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Journal of Behavioral Medicine

, Volume 38, Issue 3, pp 450–459 | Cite as

Correlates of perceived self-care activities and diabetes control among Dutch type 1 and type 2 diabetics

  • Lieke G. M. RaaijmakersEmail author
  • Marloes K. Martens
  • Charlotte Bagchus
  • Inge de Weerdt
  • Nanne K. de Vries
  • Stef P. J. Kremers
Article

Abstract

This study examined how Dutch type 1 and type 2 diabetes patients’ perceived autonomy support, as well as their perceived competence and treatment self-regulation, are associated with their diabetes self-care activities (healthy diet, physical activity, monitoring blood glucose, medication use) and general diabetes control. A cross-sectional questionnaire study was conducted among 143 type 1 diabetics and 384 type 2 diabetics. Overall, participants felt competent, supported in their autonomy, and perceived to autonomously self-regulate their diabetes. Our results underline the importance of perceived competence in type 1 and 2 diabetics, as this was strongly associated with adhering to a healthy diet and general diabetes control. Our findings also emphasize the need for autonomy supportive health care professionals in diabetes care. Interestingly, perceived competence partially mediated the influence of autonomy support on general diabetes control.

Keywords

Diabetes type 1 and type 2 Self determination theory Self-care Self-management 

Notes

Acknowledgments

This study was conducted as part of the Dutch National Diabetes Action Program with a Grant from the Diabetes Federation (Project Number 2010.105.1356).

Conflict of interest

L. Raaijmakers, M. Martens, L. Bagchus, I. de Weerdt, S. Kremers & N. de Vries declare that they have no conflict of interest.

Human and Animal Rights and Informed Consent

All procedures followed were in accordance with ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000. Informed consent was obtained from all patients for being included in the study.

