Factors Predicting Self-Management Behaviors among Persons with Diabetic Retinopathy

Authors

  • Sornthai Kaewjaiboon -
  • Pratum Soivong Faculty of nursing, Chiang Mai university
  • Benjamas Suksatit Faculty of nursing, Chiang Mai university

Keywords:

self-management, perceived barriers to performing self-management behavior, social support, person with diabetic retinopathy

Abstract

Persons with diabetic retinopathy who engage in consistent and appropriate self-management behavior (SMB) can decrease the severity of this issue. This study aimed to determine SMB and factors predicting SMB among persons with diabetic retinopathy, including perceived barriers to performing SMB and social support. Purposive sampling was applied to recruit 88 persons with diabetic retinopathy who received service at the outpatient department of the retina clinic at a university hospital. Research instruments included a demographic data record form, the SMB Questionnaire, the Perceived Barriers to Performing SMB Questionnaire, and Social Support Questionnaire. Their reliabilities were .88, .81, and .91, respectively. The interview method was used to collect data. Data were analyzed using descriptive statistics, Pearson product-moment correlation coefficient, and stepwise multiple regression statistics.

             The results revealed that 79.55% of participants had insufficient overall SMB (x̅ = 99.70, S.D. = 9.60). Perceived barriers to performing SMB and social support predicted 17% (R2 = .17) of SMB (SEest= ±8.84). The findings of this study demonstrate that interventions for enhancing SMB among persons with diabetic retinopathy should be developed. Furthermore, although perceived barriers to performing SMB and social support can predict SMB, the percentage is low. Thus, further studies should explore other factors influencing SMBs.

References

Al-Jarrah, M. A., & Shatnawi, H. (2017). Non-proliferative

diabetic retinopathy symptoms detection and

classification using neural network. Journal of

Medical Engineering and Technology, 41(6),

-505.

American Diabetes Association.(2021). Microvascular

complications and foot care: Standards of medical

care in diabetes. Diabetes Care, 44 (Suppl. 1),

S151-S167.

American Diabetes Association. (2021). Pharmacologic

approaches to glycemic treatment: Standards

of medical care in diabetes 2021. Diabetes

Care, 44(Suppl.1), S111-S124.

Angermann, R., Rauchegger, T., Nowosielski, Y.,

Casazza, M., Bilgeri, A., Ulmer, H., & Zehetner,

C. (2019). Treatment compliance and adherence

among patients with diabetic retinopathy and

age-related macular degeneration treated by

anti-vascular endothelial growth factor under

universal health coverage. Graefe’s Archive for

Clinical and Experimental Ophthalmology, 257

(10), 2119-2125

Ariani, A., & Utami, L. A. (2020). Human problems:

Sick role behavior among chronic disease

sufferers and various treatment models to increase

it. Advances in Social Science, Education and

Humanities Research, 395, 39-43.

Becker, M. H. (1974). The health belief model and personal

health behavior. Thorofare: Slack.

Bloom, B. S., & Krathwohl, D.R. (1975). Taxonomy of

educational objectives: The classification of

educational goals, handbook 1: Cognitive domain.

New York: McKay.

Bloom, J. M., Mason, J. O., Mason, L., & Swain, T. A.

(2020). Fears, depression, and anxieties of

patients with diabetic retinopathy and implications

for education and treatment.Journal of Vitreoretinal

Diseases, 4(6), 484-489.

Chiangmai Provincial Public Health Office. (2018).

Health screening guide for the elderly health

promotion. Chiang Mai: Author. Retrieved 10 May

from https://smart-ageing.chiangmaihealth.

go.th/web/index.php?r=report/group. [In Thai].

Cohen, J. (1988). Statistical power analysis for

the behavioral sciences (2nd ed.). Hillsdale, NJ:

Lawrence Erlbaum Associates Publishers.

Colberg, S. R., Sigal, R. J., Yardley, J. E., Riddell, M. C.,

Dunstan, D. W., Dempsey, P. C., Horton, E. S.,

Castorino, K., & Tate, D. F. (2016). Physical

activity/exercise and diabetes: A position statement

of the American diabetes association. Diabetes

Care, 39(11), 2065–2079.

Cooper, O. A. E., Taylor, D. J., Crabb, D. P., Sim, D. A.,

& McBain, H. (2020). Psychological, social and

everyday visual impact of diabetic macular

oedema and diabetic retinopathy: A systematic

review. Diabetic Medicine, 37(6), 924-933.

Euswas, N., Phonnopparat, N., Morasert, K., Thakhampaeng,

P., Kaewsanit, A., Mungthin, M., ...Sakboonyarat,

B. (2021). National trends in the prevalence of

diabetic retinopathy among Thai patients with type

diabetes and its associated factors from 2014

to 2018. Plos One, 16(1), e0245801.

