J Korean Acad Nurs.  2017 Aug;47(4):514-525. 10.4040/jkan.2017.47.4.514.

Structural Equation Modeling on Self-Care Behavior and Quality of Life in Older Adults with Diabetes Using Citizen Health Promotion Centers

• Lee S
• Kim H

• KMID: 2389027
• DOI: http://doi.org/10.4040/jkan.2017.47.4.514

Abstract

PURPOSE
The purpose of this study was to construct and test a structural equation model for Diabetes self-management (DSM) behavior and Quality of life (QoL) in older adults with diabetes who use Citizen Health Promotion Centers. The theory used this study was a combination of the Information-Motivation-Behavioral Model (IMB) and Self-Determination Theory (SDT) to reflect autonomous characteristics of participants.
METHODS
Data were collected from April 20 to August 31, 2015 using a self-report questionnaire. The sample was 205 patients with type 2 Diabetes who regularly visited a Citizen Health Promotion Center. SPSS 22.0 and AMOS 22.0 programs were used to analyze the efficiency of the hypothesized model and calculate the direct and indirect effects of factor affecting the participants' DSM behavior and QoL.
RESULTS
The supported hypotheses were as follows; 1) The variable that had a direct effect on QoL was health behavior adherence (γ=.55, p=.007). 2) The variables that had a direct effect on DSM behavior were DSM information (γ=.15, p=.023), DSM confidence (γ=.25, p<.001), and autonomous motivation (γ=.13, p=.048). 3) The variable that had a direct effect on DSM confidence was autonomy support (γ=.33, p<.001).
CONCLUSION
The major findings of this study are that supporting patient's autonomous motivation is an influential predictor for adherence to DSM behavior, and integrative intervention strategies which include knowledge, experience and psychosocial support are essential for older adults with diabetes to continue DSM behavior and improve QoL.

Keyword

Health behavior; Personal autonomy; Self care; Diabetes mellitus type 2; Quality of life

MeSH Terms

Adult*
Health Behavior
Health Promotion*
Humans
Motivation
Personal Autonomy
Quality of Life*
Self Care*

Figure

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  Figure 1. Hypothetical model.

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  Figure 2. Path diagram for the hypothetical model.

Reference

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