Illness perceptions, self-care practices, and glycemic control among type 2 diabetes patients in Chiang Mai, Thailand

<p><strong>Background:</strong> Diabetes Self-Management Education (DSME) is a fundamental aspect of diabetes care, but no standard program exists in Thailand. Understanding current patterns of illness perceptions (concerns) and self-management practices among patients with diabete...

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Main Authors: Ngetich, E, Pateekhum, C, Hashmi, A, Nadal, IP, Pinyopornpanish, K, English, M, Quansri, O, Wichit, N, Kinra, S, Angkurawaranon, C
Format: Journal article
Language:English
Published: BioMed Central 2022
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author Ngetich, E
Pateekhum, C
Hashmi, A
Nadal, IP
Pinyopornpanish, K
English, M
Quansri, O
Wichit, N
Kinra, S
Angkurawaranon, C
author_facet Ngetich, E
Pateekhum, C
Hashmi, A
Nadal, IP
Pinyopornpanish, K
English, M
Quansri, O
Wichit, N
Kinra, S
Angkurawaranon, C
author_sort Ngetich, E
collection OXFORD
description <p><strong>Background:</strong> Diabetes Self-Management Education (DSME) is a fundamental aspect of diabetes care, but no standard program exists in Thailand. Understanding current patterns of illness perceptions (concerns) and self-management practices among patients with diabetes in Thailand is vital to develop culturally tailored DSME programs. This study sought to explore the association between reported self-management practices and diabetes perceptions on glycemic control among patients with type 2 diabetes in Chiang Mai Province, Thailand. Specifically, the study examined whether the association between illness perceptions and diabetes control was mediated by self-management.</p> <p><strong>Methods:</strong> This was a cross-sectional study conducted among type 2 diabetes patients on outpatient care and follow-up in four districts hospitals in Chiang Mai, Thailand. Illness perceptions was measured by the Brief Illness Perceptions Questionnaire (BIPQ). Self-management practices were measured by Summary Diabetes Self-Care activities (SDSCA). For illness perceptions and self-management practices, patients were classified into two groups, high level and low level based on the median values. Univariate and multivariable analyses were done to determine the association between the determinant factors: self-care practices and illness perceptions and the outcome of interest- good glycemic control (HbA1c < 7%).</p> <p><strong>Results:</strong> Of the 200 participants recruited into the study, 180 completed the questionnaire. Only 35% of participants had good glycemic control (HBA1c < 7.0). Both illness perceptions and self-management practices were independently linked to glycemic control. Among illness perceptions, a sense of personal control was strongly associated with good glycemic control (<i>p</i> = 0.01). For self-management, appropriate diet (<i>p</i> = 0.03) and medication adherence (<i>p</i> = 0.05) were associated with good glycemic control. After adjustments for key baseline characteristics, patients with high levels of illness perceptions were less likely to achieve glycemic control (OR 0.55, 95% CI 0.29 to 1.14, <i>p</i> = 0.11) and those with high level of self-management were more likely to achieve glycemic control (OR 2.11, 95% CI 1.04 to 4.30, <i>p</i> = 0.04). The effect size for illness perception attenuated when further adjusted for levels of self-management (OR 0.88, 95% CI 0.39 to 1.96, <i>p</i> = 0.75) while the effect size for self-management and glycemic control did not materially change (OR 2.30, 95% CI 1.06 to 5.02, <i>p</i> = 0.04).</p> <p><strong>Conclusion:</strong> Illness perceptions and self-management practices are associated with glycemic control. Future culturally tailored interventions in Thailand aimed at improving glycemic should focus on personal control, improving diet and treatment adherence as these are more likely to help improve diabetes control as demonstrated in this study.</p>
