Beliefs, knowledge, and the self-management of diabetes

Abstract

Insulin-dependent diabetes mellitus (IDDM) is a chronic metabolic condition that is increasing in prevalence. It can be difficult to control and has an appreciable morbidity and mortality rate. The daily management of diabetes is generally considered to be the responsibility of diabetic individuals. Some individuals are more successful in the management of their condition than others, but the reasons for this remain unclear.

This study aimed to investigate the influence of perceived locus of control, health beliefs, and knowledge upon the practice and outcome of diabetic self-management. Both quantitative and qualitative inquiry were involved. Scales were used to assess locus of control and health beliefs, while knowledge was assessed by a questionnaire in 264 adults with IDDM aged between 18 and 35 years. Clinical details relating to control and clinic attendance for a two-year period were drawn from medical records. Qualitative data was gathered through semi-structured interviews from a sub-sample of twenty people.

The results indicated that none of the variables concerning beliefs or knowledge had a demonstrable effect upon clinic attendance or glycosylated haemoglobin levels, the chosen outcomes. The mean glycosylated haemoglobin level was above the normal range, which may be detrimental to future health. The diabetic outpatient clinic was not attended as frequently as recommended. However, hospital admissions for treatment of diabetes and the development of diabetic complications were low.

The reliability and validity of the measurement instruments were investigated, and the accuracy of these instruments is reported. The interview data confirmed that self-management of diabetes is complex, and that psychological and social factors must be taken into account for successful management.

These results have implications for individuals who work with diabetic people and those with other chronic conditions. Furthermore, the findings have implications for future research in terms of instrument development and methods of inquiry.

Date of Award	1993
Original language	English