Structural model of self-care agency in patients with diabetes: A path analysis of the Instrument of Diabetes Self-Care Agency and body self-awareness.
Sachiko Waki, Yasuko Shimizu, Kyoko Uchiumi and 6 others
PMID 27224894WHAT IT FOUND
In 353 adults with diabetes, understanding their own body was linked to knowing about diabetes and monitoring it, which was linked to adjusting self-care and managing diabetes.
These are questionnaire relationships, not proof that any intervention works.
Key findings
01The five remaining body self-awareness items formed one factor, with loadings from 0.511 to 0.743 and Cronbach's alpha 0.739.
02In the path model, ability to acquire knowledge had a direct effect of 0.55 on monitoring ability, and monitoring ability had a direct effect of 0.21 on application or adjustment ability.
03In the path model, body self-awareness and application or adjustment ability each had a direct effect of 0.44 on ability to self-manage; ability to self-manage had a direct effect of 0.50 on motivation to self-manage, and motivation to self-manage had a direct effect of -0.32 on ability to self-manage.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study measured responses at one time, so it cannot show that changes in body self-awareness cause changes in diabetes self-care. The paper reports 353 usable questionnaires but the characteristics table uses N = 368, so the analysed sample is unclear. Background variables such as age, sex, condition, and treatment were not investigated. Participants had to communicate verbally, use the instrument, have no mental illness, and not need special care beyond self-care education, so findings may not apply to more unstable or dependent patients. The body self-awareness measure was based on five items after one item was removed.
The easy way to misread this
Do not read the model as proof that a nurse-led education programme will improve diabetes self-management. The study used one questionnaire survey, did not test an intervention, and did not analyse age, sex, condition, or treatment as background variables.