Donna Zulman

Publication Details

  • The influence of diabetes psychosocial attributes and self-management practices on change in diabetes status PATIENT EDUCATION AND COUNSELING Zulman, D. M., Rosland, A., Choi, H., Langa, K. M., Heisler, M. 2012; 87 (1): 74-80


    To examine the influence of diabetes psychosocial attributes and self-management on glycemic control and diabetes status change.Using data from the Health and Retirement Study, a nationally representative longitudinal study of U.S. adults >51 years, we examined cross-sectional relationships among diabetes psychosocial attributes (self-efficacy, risk awareness, care understanding, prioritization of diabetes, and emotional distress), self-management ratings, and glycemic control. We then explored whether self-management ratings and psychosocial attributes in 2003 predicted change in diabetes status in 2004.In multivariate analyses (N=1834), all diabetes psychosocial attributes were associated with self-management ratings, with self-efficacy and diabetes distress having the strongest relationships (adj coeff=8.1, p<0.01 and -4.1, p<0.01, respectively). Lower self-management ratings in 2003 were associated cross-sectionally with higher hemoglobin A1C (adj coeff=0.16, p<0.01), and with perceived worsening diabetes status in 2004 (adj OR=1.36, p<0.05), with much of this latter relationship explained by diabetes distress.Psychosocial attributes, most notably diabetes-related emotional distress, contribute to difficulty with diabetes self-management, poor glycemic control, and worsening diabetes status over time.Self-management and adherence interventions should target psychosocial attributes such as disease-related emotional distress.

    View details for DOI 10.1016/j.pec.2011.07.013

    View details for Web of Science ID 000303182000013

    View details for PubMedID 21840149

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