Lifestyle, Diet, Self-care, and Diabetes Fatalism of Diabetic Patients with and without Diabetic Foot

Article information

Korean J Community Nutr. 2014;19(3):241-249

Publication date (electronic) : 2014 June 30

doi : https://doi.org/10.5720/kjcn.2014.19.3.241

Department of Food Science & Nutrition, Daejin University, Pocheon, Kyeonggi-do, Korea.

¹Department of Food & Nutrition, Suwon Women's Universtiy, Hwasung, Korea.

Corresponding author: Hongmie Lee. Department of Food Science & Nutrition, Daejin University, Pocheon, Kyeonggi-do 487-711, Korea. Tel: (031) 539-1862, Fax: (031) 539-1860, hmlee@daejin.ac.kr

Received 2014 February 19; Revised 2014 April 14; Accepted 2014 May 13.

Abstract

Objectives

This study was to determine diabetes fatalism of diabetic patients with and without diabetic foot and its association with lifestyle, diet, and self-care.

Methods

The subjects were diabetic patients with (male/female 48/21) and without diabetic foot (male/female 33/26). We administered the questionnaires which were designed to determine diabetes fatalism, lifestyle, diet, and self-care. Diabetes fatalism was determined by Diabetes fatalism scale (DFS), which consisted of total 12 items in three subscales namely, emotional stress, religiou.spiritual coping, and perceived self-efficacy.

Results

The patients with diabetic foot had undesirable diets more frequently (1.37 and 0.91 days/week respectively) and their desirable diets (2.74 and 3.61 days/week respectively) and foot care (4.61 and 5.53 days/week respectively) were less frequent than those without diabetic foot (p < 0.05). An item analysis of the 12 DFS items revealed a Chronbach' α of 0.614 and 0.869, respectively in diabetic patients with and without diabetic foot. Perceived self-efficacy related DFS of subjects without diabetic foot was positively associated with smoking (r = 0.350, p < 0.01), undesirable diet (r = 0.295, p < 0.05), and drinking (r = 0.257, p < 0.05), while its negative association with exercise (r = -0.224, p < 0.088) and foot care (r = -0.247, p < 0.059) did not reach to statistical significance.

Conclusions

This work was the first study reporting the potential usefulness of DFS, especially perceived self-efficacy related subscale as a predictor of lifestyle, diet and self-care on the Korean diabetic patients, at least those without severe diabetic foot to screen those who should be the first target for diabetes education.

Keywords: diabetes fatalism; lifestyle; diet; diabetic foot; foot care

References

1. Aljasem LI, Peyrot M, Wissow L, Rubin RR. The impact of barriers and self-efficacy on self-care behaviors in type 2 diabetes. Diabetes Educ 2001;27(3):393–404.

2. Bains SS, Edege LE. Associations between health literacy, diabetes knowledge, self-care behaviors, and glycemic control in a low income population with type 2 diabetes. Diabetes Technol Ther 2011;13:335–341.

3. Choi JH. Lifestyle, diet, and diabetes fatalism of patients with diabetic foot Daejin University; 2014. 7. MS thesis.

4. Chung CH, Kim DJ, Kim JY, Kim HY, Min KW, Park SW, Park JH, Baik SH, Son HS, Ahn CW, Oh JY, Lee SH, Lee JY, Choi KM, Choi IJ, Park IB. Current status of diabetic foot in Korean patients using national health insurance database. J Korean Diabetes Assoc 2006;30(5):372–376.

5. Whiting DR, Guariguata L, Weil C, Shaw J. IDF diabetes atlas: global estimates of the prevalence of diabetes for 2011 and 2030. Diabetes Res Clin Pract 2011;94(3):311–321.

6. Delamater AM, Jacobson AM, Anderson B, Cox D, Fisher L, Lustman P, Rubin R, Wysocki T. Psychosocial therapies in diabetes: report of the psychosocial therapies working group. Diabetes Care 2001;24(7):1286–1292.

7. Egede LE, Ellis C. Development and psychometric properties of the 12-item diabetes fatalism scale. J Gen Intern Med 2009;25(1):61–66.

8. Han SS, Lee SC. Nursing and Health statistical analysis Seoul: Hannarae Academy; 2012. p. 279.

9. International Diabetes Federation. IDF Diabetes Atlas 5th edth ed. Brussels, Belgium: International Diabetes Federation; 2011.