Fajnkuchen, F., Delyfer, M. N., Conrath, J., Baillif, S.,

Mrejen, S., Srour, M., ... Giocanti-Auregan, A.

(2020). Expectations and fears of patients with

diabetes and macular edema treated by intravitreal

injections. Acta Diabetologica, 57(9), 1081-1091.

Faul, F., Erdfelder, E., Buchner, A., & Lang, A. G. (2009).

Statistical power analyses using g* power

1: Tests for correlation and regression analyses.

Behavior Research Methods, 41(4), 1149-1160.

Feng, Z., Cramm, J. M., & Nieboer, A. P. (2020). Social

participation is an important health behavior for

health and quality of life among chronically ill

older Chinese people. BMC Geriatrics, 20(1), 299.

Fenwick, E. K., Cheng, G. H., Man, R. E., Khadka, J.,

Rees, G., Wong, T. Y., ... Lamoureux, E. L. (2018).

Inter-relationship between visual symptoms,

activity limitation and psychological functioning

in patients with diabetic retinopathy. British

Journal of Ophthalmology, 102(7), 948-953.

Fenwick, E. K., Khadka, J., Pesudovs, K., Rees, G.,

Wong, T. Y., & Lamoureux, E. L. (2017). Diabetic

retinopathy and macular edema quality-of-life

item banks: Development and initial evaluation

using computerized adaptive testing. Investigative

Ophthalmology and Visual Science, 58(14),

-6387.

Grove, S.K., Burns, N., & Gray, J.R. (2013). The practice

of nursing research: Appraisal, synthesis, and

generation of evidence (7thed.) St. Louis, Missouri:

Elsevier Saunders.

Gupta, P., Aravindhan, A., Gan, A. T., Man, R. E.,

Fenwick, E. K., Mitchell, P., ... Lamoureux, E. L.

(2017). Association between the severity of

diabetic retinopathy and falls in an Asian population

with diabetes: The Singapore epidemiology of

eye diseases study. Jama Ophthalmology, 135(12),

-1416.

Habib, A. E., Abdel-Kader, A. A., Eissa, I. M., &

Awadein, A. (2019). Adherence to intravitreal

anti-vascular endothelial growth factor drugs in

diabetic macular edema in an Egyptian population:

A health belief model. Current Eye Research,

(3), 303–310.

Hanucharurnkul, S. (1988). Social support, self-care, and

quality of life cancer patients receiving radiation

in Thailand (Doctoral thesis of nursing science).

Wayne State University.

International council of ophthalmology. (2017). Updated

guidelines for diabetic eye care. Retrieved

May 2020 from https://www.urmc. rochester.

edu/MediaLibraries/URMCMedia/eye-institute/

images/ICOPH.pdf

Kanan, P., Piaseu, N., Malathum, P. and Belza, B. (2019).

Predictors of diabetes self-management in older

adults with poorly controlled type 2 diabetes

mellitus. Pacific Rim International Journal of

Nursing Research. 23(4), 357- 367.

Kawitu, M., & Mattavangkul, C. (2019). Factors associated

with blood sugar controlling among the elderly

with diabetes living in communities nearby Siam

university. Journal of Nursing Siam University,

(38), 82-95. [In Thai].

Kong, S. Y., & Cho, M. K. (2020). Factors related

to self-care in patients with type 2 diabetes.

The Open Nursing Journal, 14(1), 64-73.

Lael-Monfared, E., Tehrani, H., Moghaddam, Z. E.,

Ferns, G. A., Tatari, M., & Jafari, A. 2019).

Health literacy, knowledge and self-care behaviors

to take care of diabetic foot in low-income

individuals: Application of extended parallel

process model. Diabetes and Metabolic Syndrome,

(2), 1535-1541.

Liu, Y., Jiang, J., You, W., Gong, D., Ma, X., Wu, M.,

& Li, F. 2022). Exploring facilitators and barriers

to self-management engagement of Chinese

people with type 2 diabetes mellitus and poor

blood glucose control: A descriptive qualitative

study. BMC endocrine disorders, 22(1), 1-13.

Lorig, K., & Holman, H. (2003). Self-management

education: History, definition, outcomes, and

mechanisms. Annals of Behavioral Medicine,

(1), 1-7.

Mahaputera, D., Hutapea, M., Thaniwattananon, P.,

Yodchai, K., & Hutapea, A. M. 2017). Perceived

benefits to treatment adherence, perceived

barriers to treatment adherence, and level of

treatment adherence among Indonesian older

adults with type 2 diabetes mellitus. Gstf Journal

of Nursing and Health Care, 4(2), 93-98.

Mohebi, S., Parham, M., Sharifirad, G., Gharlipour,

Z., Mohammadbeigi, A., & Rajati, F. (2018).

Relationship betweenperceived social support

and self-care behavior in type 2 diabetics: A

cross-sectional study. Journal of Education and

Health Promotion, 7, 48.

