• Research in Community and Public Health Nursing
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• v.32 no.1
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• pp.86-94
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• 2021

Purpose: This descriptive study investigated the effects of self-efficacy and self-stigma on self-care in people with diabetes. Methods: The study included a total of 377 patients with diabetes enrolled in university hospitals in D city and public health centers in S city. Data were collected from 1 July to 31 August, 2017, and were analyzed using descriptive statistics, t-test, analysis of variance, Pearson's correlation coefficient, and hierarchical multiple regression. Results: Diabetes self-care was positively correlated with diabetes self-efficacy, whereas it was negatively correlated with diabetes self-stigma. Participants' education level, marital status, perceived health status, type of medication, self-efficacy, and self-stigma explained 42.4% of the variance in diabetes self-care. Conclusion: The findings indicate that diabetes self-efficacy and self-stigma are important factors for improving self-care in patients with diabetes. Therefore, systematic programs for enhancing self-efficacy and reducing self-stigma of these individuals should be developed.

• Women's Health Nursing
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• v.27 no.4
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• pp.358-367
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• 2021

Purpose: This study aimed to identify factors associated with diabetes management self-efficacy in pregnant women with gestational diabetes mellitus (GDM) in Korea. Methods: A total of 173 pregnant women with GDM in Korea were recruited by posting announcements at two Korean online communities focusing on pregnancy and GDM. Participants completed a structured online survey from July to September 2018. Thirteen inappropriate responses were excluded and a total of 160 questionnaires were used in the final analysis. Descriptive statistics were calculated and multiple regression with the enter method was done to identify the associations of depressive mood, anxiety, emotional intelligence, and sleep quality with diabetes management self-efficacy. Results: Respondents reported a moderately depressive mood (mean, 10.36), low to moderate anxiety (mean, 41.65), above-average emotional intelligence (mean, 78.04), moderate sleep quality (mean, 42.01), and above-average diabetes management self-efficacy (mean, 52.29). The major factor associated with diabetes management self-efficacy of pregnant women with GDM was emotional intelligence (β=.51, p<.001). Other factors, in descending order of influence, were sleep quality (β=.22, p<.001) and exercise (β=.18, p=.004). Taken together, the aforementioned factors explained 34.6% (F=39.53, p<.001) of the total variance. Conclusion: The results of this study suggest that to improve the diabetes management self-efficacy of pregnant women with GDM, it is necessary to develop an education program that can also enhance emotional intelligence, sleep quality, and exercise.

• The Journal of Korean Academic Society of Nursing Education
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• v.21 no.4
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• pp.509-517
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• 2015

Purpose: This study examined diabetes knowledge, self-efficacy, and health promoting behaviors, and investigated factors affecting health-promoting behaviors of middle-aged people. Methods: From August to September 2014, a convenience sample of 264 subjects was recruited from B city and G province. The data analysis was done by ${\chi}^2$ test, t-test, Pearson's correlation coefficient, and stepwise multiple regression. Results: Diabetes knowledge was $11.3{\pm}3.63$ in men and $12.7{\pm}3.74$ in women. The average levels of self-efficacy and health promoting behaviors of subjects were similar with other middle-aged individuals. Diabetes knowledge, self-efficacy, and health promoting behaviors had a positive correlation with each other in both men and women. To test the mediating effect of self-efficacy in the relationship between diabetes knowledge and health promoting behaviors, a Sobel test was performed and Z-scores of 3.698(p<.001) in men and 2.748(p=.006) in women were obtained. Conclusion: Diabetes prevention education is recommended for the middle-aged community. When developing diabetes prevention program for middle-aged people, such programs should consider self-efficacy, especially in women.

• Journal of Korean Academy of Nursing
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• v.29 no.5
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• pp.1087-1102
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• 1999