References

  1. American Diabetes Association. (2013). Standards of medical care in diabetes-2013. Diabetes Care, 136, S11–S66.CrossRefGoogle Scholar
  2. Baan, C. A., & Poos, M. J. J. C. (2013). Hoe vaak komt diabetes mellitus voor en hoeveel mensen sterven eraan? [How often does diabetes occur and how many people die from it?] In: VTV public health forecast, National Public Health Compass. Bilthoven: National Institute for Public Health and the Environment.Google Scholar
  3. Barlow, J., Wright, C., Sheasby, J., Turner, A., & Hainsworth, J. (2002). Self-management approaches for people with chronic conditions: A review. Patient Education and Counseling, 48, 177–187. doi: 10.1016/s0738-3991(02)00032-0 CrossRefPubMedGoogle Scholar
  4. Baron, R. M., & Kenny, D. A. (1986). The moderator-mediator variable distinction in social psychological research: Conceptual, strategic and statistical considerations. Journal of Personality and Social Psychology, 51, 1173–1182.CrossRefPubMedGoogle Scholar
  5. Central Committee on Research inv. Human subjects. http://www.ccmo-online.nl/main.asp?pid=1
  6. Chen, S. M., Creedy, D., Lin, H. S., & Wollin, J. (2012). Effects of motivational interviewing intervention on self-management, psychological and glycemic outcomes in type 2 diabetes: A randomized controlled trial. International Journal of Nursing Studies, 49, 637–644.CrossRefPubMedGoogle Scholar
  7. Cohen, J. (1988). Statistical power analysis for the behavioral sciences. New York: Academic Press.Google Scholar
  8. Deci, E. L., & Ryan, R. M. (2012). Self-determination theory in health care and its relations to motivational interviewing: A few comments. The international Journal of Behavioral Nutrition and Physical Activity, 9, 24.CrossRefPubMedCentralPubMedGoogle Scholar
  9. EADV, & NAD. (2012). From indication to execution. A multidisciplinary guideline for selfcontrol of blood glucose by diabetes patients. [Van indicatiestelling naar uitvoering. Een multidisciplinaire richtlijn over zelfcontrole van bloedglucosewaarden door mensen met diabetes.] Utrecht: EADV & NAD.Google Scholar
  10. International Diabetes Federation. (2012). Diabetes atlas update 2012: International Diabetes Federation. http://www.idf.org/sites/default/files/5E_IDFAtlasPoster_2012_EN.pdf
  11. Janevic, M. R., McLaughlin, S. J., & Connell, C. M. (2012). Overestimation of physical activity among a nationally representative sample of underactive individuals with diabetes. Medical Care, 50, 441–445.CrossRefPubMedCentralPubMedGoogle Scholar
  12. Lundahl, B., Moleni, T., Burke, B. L., Butters, R., Tollefson, D., Butler, C., & Rollnick, S. (2013). Motivational interviewing in medical care settings: A systematic review and meta-analysis of randomized controlled trials. Patient Education and Counseling, 93, 157–168.CrossRefPubMedGoogle Scholar
  13. Malanda, U. L., Welschen, L. M., Riphagen, II, Dekker, J. M., Nijpels, G., & Bot, S. D. (2012). Self-monitoring of blood glucose in patients with type 2 diabetes mellitus who are not using insulin. Cochrane Database of Systematic Reviews, 1, CD005060.Google Scholar
  14. Markland, D., Ryan, R. M., Tobin, V. J., & Rollnick, S. (2005). Motivational interviewing and self-determination theory. Journal of Social and Clinical Psychology, 24, 811–831.CrossRefGoogle Scholar
  15. Meis, J. J., Kremers, S. P., & Bouman, M. P. (2012). Television viewing does not have to be sedentary: Motivation to participate in a TV exercise program. Journal of Obesity, 2012, 752820.Google Scholar
  16. National Institute for Public Health and the Environment. (2011). ‘Nederland de maat genomen 2009–2012’. Monitoring van risicofactoren in de algemene bevolking. [‘Nederland de maat genomen 2009–2010’. Monitoring of risk factors in the general population.] Bilthoven: National Institute for Public Health and the Environment.Google Scholar
  17. Netherlands Diabetes Federation. (2007). NDF Zorgstandaard. Transparantie en kwaliteit van diabeteszorg voor mensen met diabetes type 2. [NDF Care Standard. Transparacny and quality of diabetescare for people with diabetes type 2.] Amersfoort: Netherlands Diabetes Federation.Google Scholar
  18. Ng, J. Y. Y., Ntoumanis, N., Thøgersen-Ntoumani, C., Deci, E. L., Ryan, R. M., Duda, J. L., & Williams, G. C. (2012). Self-determination theory applied to health contexts: A meta-analysis. Perspectives on Psychological Science, 7, 325.CrossRefGoogle Scholar
  19. Norris, S. L., Engelgau, M. M., & Narayan, K. M. (2001). Effectiveness of self-management training in type 2 diabetes: A systematic review of randomized controlled trials. Diabetes Care, 24, 561–587.CrossRefPubMedGoogle Scholar
  20. Pollak, K. I., Alexander, S. C., Tulsky, J. A., Lyna, P., Coffman, C. J., Dolor, R. J., & Ostbye, T. (2011). Physician empathy and listening: Associations with patient satisfaction and autonomy. The Journal of the American Board of Family Medicine, 24, 666–674.CrossRefGoogle Scholar
