Validation of the revised Diabetes Self-Management Questionnaire (DSMQ-R) in the primary care setting

Abstract Background Available tools measuring self-management in diabetes are often improperly validated or do not correlate with glucose metabolism. The Diabetes Self-Management Questionnaire (DSMQ-R) is a valid tool, that showed strong relationship with glucose metabolism in tertiary care among people with mostly type 1 diabetes. Aim of the study To validate the translated DSMQ-R questionnaire in a Hungarian sample of people with predominantly type 2 diabetes in primary care. Methods We enrolled 492 adults from 38 practices in this cross-sectional cohort study, who filled out the self-administered questionnaire, consisting of DSMQ-R and the Summary of Diabetes Self-Care Activities (SDSCA) questionnaires. Family doctors provided clinical data. The translation process was performed in six steps, reaching the expert committee appraisal. The validity of the questionnaire was evaluated by assessing reliability and construct validity. Results Cronbach’s alpha showed the questionnaire to reach good reliability (α = 0.845), although subscales had lower alphas. Contrary to the SDSCA questionnaire, the DSMQ-R sum scale differed significantly between persons on target vs not on target (median (interquartile range): 7.23 (6.17–8.44) vs 6.91 (5.91–8.02), and the DSMQ-R sum scale correlated significantly with BMI, HbA1c and SDSCA sum scale. In multivariate analysis higher DSMQ-R scores were significant predictor of achieving glycemic target goal. Conclusion The Hungarian translation of the DSMQ-R is a comprehensible tool to assess self-management of persons with diabetes. The questionnaire is valid and reliable in family practice, although its association with achievement of diabetes HbA1c target is weaker in primary than in tertiary care.

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COPD patients need more information about self-management: a cross-sectional study in Swedish primary care

Scandinavian Journal of Primary Health Care ◽

10.1080/02813432.2019.1684015 ◽

2019 ◽

Vol 37 (4) ◽

pp. 459-467 ◽

Cited By ~ 5

Author(s):

Hanna Sandelowsky ◽

Ingvar Krakau ◽

Sonja Modin ◽

Björn Ställberg ◽

Anna Nager

Keyword(s):

Primary Care ◽

Cross Sectional Study ◽

Self Management ◽

Sectional Study ◽

Cross Sectional ◽

Copd Patients

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Self-management support for chronic pain in primary care: a cross-sectional study of patient experiences and nursing roles

Journal of Advanced Nursing ◽

10.1111/jan.12717 ◽

2015 ◽

Vol 71 (11) ◽

pp. 2551-2562 ◽

Cited By ~ 13

Author(s):

Julia Lukewich ◽

Elizabeth Mann ◽

Elizabeth VanDenKerkhof ◽

Joan Tranmer

Keyword(s):

Primary Care ◽

Chronic Pain ◽

Cross Sectional Study ◽

Patient Experiences ◽

Self Management ◽

Management Support ◽

Sectional Study ◽

Cross Sectional ◽

Nursing Roles

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EVALUATION OF DIABETES SELF-MANAGEMENT EDUCATION IN PATIENTS WITH CONCOMITANT CHRONIC KIDNEY DISEASE

Wiadomości Lekarskie ◽

10.36740/wlek202010112 ◽

2020 ◽

Vol 73 (10) ◽

pp. 2170-2174

Author(s):

Oleksii M. Korzh

Keyword(s):

Primary Care ◽

Primary Care Physicians ◽

Management Training ◽

Cross Sectional Study ◽

Self Management ◽

Average Score ◽

Cross Sectional ◽

Self Monitoring ◽

Diabetes Educators

The aim: Was to evaluate the quality of DSME provided by primary care physicians to people with diabetes mellitus. Materials and methods: A descriptive cross-sectional study was conducted among 120 primary care physicians. The quality of diabetes self-management training provided by physicians was assessed on a personal scale of 39 Likert questions obtained from the American Association of Diabetes Educators in seven areas of diabetes self-monitoring. The Cronbach’s reliability coefficient for each domain / subscale was ≥ 0.7. The data were analyzed using an independent selective t-test and one-way ANOVA. Results: More than half of the doctors provided “inadequate quality” of diabetes self-management in all areas. Doctors had the highest average score in the domain of “drug intake” (4.46 ± 0.61). Average scores in the “problem-solving domain” (3.52 ± 0.63) and “ being active domain” (3.46 ± 0.75) were low. The quality of DSME provided by physicians was not related to any of the characteristics of the physician. Conclusions: The quality of doctors’ communication on DSME in this study was suboptimal. Most adequately informed cases of diabetic behavior associated with self-management have been associated with reduced risk factors and an orientation towards disease. Thus, training of primary care physicians in diabetic self-management is recommended because of the key role that these doctors play in managing diabetes.

