research is needed to understand barriers and facilitators to behavior change. Studies have identified that people with diabetes have worries about their disease and specific sources of worries include worries about being able to carry out family responsibilities in the future, worries about their financial future, worries about weight, and worries about risk for hypoglycemia (Peyrot, Rubin, Lauritzen, Snoek, Matthews, & Skovlund, 2005). Investigation into the effects of worry on health has focused primarily on worry's motivational properties and little is known about how worry impacts self management adherence in the diabetic population. The purpose of this study was to investigate the relationship between worry, self efficacy and adherence to self management recommendations in the API diabetic population. An analysis of data previously collected from a two arm randomized controlled intervention trial (ENHANCE project) was undertaken to answer the research questions. The findings of this study suggest that levels of and types of worry have an effect on self efficacy and on self management adherence. Social worries had a direct effect on self efficacy and positively moderated self efficacy's impact on self management adherence. Disease specific worries had a negative direct effect on self efficacy and negatively moderated self efficacy's effect on adherence. In addition, our study supported the understanding that worry perception and impact may differ among ethnic groups. The Hawaiian and Pacific Islanders in our study experienced less worries as measured by our social worry tools than the Asian participants.
74 pages
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Theses for the degree of Doctor of Philosophy (University of Hawaii at Manoa). Nursing ; no. 5383
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