  21. Reed, J. A., Ashton, H., Hollinghurst, S., & Higgs, E. R. (2003). Diabetes self management: How are we doing? Practical Diabetes International, 20, 318–322.CrossRefGoogle Scholar
  22. Resnicow, K., & McMaster, F. (2012). Motivational Interviewing: Moving from why to how with autonomy support. The international Journal of Behavioral Nutrition and Physical Activity, 9, 19.CrossRefPubMedCentralPubMedGoogle Scholar
  23. Ryan, R. M., & Deci, E. L. (2000). Self-determination theory and the facilitation of intrinsic motivation, social development, and well-being. American Psychology, 55, 68–78.CrossRefGoogle Scholar
  24. Senecal, C., Nouwen, A., & White, D. (2000). Motivation and dietary self-care in adults with diabetes: Are self-efficacy and autonomous self-regulation complementary or competing constructs? Health Psychology, 19, 452–457.CrossRefPubMedGoogle Scholar
  25. Shigaki, C., Kruse, R. L., Mehr, D., Sheldon, K. M., Bin, G., Moore, C., & Lemaster, J. (2010). Motivation and diabetes self-management. Chronic Illness, 6, 202–214.CrossRefPubMedGoogle Scholar
  26. Sobel, M. E. (1982). Asymptotic confidence intervals for indirect effects in structural equation models. Sociological Methodology, 13, 290–312.CrossRefGoogle Scholar
  27. Toobert, D. J., Hampson, S. E., & Glasgow, R. E. (2000). The sunmmary of diabetes self-care activities measure. Diabetes Care, 23, 943–950.CrossRefPubMedGoogle Scholar
  28. Vansteenkiste, M., Williams, G. C., & Resnicow, K. (2012). Toward systematic integration between self-determination theory and motivational interviewing as examples of top-down and bottom-up intervention development: Autonomy or volition as a fundamental theoretical principle. International Journal of Behavioral Nutrition and Physical Activity, 9(23), 1–11.Google Scholar
  29. Verweij, A. (2008). Scholing en opleiding: Indeling opleidingsniveau. [Education and training: categorization of educational levels]. Bilthoven: National Institute for Public Health and the Environment.Google Scholar
  30. Williams, G. C., Freedman, Z. R., & Deci, E. L. (1998a). Supporting autonomy to motivate patients with diabetes for glucose control. Diabetes Care, 21, 1644–1651.CrossRefPubMedGoogle Scholar
  31. Williams, G. C., Gagné, M., Mushlin, A. I., & Deci, E. L. (2002a). Motivation for behavior change in patients with chest pain. Health Education Research, 105, 304–321.CrossRefGoogle Scholar
  32. Williams, G. C., Gagne, M., Ryan, R. M., & Deci, E. L. (2002b). Facilitating autonomous motivation for smoking cessation. Health Psychology, 21, 40–50.CrossRefPubMedGoogle Scholar
  33. Williams, G. C., Grow, V. M., Freedman, Z., Ryan, R. M., & Deci, E. L. (1996). Motivational predictors of weight loss and weight-loss maintenance. Journal of Personality and Social Psychology, 70, 115–126.CrossRefPubMedGoogle Scholar
  34. Williams, G. C., McGregor, H. A., King, D., Nelson, C. C., & Glasgow, R. E. (2005). Variation in perceived competence, glycemic control, and patient satisfaction: Relationship to autonomy support from physicians. Patient Education and Counseling, 57, 39–45.CrossRefPubMedGoogle Scholar
  35. Williams, G. C., McGregor, H. A., Zeldman, A., Freedman, Z. R., & Deci, E. L. (2004). Testing a self-determination theory process model for promoting glycemic control through diabetes self-management. Health Psychology, 23, 58–66.CrossRefPubMedGoogle Scholar
  36. Williams, G. C., Patrick, H., Niemiec, C. P., Williams, L. K., Divine, G., Lafata, J. E., & Pladevall, M. (2009). Reducing the health risks of diabetes: How self-determination theory may help improve medication adherence and quality of life. Diabetes Education, 35, 484–492.CrossRefGoogle Scholar
  37. Williams, G. C., Rodin, G. C., Ryan, R. M., Grolnick, W. S., & Deci, E. L. (1998b). Autonomous regulation: the motivational basis of adherence to medical regimens. Health Psychology, 17, 269–276.CrossRefPubMedGoogle Scholar
  38. World Health Organization. (2011). BMI classification. from http://apps.who.int/bmi/index.jsp?introPage=intro_3.html
  39. World Health Organization. (2013). Factsheet diabetes. http://www.who.int/mediacentre/factsheets/fs312/en/index.html
  40. Windows, I. S. S. F. (Version 20.0). In I. Corporation (Ed.). Armonk, New York.Google Scholar

Copyright information

© Springer Science+Business Media New York 2015

Authors and Affiliations

  • Lieke G. M. Raaijmakers
    • 1
    Email author
  • Marloes K. Martens
    • 2
  • Charlotte Bagchus
    • 3
  • Inge de Weerdt
    • 4
  • Nanne K. de Vries
    • 5
  • Stef P. J. Kremers
    • 1
  1. 1.Department of Health Promotion, NUTRIM School for Nutrition, Toxicology and MetabolismMaastricht University Medical CentreMaastrichtThe Netherlands
  2. 2.ResCon, Research and ConsultancyHaarlemThe Netherlands
  3. 3.Athena InstituteVU UniversityAmsterdamThe Netherlands
  4. 4.Netherlands Diabetes FederationAmersfoortThe Netherlands
  5. 5.Caphri, School for Primary Care and Public HealthMaastricht University Medical CentreMaastrichtThe Netherlands

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