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Pathways of emotional autonomy, problem‐solving ability, self‐efficacy, and self‐management on the glycemic control of adolescents with type 1 diabetes: A prospective study
Author(s) -
Chen ChiaYing,
Lo FuSung,
Shu ShaoHui,
Wang RueyHsia
Publication year - 2021
Publication title -
research in nursing and health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.836
H-Index - 85
eISSN - 1098-240X
pISSN - 0160-6891
DOI - 10.1002/nur.22162
Subject(s) - glycemic , glycated hemoglobin , structural equation modeling , self efficacy , baseline (sea) , mediation , self management , autonomy , prospective cohort study , psychology , medicine , clinical psychology , type 2 diabetes , diabetes mellitus , developmental psychology , social psychology , endocrinology , statistics , oceanography , mathematics , machine learning , geology , political science , computer science , law
This prospective study tested a model to depict associations between a number of individual characteristics and 6‐month glycated hemoglobin (HbA1c) levels in adolescents with type 1 diabetes (T1D). Adolescents ( N = 232) aged 10–19 years with T1D were recruited from a medical center in Taiwan. Demographic characteristics, emotional autonomy, problem‐solving ability, self‐efficacy at baseline, and self‐management information three months after baseline were collected using a self‐reported questionnaire. HbA1c levels 6 months after study commencement were obtained from medical records. Structural equation modeling was used to test the model. Higher baseline self‐efficacy and self‐management at 3 months were directly associated with lower 6‐month HbA1c levels. Higher baseline problem‐solving ability and self‐efficacy were directly associated with higher 3‐month self‐management, and higher baseline problem‐solving ability was directly associated with higher baseline self‐efficacy. Higher baseline emotional autonomy was directly associated with lower 6‐month HbA1c levels but indirectly associated with higher 6‐month HbA1c levels through the mediation of lower problem‐solving ability, self‐efficacy, and 3‐month self‐management. Findings indicate that improving self‐management is essential to improving subsequent glycemic control, which might be achieved by enhancing problem‐solving ability and self‐efficacy. Strengthening problem‐solving ability could diminish the negative impact of emotional autonomy on subsequent glycemic control in adolescents with T1D.