Research On Relationship Between Diabetes Knowledge,Self-efficacy And Self-management Among Rural Elderly Patients

Diabetes mellitus has been considered as one of the major global public health problems since21century.The practice around the world proved that diabetes self-management was one of the most ideal control mode to promote patients’health behavior and patients’self-management was closely related with knowledge as well as self-efficacy. Thus we viewed such a study which discussed the relationship among diabetes knowledge, self-efficacy and self-management, analyzed their influencing routes and improved the capability of patients’self-management.Objective:(1) To know the current situation of knowledge, self-efficacy and self-management among rural elderly patients;(2) To analyze the relationship among patients’knowledge, self-efficacy and self-management;(3) To establish rural elderly diabetic patients’self-management model which clearly show the detailed influencing routes among knowledge, self-efficacy and self-management.Methods:A descriptive, cross-sectional design was used. Multistage cluster sampling was adopted to recruit rural elderly patients from the Chronic Disease Management Archives in Jiangshan and Puyan Community Health Service Center, which were respectively located in Ningbo and Hangzhou. Patients were invited to fill a series of questionnaires, including demographic, illness-related questionnaire, Diabetes Knowledge Test, Diabetes Self-efficacy questionnaire and the Summary of Diabetes Self-Care Activities. The relationship among patients’knowledge, self-efficacy and self-management were analyzed by Frequency, Chi-square test, Reliability and Validity test, Spearman rank correlation and Path analysis.Results:(1Reliability and Validity test indicated the Cronbach’s a of Diabetes Knowledge, Diabetes Self-Efficacy and Summary of Diabetes Self-Care Activities were respectively0.835、0.890and0.691.(2)The average score of the Diabetes Knowledge, Diabetes Sell-Efficacy and Summary of Diabetes Self-Care Activities were respectively11±6,3.67±1.22and3.08±1.25.(3) Chi-square test indicated that knowledge distribution showed significant differences by patients’living conditions, insurance types, diabetes causes and the types of diabetes (P<0.05); self-efficacy distribution showed significant differences by patients’age, education, occupation, income, diabetes causes and blood glucose control (P<0.05);self-management distribution showed significant differences by patients’age, diabetes causes, diabetes types, kinds of complications and medical costs (P<0.05).(4)Spearman correlation analysis indicated that diabetes knowledge had significantly positive correlation with patients’self-management behavior(P<0.05) and the correlation coefficient was0.325; self-efficacy had significantly positive correlation with patients’self-management behavior(P<0.05) and the correlation coefficient was0.545.(5) The self-management model was capable of fitting the fact and the results of NFI、RFI、CFI and RMSEA were respectively0.989、0.983、0.992and0.058.Path analysis indicated that diabetes knowledge total effect on self-management behavior was0.482and self-efficacy total effect on self-management behavior was0.640.Besides, diabetes knowledge indirect effect on self-management behavior was0.212through the self-efficacy as mediating variable.Conclusion:(1) Self-management level of rural elderly patients remained to be further improved. It was influenced by patients’ages, diabetes causes, diabetes types, kinds of complications and medical costs; patients acquired some diabetes knowledge and it was influenced by patients’ages, diabetes causes, diabetes types, kinds of complications and medical costs; rural elderly patients self-efficacy was need to be further strengthened. It was influenced by ages, education, occupation, income, diabetes causes and blood glucose control.(2) Patients’diabetes knowledge had significantly positive correlation with self-management behavior(P<0.05),and the knowledge about foot care, exercise and regular blood glucose monitoring were the closest; patients’self-efficacy had significantly positive correlation with self-management behavior(P<0.05), and the efficacy about exercise, blood glucose disposing and diet were the closest.(3)Diabetes knowledge and self-efficacy had a positive effect on self-management behaviors, besides diabetes knowledge had indirect effect on self-management behaviors through the self-efficacy as mediating variable.