Survey Of Chronic Illness Resources Utilization, Self-efficacy And Self-management On Diabetes In Community

Objective : To evaluate the reliability and validity of the revised version of Chronic Illness Resources Survey(CIRS) in patients with diabetes. And investigate the current status and influencing factors of the utilization of chronic illness resources, perceived self-efficacy and diabetes self-management of patients with diabetes. This study also aims to explore the relationship between chronic illness resources and self-management of diabetes patients in community, and analysis the mediating role of self-efficacy.Methods: 1.Translate and revise the scale of Chronic Illness Resources Survey(CIRS) Firstly, we translated the English version of CIRS developed by Glasgow into chinese version. To revise it, 40 patients with diabetes were investigated in communities using the translated version. And a 19-item scale was initially formed.2.Evaluate the reliability and validity of the CIRS 160 diabetic patients from 7 communities in Shihezi were chosen to perform a survey using the revised version of CIRS. And the reliability and validity of the scale were evaluated by item analysis, construct validity, convergent validity, discrimination validity analysis and reliability test using SPSS17.0.3. Cross-sectional investigation Convenient sampling was used in this study. And totally 300 patients with diabetes from 8 communities were investigated using the questionnaire which includes demographic information, the revised scale of CIRS, perceived diabetes self-management scale(PDSMS), diabetes self-care scale(DSCS). Epi Data3.1 software was used to establish the Database. All the data statistical analysis was performed using SPSS17.0 software.Results: 1. Reliability and validity of the revised version of CIRS A total of 5 common factors were extracted, the cumulative variance contribution rate was 62. 66%. And six dimensionalities were selected through factor screening. The collecting validity and discrimination validity of each item was calibrated successfully. The Cronbach’s ɑ coefficient for CIRS was 0. 845, those of the dimensionalities were 0. 649 to 0. 788; the split — half reliability was 0. 754, those of the dimensionalities 0. 524 to 0. 807.2. The current status and influencing factors of the utilization of chronic illness resources, perceived selfefficacy and diabetes self-management of patients with diabetes. The mean score of CIRS was 2.86±0.63, the dimension of family or friends were scored highest, which were followed by the dimensions of health care team, neighbourhood or community, media or policy, self adjustment and organization. Multivariate logistic regression analysis showed that the income, education, age, gender and duration may influence the score of CIRS.The score of perceived diabetes self-management scale was 3.44±0.80. Multivariate logistic regression analysis showed that the education, age and way of therapy may influence the score of perceived diabetes self-management scale.The mean score of self-care scale was 3.28±0.59, the dimensions of taking medicine and doing exercise were rated highest, which were prior to the dimensions of dietary therapy, foot care, dealing with hyperglycemia and hypoglycemia, glucose monitoring. And multivariate logistic regression analysis showed that the scores of CIRS and PDSMS, duration may influence the score of self-care scale.3. Analysis of the relationships among CIRS, PDSMS and DSCS Correlate analysis showed that the CIRS, PDSMS and DSCS were positively correlated with each other. Regression analysis showed that the chronic illness resources could either directly affect the diabetes self-management(β=0.78, P<0. 01),self-efficacy(β=0.39, P<0. 01)or make effect on self-management indirectly by the mediating role of self-efficacy, the media effect ratio was 7%.Conclusion: 1. The revised version of CIRS in this study was an efficient tool to assess the utilization of chronic illness resources for community diabetic patients.2. The utilization of chronic illness resources by community diabetic patients was not ideal. The diabetes patients got most support from family/friends and health care team, and they took worst use of self adjustment and organization resources. The level of self-efficacy of the samples should be enhanced. For the self-management behavior of the diabetic patients, they performed best in taking medicine and doing exercise, and done worst in dealing with hyperglycemia and hypoglycemia, glucose monitoring.3. The level of utilizing chronic illness resources and self-efficacy may influence their self-management behaviors. The utilization of chronic illness resources may be influenced by gender, age, education, income, duration. And diabetic patients with different age, way of therapy and education perceived different level of self-efficacy.4. The utilization of chronic illness resources, self-efficacy and diabetes self-management of diabetic patients were positively correlated with each other. The uses of chronic illness resources was an important factor on self-management of patients with diabetes in community. And self-efficacy may play a partial mediating role in their relationship.