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spelling oxford-uuid:f0430664-bc5e-4a27-8d26-bbd26c6947992023-10-25T12:54:43ZIllness perceptions, self-care practices, and glycemic control among type 2 diabetes patients in Chiang Mai, ThailandJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:f0430664-bc5e-4a27-8d26-bbd26c694799EnglishSymplectic ElementsBioMed Central2022Ngetich, EPateekhum, CHashmi, ANadal, IPPinyopornpanish, KEnglish, MQuansri, OWichit, NKinra, SAngkurawaranon, C<p><strong>Background:</strong> Diabetes Self-Management Education (DSME) is a fundamental aspect of diabetes care, but no standard program exists in Thailand. Understanding current patterns of illness perceptions (concerns) and self-management practices among patients with diabetes in Thailand is vital to develop culturally tailored DSME programs. This study sought to explore the association between reported self-management practices and diabetes perceptions on glycemic control among patients with type 2 diabetes in Chiang Mai Province, Thailand. Specifically, the study examined whether the association between illness perceptions and diabetes control was mediated by self-management.</p> <p><strong>Methods:</strong> This was a cross-sectional study conducted among type 2 diabetes patients on outpatient care and follow-up in four districts hospitals in Chiang Mai, Thailand. Illness perceptions was measured by the Brief Illness Perceptions Questionnaire (BIPQ). Self-management practices were measured by Summary Diabetes Self-Care activities (SDSCA). For illness perceptions and self-management practices, patients were classified into two groups, high level and low level based on the median values. Univariate and multivariable analyses were done to determine the association between the determinant factors: self-care practices and illness perceptions and the outcome of interest- good glycemic control (HbA1c < 7%).</p> <p><strong>Results:</strong> Of the 200 participants recruited into the study, 180 completed the questionnaire. Only 35% of participants had good glycemic control (HBA1c < 7.0). Both illness perceptions and self-management practices were independently linked to glycemic control. Among illness perceptions, a sense of personal control was strongly associated with good glycemic control (<i>p</i> = 0.01). For self-management, appropriate diet (<i>p</i> = 0.03) and medication adherence (<i>p</i> = 0.05) were associated with good glycemic control. After adjustments for key baseline characteristics, patients with high levels of illness perceptions were less likely to achieve glycemic control (OR 0.55, 95% CI 0.29 to 1.14, <i>p</i> = 0.11) and those with high level of self-management were more likely to achieve glycemic control (OR 2.11, 95% CI 1.04 to 4.30, <i>p</i> = 0.04). The effect size for illness perception attenuated when further adjusted for levels of self-management (OR 0.88, 95% CI 0.39 to 1.96, <i>p</i> = 0.75) while the effect size for self-management and glycemic control did not materially change (OR 2.30, 95% CI 1.06 to 5.02, <i>p</i> = 0.04).</p> <p><strong>Conclusion:</strong> Illness perceptions and self-management practices are associated with glycemic control. Future culturally tailored interventions in Thailand aimed at improving glycemic should focus on personal control, improving diet and treatment adherence as these are more likely to help improve diabetes control as demonstrated in this study.</p>
spellingShingle Ngetich, E
Pateekhum, C
Hashmi, A
Nadal, IP
Pinyopornpanish, K
English, M
Quansri, O
Wichit, N
Kinra, S
Angkurawaranon, C
Illness perceptions, self-care practices, and glycemic control among type 2 diabetes patients in Chiang Mai, Thailand
title Illness perceptions, self-care practices, and glycemic control among type 2 diabetes patients in Chiang Mai, Thailand
title_full Illness perceptions, self-care practices, and glycemic control among type 2 diabetes patients in Chiang Mai, Thailand
title_fullStr Illness perceptions, self-care practices, and glycemic control among type 2 diabetes patients in Chiang Mai, Thailand
title_full_unstemmed Illness perceptions, self-care practices, and glycemic control among type 2 diabetes patients in Chiang Mai, Thailand
title_short Illness perceptions, self-care practices, and glycemic control among type 2 diabetes patients in Chiang Mai, Thailand
title_sort illness perceptions self care practices and glycemic control among type 2 diabetes patients in chiang mai thailand
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