Muksiritipanun, B., & Monthaisong, D. (2014). Factors

related to quality of life in patients with diabetic

retinopathy.Journal of The Royal Thai Army

Nurses, 15(2), 395-404. [In Thai].

National statistical office. (2022). The 2021 household

socio-economic survey. Bangkok: Bangkok

blocks. [In Thai]

Pfeiffer, E. (1975). A short portable mental status

questionnaire for the assessment of organic

brain deficit in elderlypatients. Journal of The

American Geriatrics Society, 23(10), 433-441.

Qaseem, Y., Samra, S., German, O., Gray, E., & Gill,

M. K. (2020). Self-reported awareness of

retinopathy severity in diabetic patients. Clinical

Ophthalmology, 14, 2855-2863.

Schaefer, C., Coyne, J. C., & Lazarus, R. S. (1981).

The health-related functions of social support.

Journal of Behavioral Medicine, 4(4), 381–406.

Schwennesen, N., Barghadouch, A., & Olesen, K.

(2019). Health literacy and self-care among

visually impaired people with type 1 diabetes in

Denmark. Chronic Illness, 15(2), 157-164.

Shayeghian, Z., Aguilar-Vafaie, M. E., Besharat, M. A.,

Amiri, P., Parvin, M., Gillani, K. R., &

Hassanabadi, H. (2015). Self-care activities and

glycated haemoglobin in Iranian patients with type

diabetes: Can coping styles and social support

have a buffering role?. Psychology and Health,

(2), 153-164.

Silpa-archa, S., & Ruamviboonsuk, P. (2017). Diabetic

retinopathy: Current treatment and Thailand

perspective. Journal of The Medical Association

of Thailand, 100(Suppl. 1), S136-47.

Simakurthy, S., & Tripathy, K. (2023). Valsalva

retinopathy. Retrieved 10 May 2020 from https://

www.ncbi.nlm.nih.gov /books/NBK545219/

Sirikaensine, S. (2019). Health belief related to blood

glucose control among patients with diabetes

mellitus type 2 in Kutchik subdistrict, mueang

district, Nongbua Lamphu province. Southeast

Bangkok Journal, 5(1), 55-68. [In Thai].

Sittikankaew, K., & Navicharoen, R. (2014). Factors

related to health promoting behaviors of type 2

diabetes patients withinsulin and oral agent

therapy. Journal of The Police Nurse, 6(1), 102-

[In Thai].

Sturrock, B. A., Rees, G., Lamoureux, E. L., Wong, T.

Y., Holloway, E., & Fenwick, E. K. 2018).

Individuals’perspectives on coping with vision loss

from diabetic retinopathy. Optometry and Vision

Science, 95(4), 362-372.

Teo, Z. L., Tham, Y. C., Yu, M., Chee, M. L., Rim, T. H.,

Cheung, N., ... & Cheng, C. Y. (2021). Global

prevalence of diabetic retinopathy and projection

of burden through 2045: Systematic review and

meta-analysis. Ophthalmology, 128(11), 1580-1591.

World Health Organization. (2003). Consultation on

development of standards for characterization

of vision loss and visual functioning. Retrieved

May 2020 from https://apps.who.int/iris/handle/

/68601

World Health Organization. (2017).Healthy lifestyles for

patients with diabetes. Retrieved 10 May 2020

from https://apps.who.int/iris/bitstream/handle/

/254746/9789290618058-diab-mod2-eng.

pdf?sequence=9&isAllowed=y

Xu, X., Zhao, X., Qian, D., Dong, Q., & Gu, Z. (2015).

Investigating factors associated with depression

of type 2 diabetic retinopathy patients in China.

Plos One, 10(7), e0132616.

Yang, L., Wu, Q., Hao, Y., Cui, Y., Liang, L., Gao, L.,

Jiao, M., Ning, N., Sun, H., Kang, Z., Han, L.,

Li, Y., & Yin, H. (2017). Self-management

behavior among patients with diabetic retinopathy

in the community: A structural equation model.

Quality of Life Research, 26(2), 359-366.

Zhang, X., Low, S., Kumari, N., Wang, J., Ang, K.,

Yeo, D., Yip, C. C., Tavintharan, S., Sum,

C. F., & Lim, S. C. (2017). Direct medical cost

associated with diabetic retinopathy severity

in type 2 diabetes in Singapore. Plos One, 12(7),

e0180949.

Downloads

Published

2023-10-09

How to Cite

Kaewjaiboon, S., Soivong, P., & Suksatit, B. (2023). Factors Predicting Self-Management Behaviors among Persons with Diabetic Retinopathy. NU Journal of Nursing and Health Sciences, 17(3), 148–164. Retrieved from https://he01.tci-thaijo.org/index.php/NurseNu/article/view/263019