Date of Award
Spring 2008
Document Type
Dissertation - Restricted
Degree Name
Doctor of Philosophy (PhD)
Department
Nursing
First Advisor
Miller, Judith A.
Second Advisor
Shaw, Christine
Third Advisor
Lough, Mary Ann
Abstract
The impact of type 2 diabetes continues to escalate in the United States. The estimated number of those diagnosed with the disease has more than doubled, from 5.8 million to 14.6 million over the past several years. Living well with diabetes and having maximum self-management requires multiple skill development, a positive expectation about outcomes, and self-confidence in one's own ability. The influence of select factors on diabetes control including self-efficacy and outcome expectation and their relationship to self-care is not well known. The purpose of this predictive study was to examine the relationships of self-efficacy, outcome expectation, and self-care behavior on glycosylated hemoglobin level in persons with type 2 diabetes. Identifying the predictive relationships of the study variables should enhance the patient's and the nurse's understanding about factors associated with diabetes control as measured by glycosylated hemoglobin level. Bandura's Self-Efficacy Model provides a structure for understanding the interrelated relevant variables of self-efficacy, outcome expectation, self-care behavior and their impact on the outcome, glycosylated hemoglobin level. A convenience sample of 100 participants, who met the inclusion criteria of: (a) 25-75 years of age, (b) established diagnosis of type 2 diabetes greater than 6 months, (c) English speaking, literate adult, and (d) free of serious diabetes complications, was recruited for the study. All participants completed the self-report measures: The Demographic Data Questionnaire, The Diabetes Management Self-Efficacy Scale for Type 2 Diabetes, the Outcome Expectancy Questionnaire, and the Self-Care Inventory. A cross-sectional, regression analysis was used to predict the outcome of glycosylated hemoglobin level using the self-report measures, and glycosylated hemoglobin analysis. Backward deletion regressions empirically selected the combination of independent variables with the most predictive power. Self-efficacy was the only significant predictor in the model, explaining 5% of the variance on glycosylated hemoglobin level. The results of the research suggest further study is needed about diabetes self-care behavior, mechanisms to increase self-efficacy, and ultimately to identify factors requiring focused nursing interventions to improve control in persons with type 2 diabetes.