The purpose of this study was to examine the relationships between maternal environment (child behavior and coping resources), diabetes self-efficacy, diabetes management behaviors, and child glycemic control.

Methods

Study participants were recruited from 3 outpatient clinics in the Midwest and included 41 mothers of children with type 1 diabetes, ages 6 to 10. All participants completed the following measures: Coping Resources Inventory, Behavioral Assessment System for Children-Parent Report, Maternal Self-Efficacy for Diabetes Scale, Diabetes Management Scale—Parent, and 24-hour diabetes behavior recall. Downloaded glucose data and child HgbA1c were obtained by chart review. Stepwise multiple regression was used to determine the influence of maternal environment on maternal diabetes self-efficacy and diabetes management behavior. Pearson product moment correlations were used to determine if relationships existed between maternal self-efficacy, diabetes management behaviors, and child metabolic control.

Results

Coping resources contributed significantly to mothers' diabetes self-efficacy. No significant relationship was found between the mothers' environment and diabetes management behavior. Self-efficacy did not predict maternal diabetes management behaviors. The blood glucose testingand maternal recall of diabetes behaviors were correlated to metabolic control.

Conclusions

Mothers with coping resources felt more confident in managing their children's diabetes. Child behavior did not influence a mother's diabetes management behaviors. Mothers who were consistent in their diabetes management behaviors had children in better metabolic control. More information is needed to determine what mothers view as barriers in providing diabetes care for their children.

The purpose of this study was to examine coronary heart disease (CHD) risk perception, risk factor status, and factors associated with CHD risk perception in Korean immigrants with type 2 diabetes mellitus.

Methods

A community sample of 143 Korean adults with type 2 diabetes, aged 30 to 80 years old, completed questionnaires and biological measures. A multiple regression analysis was conducted to evaluate the relationships between CHD knowledge, general health, smoking, medications for CHD risk factors, demographic variables (independent variables), and the perception of CHD risk (dependent variable).

Results

Participants had low perception of CHD risk, with most (76.9%) indicating their risk to be the same or lower than people of the same age and sex in the general population. Overall, CHD risk factor control was suboptimal according to American Diabetes Association guidelines. Only 41.3% of participants met the HbA1c goal of less than 7%. More than half (55%) had uncontrolled blood pressure, and a similar proportion (53.6%) had higher low-density lipoprotein cholesterol than the target goal. CHD knowledge and self-reported general health influenced the perception of CHD risk. More CHD knowledge and poor general health were associated with higher perception of CHD risk.

Conclusions

To increase the perception of CHD risk in Korean immigrants with type 2 diabetes, diabetes educators and clinicians should educate such patients about CHD risk factors and discuss their risk status at every visit. Those who report their health to be good deserve particular attention.

The purpose of this review was to propose a model that describes the influences on the behavior and psychological functioning of people at risk for diabetes-related foot complications.

Methods

A literature search was conducted in Medline (1950-2005), CINAHL (1982-2005), and PsycInfo (1967-2005) databases and in reference lists of journal articles and relevant books. The search focused on published literature in the English language that was related to concepts such as diabetes-related foot complications, behavior, and psychology.

Results

The literature reviewed was arranged to reflect the reciprocal relationship between the personal, environmental, and behavioral factors of people at risk of diabetes-related foot complications. The model proposed uses the concept of reciprocal determinism to illustrate how these factors interact and influence the development of diabetes-related foot complications.

Conclusion

The concept of reciprocal determinism may be useful when developing further investigation into educational and behavioral interventions in this clinical population.

The purpose of this study was to describe how coping styles among African Americans with type 2 diabetes relate to diabetes appraisals, self-care behaviors, and health-related quality of life or well-being.

Methods

This cross-sectional analysis of baseline measures from 185 African Americans with type 2 diabetes enrolled in a church-based randomized controlled trial uses the theoretical framework of the transactional model of stress and coping to describe bivariate and multivariate associations among coping styles, psychosocial factors, self-care behaviors, and well-being, as measured by validated questionnaires.

Results

Among participants who were on average 59 years of age with 9 years of diagnosed diabetes, passive and emotive styles of coping were used most frequently, with older and less educated participants using more often passive forms of coping. Emotive styles of coping were significantly associated with greater perceived stress, problem areas in diabetes, and negative appraisals of diabetes control. Both passive and active styles of coping were associated with better diabetes self-efficacy and competence in bivariate analysis. In multivariate analysis, significant proportions of the variance in dietary behaviors and mental well-being outcomes (general and diabetes specific) were explained, with coping styles among the independent predictors. A positive role for church involvement in the psychological adaptation to living with diabetes was also observed.

Conclusions

In this sample of older African Americans with diabetes, coping styles were important factors in diabetes appraisals, self-care behaviors, and psychological outcomes. These findings suggest potential benefits in emphasizing cognitive and behavioral strategies to promote healthy coping outcomes in persons living with diabetes.

The purpose of this study is to explore the attitudes that contribute to psychological insulin resistance (PIR) in insulin-naive patients with type 2 diabetes and to identify predictors of PIR.

Methods

A prospective study using 2 self-report surveys and incorporating demographic and health variables was conducted to determine the prevalence of PIR among a sample of 100 adult, insulin-naive patients with type 2 diabetes at an outpatient diabetes center in a university-affiliated teaching hospital.

Results

Thirty-three percent of patients with type 2 diabetes were unwilling to take insulin. The most commonly expressed negative attitudes were concern regarding hypoglycemia, permanent need for insulin therapy, less flexibility, and feelings of failure. Less than 40% expressed fear of self-injection or thought that injections were painful. However, compared with willing subjects, unwilling subjects were more likely to fear injections and thought injections would be painful, life would be less flexible, and taking insulin meant health would deteriorate (P < .005 for all comparisons). Poorer general health and higher depression scores also correlated with PIR.

Conclusions

The results of the surveys, which were generally consistent, identified several remediable misconceptions regarding insulin therapy and suggest targets for educational interventions.