Diabetes mellitus, a universal and prevalent chronic disease, is projected to be one of the most formidable worldwide health problems in the 21st century. For those living with diabetes, there is a need for self-care skills to manage a complex medical regimen. Self-efficacy which refers to one's belief in his/her capability to monitor and perform the daily activities required to manage diabetes has be found to be related to self-care. The concept of self-efficacy comes from social cognitive theory which maintains that cognitive mechanism mediate the performance of behavior. The literature cites several research studies which show a strong relationship between self-efficacy and self-care behavior. Meta-analysis is a technique that enables systematic review and quantitative integration of the results from multiple primary studies that are relevant to a particular research question. Therefore, this study was done using meta-analysis to quantitatively integrate the results of independent research studies to obtain numerical estimates of the overall effect of a self-efficacy with diabetic patient on self-care behaviors. The research proceeded in three stages : 1) literature search and retrieval of studies in which self-efficacy was related to self-care, 2) coding, and 3) calculation of mean effect size and data analysis. Seventeen studies which met the research criteria included study population of adults with diabetes, measures of self-care and measures of self-efficacy as a predictive variable. Computation of effect size was done on DSTAT which is a statistical computer program specifically designed for meta-analysis. To determine the effect of self-efficacy on self-care practice homogeneity tests were conducted. Pooled effect size estimates, to determine the best subvariable for composite variables, metabolic control variables and component of self-efficacy and self-care, indicated that the effect of self-efficacy composite on self-care composite was moderate to large. The weighted mean effect size of self-efficacy composite and self-care composite were ＋.76 and the confidence interval was from ＋.66 to ＋.86 with the number of subjects being 1,545. The total for this meta-analysis result showed that the weighted mean effect sizes ranged from ＋.70 to ＋1.81 which indicates a large effect. But since reliabilities of the instruments in the primary studies were low or not stated, caution must be applied in unconditionally accepting the results from these effect sizes. Meta-analysis is a useful took for clarifying the status of knowledge development and guiding decision making about future research and this study confirmed that there is a relationship between self-efficacy and self-care in patients with diabetes. It, thus, provides support for nurses to promote self-efficacy in their patients. While most of the studies included in this meta-analysis used social cognitive theory as a framework for the study, some studies use Fishbein & Ajzen's attitude model as a model for active self-care. Future research is needed to more fully define the concept of self-care and to determine what it is that makes patients feel competent in their self-care activities. The results of this study showed that self-efficacy can promote self-care. Future research is needed with experimental design to determine nursing interventions that will increase self-efficacy.

• The Journal of Korean Academic Society of Nursing Education
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• v.6 no.1
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• pp.103-114
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• 2000

The purpose of this study was to determine the effect of nursing education in diabetes patient, and to define the strategy to promote their sick-roll behavior, self efficacy. The quasi-experimental design was designed non-equivalent control group, non-synchronized design. The study had been done by investigating the experimental group and control group through the questionnaire on 58 patients who had been hospitalized and visiting out-patient department in K hospital in Pusan from June 1, 1998 to September 30, 1998. Individual diabetes education was carried out experimental group for the average 45 minutes. Self-efficacy was measured by Diabetes Management Self-efficacy Instrument developed by Park(1984). Data was collected before and after the experimentation. Collected data was analyzed by means of frequency, percentage, chi-square test, mean, standard deviation, and t-test with SPSS/PC program. The results were summarized as follows : 1. 'The experimental group which received the individual diabetes education should be higher in self-efficacy than control group' was not supported. 2. 'The experimental group which received the individual diabetes education should be higher in sick-roll behavior than control group' was not supported(P=.043). In conclusion, the patient who received individual diabetes education showed the increase in degree of sick - roll behavior of diabetes patients. So individual diabetes education had been judged the nursing intervention to improve sick-roll behavior of diabetes patients. But there was no effect about self-efficacy so to have the program which can improve self-efficacy is needed.

• Women's Health Nursing
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• v.19 no.2
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• pp.88-98
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• 2013

Purpose: To examine the effects of a case management program on self-efficacy, depression and anxiety in pregnant women with gestational diabetes mellitus. Methods: Thirty-seven patients who enrolled in a diabetes outpatient clinic were randomly assigned to either an experimental group (n=19) or a control group (n=18). The experimental group received a 2-week intervention composed of a series of one face-to-face interactive interview and five telephone interviews based on the National standards for diabetes self-management education and Bandura's self-efficacy resources of performance accomplishment, vicarious experience, verbal persuasion, and emotional arousal. The effects of the intervention were assessed by completion of a 9-item self-efficacy questionnaire, a 20-item depression questionnaire and a 20-item anxiety questionnaire prior to, and after the intervention. The statistical significances were examined using t-test. Results: The change in self-efficacy was significantly greater in the experimental group than in the control group. Depression and anxiety changes in the experimental group were significantly greater compared to those in the control group. Conclusion: The results of study suggest that a case management program improves self-efficacy, and decreases depression and anxiety in pregnant women with gestational diabetes mellitus.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.21 no.9
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• pp.498-508
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• 2020

