File Download
  Links for fulltext
     (May Require Subscription)
Supplementary

Article: An examination of the socio-demographic correlates of patient adherence to self-management behaviors and the mediating roles of health attitudes and self-efficacy among patients with coexisting type 2 diabetes and hypertension

TitleAn examination of the socio-demographic correlates of patient adherence to self-management behaviors and the mediating roles of health attitudes and self-efficacy among patients with coexisting type 2 diabetes and hypertension
Authors
KeywordsSelf-management
Type 2 diabetes mellitus
Hypertension
Self-efficacy
Health attitudes
Issue Date2020
PublisherBioMed Central Ltd. The Journal's web site is located at http://www.biomedcentral.com/bmcpublichealth/
Citation
BMC Public Health, 2020, v. 20, p. article no. 1227 How to Cite?
AbstractBackground: Patients with coexisting type 2 diabetes and hypertension generally exhibit poor adherence to self-management, which adversely affects their disease control. Therefore, identification of the factors related to patient adherence is warranted. In this study, we aimed to examine (i) the socio-demographic correlates of patient adherence to a set of self-management behaviors relevant to type 2 diabetes and hypertension, namely, medication therapy, diet therapy, exercise, tobacco and alcohol avoidance, stress reduction, and self-monitoring/self-care, and (ii) whether health attitudes and self-efficacy in performing self-management mediated the associations between socio-demographic characteristics and adherence. Methods: We performed a secondary analysis of data collected in a randomized controlled trial. The sample comprised 148 patients with coexisting type 2 diabetes mellitus and hypertension. Data were collected by a questionnaire and analyzed using logistic regression. Results: Female patients were found to be less likely to exercise regularly (odds ratio [OR] = 0.49, P = 0.03) and more likely to avoid tobacco and alcohol (OR = 9.87, P < 0.001) than male patients. Older patients were found to be more likely to adhere to diet therapy (OR = 2.21, P = 0.01) and self-monitoring/self-care (OR = 2.17, P = 0.02). Patients living with family or others (e.g., caregivers) were found to be more likely to exercise regularly (OR = 3.44, P = 0.02) and less likely to avoid tobacco and alcohol (OR = 0.10, P = 0.04) than those living alone. Patients with better perceived health status were found to be more likely to adhere to medication therapy (OR = 2.02, P = 0.03). Patients with longer diabetes duration (OR = 2.33, P = 0.01) were found to be more likely to adhere to self-monitoring/self-care. Self-efficacy was found to mediate the association between older age and better adherence to diet therapy, while no significant mediating effects were found for health attitudes. Conclusions: Adherence to self-management was found to be associated with socio-demographic characteristics (sex, age, living status, perceived health status, and diabetes duration). Self-efficacy was an important mediator in some of these associations, suggesting that patient adherence may be improved by increasing patients’ self-management efficacy, such as by patient empowerment, collaborative care, or enhanced patient–physician interactions.
Persistent Identifierhttp://hdl.handle.net/10722/293362
ISSN
2023 Impact Factor: 3.5
2023 SCImago Journal Rankings: 1.253
PubMed Central ID
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorXie, Z-
dc.contributor.authorLiu, K-
dc.contributor.authorOr, KL-
dc.contributor.authorChen, J-
dc.contributor.authorYan, M-
dc.contributor.authorWang, H-
dc.date.accessioned2020-11-23T08:15:38Z-
dc.date.available2020-11-23T08:15:38Z-
dc.date.issued2020-
dc.identifier.citationBMC Public Health, 2020, v. 20, p. article no. 1227-
dc.identifier.issn1471-2458-
dc.identifier.urihttp://hdl.handle.net/10722/293362-
dc.description.abstractBackground: Patients with coexisting type 2 diabetes and hypertension generally exhibit poor adherence to self-management, which adversely affects their disease control. Therefore, identification of the factors related to patient adherence is warranted. In this study, we aimed to examine (i) the socio-demographic correlates of patient adherence to a set of self-management behaviors relevant to type 2 diabetes and hypertension, namely, medication therapy, diet therapy, exercise, tobacco and alcohol avoidance, stress reduction, and self-monitoring/self-care, and (ii) whether health attitudes and self-efficacy in performing self-management mediated the associations between socio-demographic characteristics and adherence. Methods: We performed a secondary analysis of data collected in a randomized controlled trial. The sample comprised 148 patients with coexisting type 2 diabetes mellitus and hypertension. Data were collected by a questionnaire and analyzed using logistic regression. Results: Female patients were found to be less likely to exercise regularly (odds ratio [OR] = 0.49, P = 0.03) and more likely to avoid tobacco and alcohol (OR = 9.87, P < 0.001) than male patients. Older patients were found to be more likely to adhere to diet therapy (OR = 2.21, P = 0.01) and self-monitoring/self-care (OR = 2.17, P = 0.02). Patients living with family or others (e.g., caregivers) were found to be more likely to exercise regularly (OR = 3.44, P = 0.02) and less likely to avoid tobacco and alcohol (OR = 0.10, P = 0.04) than those living alone. Patients with better perceived health status were found to be more likely to adhere to medication therapy (OR = 2.02, P = 0.03). Patients with longer diabetes duration (OR = 2.33, P = 0.01) were found to be more likely to adhere to self-monitoring/self-care. Self-efficacy was found to mediate the association between older age and better adherence to diet therapy, while no significant mediating effects were found for health attitudes. Conclusions: Adherence to self-management was found to be associated with socio-demographic characteristics (sex, age, living status, perceived health status, and diabetes duration). Self-efficacy was an important mediator in some of these associations, suggesting that patient adherence may be improved by increasing patients’ self-management efficacy, such as by patient empowerment, collaborative care, or enhanced patient–physician interactions.-
dc.languageeng-
dc.publisherBioMed Central Ltd. The Journal's web site is located at http://www.biomedcentral.com/bmcpublichealth/-
dc.relation.ispartofBMC Public Health-
dc.rightsBMC Public Health. Copyright © BioMed Central Ltd.-
dc.rightsThis work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.-
dc.subjectSelf-management-
dc.subjectType 2 diabetes mellitus-
dc.subjectHypertension-
dc.subjectSelf-efficacy-
dc.subjectHealth attitudes-
dc.titleAn examination of the socio-demographic correlates of patient adherence to self-management behaviors and the mediating roles of health attitudes and self-efficacy among patients with coexisting type 2 diabetes and hypertension-
dc.typeArticle-
dc.identifier.emailOr, KL: klor@hku.hk-
dc.identifier.authorityOr, KL=rp01369-
dc.description.naturepublished_or_final_version-
dc.identifier.doi10.1186/s12889-020-09274-4-
dc.identifier.pmid32787809-
dc.identifier.pmcidPMC7424981-
dc.identifier.scopuseid_2-s2.0-85089613943-
dc.identifier.hkuros318794-
dc.identifier.volume20-
dc.identifier.spagearticle no. 1227-
dc.identifier.epagearticle no. 1227-
dc.identifier.isiWOS:000562779700002-
dc.publisher.placeUnited Kingdom-
dc.identifier.issnl1471-2458-

Export via OAI-PMH Interface in XML Formats


OR


Export to Other Non-XML Formats