Adaptation of the AADE7 Self-Care Behaviors Framework to Racial/Ethnic Populations with Diabetes and Perceived Health, Self-Care, Healthy Coping, and Depression.
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2018-08
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University of Hawaii at Manoa
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Background: Racial/ethnic populations including Black/African-Americans, Asians, Hispanics, and American Indians are at risk for diabetes at rates disproportionately higher than non-Hispanic Whites. In previous studies, persons with diabetes have been shown to have increased rates of depression. In contrast, healthy coping and self-care behaviors improved perceived health among persons with diabetes. Purpose: The purpose of the study was to explore if race/ethnicity of persons with diabetes was associated with perceived health independent of self-care, healthy coping, and depression, and to further examine the racial/ethnic differences of persons with diabetes in the strengths of the associations of self-care, healthy coping, and depression with perceived health. Method: Secondary data analysis was performed using the National Health Interview Survey (NHIS) from 2010 to 2014 on 12,671 persons with diabetes aged 18-79 who responded to the question on perceived health. Variables pertaining to race/ethnicity, perceived health, self-care, healthy coping, and depression were analyzed using descriptive analyses and multivariable logistic regression. Results: There were significant relationships in perceived health of race/ethnicity among persons with diabetes independent of self-care, healthy coping, and depression, but these distinctions were eliminated when interactions between race/ethnicity, self-care, healthy coping, and depression included demographic and co-morbidity factors (p < .05). Race/ethnicity does not strengthen the relationship between self-care, healthy coping, depression, and perceived health. Self-care, healthy coping, and depression have a significant independent relationship with perceived health. Implications: This study indicates the need to consider in addition to race/ethnicity, self-care, healthy coping, and depression, covariates (demographics and co-morbidities) to provide a more comprehensive view of the person living with diabetes. In future studies, it is important to utilize refined statistical measurement tools and methods to address the concept of perceived health among persons with diabetes. Furthermore, there is a need to develop an AADE7 instrument incorporating self-care, healthy coping, depression, and perceived health.
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Diabetes
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