This study was a descriptive research study performed to identify the degree and correlation of variables and also explain the factors that influence self-efficacy of diabetes management. The participants were 150 diabetes patients who visited a primary medical institution in K city in Korea from September 17, 2015, to October 15, 2015. The data were analyzed using descriptive statistics, t-tests, ANOVA, Pearson correlation coefficients, and multiple regression with SPSS 18.0. Significant differences in age and education were detected in self-efficacy of diabetes management according to general characteristics. The levels of self-management knowledge and diabetes management self-efficacy were shown to be positively correlated. The levels of diabetes management self-efficacy and distress as well as levels of self-management knowledge and distress were shown to be negatively correlated. The significant factors influencing diabetes management self-efficacy were distress and self-management knowledge. The results suggest that appropriate diabetes management self-efficacy programs should be provided in order to improve self-management knowledge and decrease distress in type 2 diabetes patients. This study provides basic data to promote the effective education and development of arbitration in order to enhance self-efficacy of diabetes management.

• Research in Community and Public Health Nursing
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• v.20 no.3
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• pp.307-315
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• 2009

Purpose: This study was done to assess the effects of a self-help intervention on clinical, lifestyle and psycho-social outcomes in patients with Type II diabetes. Methods: Eligible adults with Type II diabetes were randomly assigned to either the intervention group receiving the diabetes self-help or the control group receiving usual care. Of the 36 patients who completed the study, 15 were in the intervention group and 21 were in the control group. The self-help group consisted of six weekly sessions covering aspects of diabetes self-care and using continuing education, discussion, and structured social activities. Outcomes included changes in glycemic control, knowledge, self-management behaviors, diabetes-related self-efficacy, and health-related quality of life. Analysis of covariance was used to compare outcomes between the groups, adjusting for baseline measures. Results: After the six week intervention, significant improvements from the baseline were observed in the measurements of self-management behaviors, diabetes-related self-efficacy, and health-related quality of life for the intervention group. Conclusion: The findings provide preliminary evidence that a diabetes self-help group intervention can benefit diabetes patients in self-management behaviors, diabetes-related self-efficacy, and health-related quality of life. However, larger longitudinal studies are needed to determine the most efficacious self-management methods to sustain long-term glycemic control and psychological well-being.

• Child Health Nursing Research
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• v.25 no.2
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• pp.234-243
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• 2019

Purpose: The purpose of this study was to investigate associations between self-management and diabetes knowledge, diabetes-related attitudes, family support, and self-efficacy in adolescents with type 1 diabetes mellitus based on the information-motivation-behavior skills model. Methods: Data collection was conducted between March 18 and September 30, 2018. Patients (N=87) aged 12 to 19 years were recruited from the outpatient clinic of S children's hospital and an online community for patient with type 1 diabetes mellitus. Data were analyzed using descriptive statistics, the independent t-test, one-way ANOVA, Pearsons correlation, and hierarchical multiple linear regression with SPSS IBM 23.0, with the two-tailed level of significance set at 0.05. Results: The mean score of self-management in adolescents with type 1 diabetes mellitus was $61.23{\pm}10.00$ out of 80. The regression analysis showed that self-efficacy and family support significantly explained 56.9% of the variance in self-management (F=21.38, p<.001). Self-efficacy (${\beta}=.504$, p<.001) and family support (${\beta}=.188$, p<.001) were significant predictors of self-management. Conclusion: It is necessary to develop individual interventions to improve self-efficacy and family support for adolescents with type 1 diabetes mellitus to help them enhance their self-management.

• Journal of Korean Academy of Fundamentals of Nursing
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• v.20 no.1
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• pp.27-36
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• 2013

Purpose: Self-care behavior is a key dimension of healthcare quality among elderlys with diabetes mellitus. The purpose of this study was to identify factors associated with self-care behaviors related to insulin therapy among elders with diabetes mellitus. Methods: The research was a cross-sectional, descriptive design using questionnaires. The participants were 147 older adult patients with diabetes mellitus receiving insulin therapy. Data were analyzed using descriptive statistics, t-test, ANOVA and multiple regression with SPSS statistics 19.0 program. Results: Participants' self-care behaviors related to insulin therapy were not adequate. Stepwise multiple regression analysis for self-care behaviors related to insulin therapy revealed that the most powerful predictor was self-efficacy. Self-efficacy, family support and frequency of blood sugar test explained 54.4% of the variance in self-care behaviors related to insulin therapy. Conclusion: The results indicate a need to promote self-efficacy, family support and frequency of blood sugar testing with these participants. In addition, strategies to improve self-care behaviors among elderly patients should be considered by health professionals, family members and the elderly patients themselves.