10. Jang SM, Choi KA, Yoo HJ. Alcohol drinking problems anddiabetes self-care in male diabetes. J Korean Diabetes Assoc 2004;28(2):139–148.

11. Korean Society for the Study of Obesity. WHO/IASO/IOTF: The Asia-Pacific perspective : Redefining obesity and its treatment 2000.

12. Kwon YJ, Han KA, Sung SK, Yoo HJ. A clinical study on the diabetic foot lesions. J Korean Diabetes Assoc 1989;13(1):39–45.

13. Lee JH, Chung CH. Diabetic foot: Past and present. J Korean Diabetes 2011;12(2):69–71.

14. Lee JR. Lifestyle modification and diabetes management. J Korean Diabetes 2011;12(4):215–218.

15. Lee YR, Kang MA, Kim PG. The effects of an admissioneducation program on knowledge, self-efficacy, self-care and glucose control in type 2 diabetes patients. J Korean Acad Soc Nurs Educ 2008;14(1):12–19.

16. Ministry of Health & Welfare. Korea Centers for Disease Control & Prevention. Korea Health Statistics 2011 : Korea National Health and Nutrition Examination Survey (KNHANES V-2) 2012. cited June 27, 2013. Available from http://knhanes.cdc.go.kr/.

17. Osborn CY, Bains SS, Egede LE. Health literacy, diabtes selfcare, and glycemic control in adults with type 2 diabetes. Diabetes Technol Ther 2010;12(11):913–919.

18. Park BS, Jin GN, Choi YC, Chung JH, Koh JH, Chung CH. Self-management and health-related quality of life in adolescent and adulthood diabetic patients. J Korean Diabetes Assoc 2005;29(3):254–261.

19. Park JY, Ko IS. Development of a comprehensive selfmanagement program promoting self efficacy for type 2 diabetic patients. J Korean Acad Fundam Nurs 2012;19(1):74–86.

20. The Korean Diabetes Association. Preventive foot care in diabetes. Clin Diabetes 2005;6(3,4):192–194.

21. Toobert DJ, Hampson SE, Glasgow RE. The summary of diabetes self-care activities measure: results from 7 studies and a revised scale. Diabetes Care 2000;23(7):943–950.

22. Yoo JW. What is needed for early detection of diabetes complications? J Korean Diabetes 2013;14(1):32–35.

23. Walker RJ, Smalls BL, Hernandez-Tejada MA, Campbell JA, Davis KS, Egede LE. Effect of diabetes fatalism on medication adherence and self-care behaviors in adults with diabetes. Gen Hosp Psychiatry 2012;34(6):598–603.

24. Wycherley TP, Mohr P, Noakes M, Clifton PM, Brinkworth GD. Self-reported facilitators of, and impediments to maintenance of healthy lifestyle behaviors following a supervised research-based lifestyle intervention programme in patients with type 2 diabetes. Diabet Med 2012;29(5):632–639.

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Table 1

General characteristics of diabetes patients with and without diabetic foot

1) Mean ± SD

2) Range

3) N (%)

4) Weight status

Under weight: < 18.5, Normal weight: 18.5~22.9, Overweight: 23~24.9, Obese: ≥ 25

^**: p < 0.01 by paired t-test or chi-square test

Table 2

Lifestyle, diet and diabetes self-care behaviors of patients with and without diabetic foot

1) Mean ± SD (times/week)

2) N (%)

^*: p < 0.05, ^**: p < 0.01 by paired t-test

Table 3

Item wording and descriptive statistics of diabetes fatalism scale in subjects with and without diabetes foot

Items 6 through 12 are reversely scored, so that high score equals high diabetes fatalism.

All items scored so that high score equals high diabetes fatalism.

Table 4

Diabetes fatalism scale of diabetes patients with and without diabetic foot

1) Items 6 through 12 are reversely scored, so that high score equals high diabetes fatalism.

2) Mean ± SD

^*: p < 0.05, ^**: p < 0.01 by paired t-test

Table 5

Correlations between diabetes fatalism scales and lifestyles, diet, and diabetes self-care behaviors

1) Analyzed only in smokers

^*: p < 0.05, ^**: p < 0.01 by Pearson's correlation coefficient