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Monitoring the Dissemination of an Educational Protocol on Pediatric Asthma in Family Practice: A Test of Associations between Dissemination Variables

Health Education & Behavior ◽

10.1177/109019819902600109 ◽

1999 ◽

Vol 26 (1) ◽

pp. 103-120 ◽

Cited By ~ 23

Author(s):

Ilse Mesters ◽

Ree M. Meertens

Keyword(s):

Primary Care ◽

Diffusion Of Innovation ◽

Family Practice ◽

Family Physicians ◽

Self Management ◽

Education Programs ◽

Cross Sectional ◽

Diffusion Of Innovation Theory ◽

Perceived Success ◽

Continued Use

Many asthma education programs aim at reducing morbidity. Now that effective programs are available, the next step is the nationwide dissemination to achieve morbidity reduction. A dissemination of a tested program has been undertaken in Dutch primary care, guided by the Diffusion of Innovation theory. It was hypothesized that greater awareness and concern and/or receptivity about asthma self-management would make it more likely that family physicians would adopt the program. Family physicians were considered more likely to adopt the program if they saw it as an improvement on their current way of providing education, as easy to use, and as having observable outcomes. It was expected that once the program had been adopted, and as it was being implemented, it would increasingly be perceived by its users as successful. Finally, more perceived success of performance was expected to be related to continued use. Both longitudinal and cross-sectional data largely confirmed the hypotheses.

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Diabetes distress in Indonesian patients with type 2 diabetes: a comparison between primary and tertiary care

BMC Health Services Research ◽

10.1186/s12913-019-4515-1 ◽

2019 ◽

Vol 19 (1) ◽

Cited By ~ 2

Author(s):

Bustanul Arifin ◽

Antoinette D. I. van Asselt ◽

Didik Setiawan ◽

Jarir Atthobari ◽

Maarten J. Postma ◽

...

Keyword(s):

Primary Care ◽

Tertiary Care ◽

Demographic Characteristics ◽

Diabetes Distress ◽

Cross Sectional ◽

Healthcare Facilities ◽

Increased Risk ◽

Clinical Conditions ◽

Distress Scale ◽

Bahasa Indonesia

Abstract Background The number of people living with diabetes mellitus (DM) in Indonesia has continued to increase over the last 6 years. Four previous studies in U.S have found that higher DD scores were associated with worse psychological outcomes, lower health-related quality of life (HRQoL) and increased risk of T2DM complications. In this study, we aimed to firstly compare DD scores in Indonesian T2DM outpatients treated in primary care versus those in tertiary care. Subsequently, we investigated whether socio-demographic characteristics and clinical conditions explain potential differences in DD score across healthcare settings. Methods A cross-sectional study was conducted on Java island in three primary care (n = 108) and four tertiary care (n = 524) facilities. The participants completed the Bahasa Indonesia version of the Diabetes Distress Scale questionnaire (DDS17 Bahasa Indonesia). Ordinal regression analysis was conducted with the quartile of the summation of the DD score as the dependent variable to investigate how the association between the level of healthcare facilities and DD altered when adding different variables in the model. Results The final adjusted model showed that the level of healthcare facilities was strongly associated with DD (p < .001), with participants in primary care having a 3.68 times (95% CI 2.46–5.55) higher likelihood of being more distressed than the participants in tertiary care. This association was detected after including the socio-demographic characteristics and clinical conditions as model confounders. Conclusions This is the first study in Indonesia to compare DD scores within different healthcare facilities. We recommend a regular DD assessment, possibly closely aligned with health-literacy partner programs, especially for T2DM patients in primary care settings.

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Protocol for a cross-sectional study measuring person-centredness among healthcare providers in Malaysian primary care clinics: the adaptation and validation of the Person-Centred Practice Inventory-Staff (PCPI-S) Questionnaire

BMJ Open ◽

10.1136/bmjopen-2019-034128 ◽

2020 ◽

Vol 10 (3) ◽

pp. e034128 ◽

Cited By ~ 1

Author(s):

Nur Zahirah Balqis-Ali ◽

Pui San Saw ◽

Anis Syakira Jailani ◽

Tze Wei Yeoh ◽

Weng Hong Fun ◽

...

Keyword(s):

Primary Care ◽

Cultural Context ◽

Healthcare Providers ◽

Internal Validity ◽

Cross Sectional Study ◽

Ethics Committee ◽

Expert Committee ◽

Cross Sectional ◽

Primary Care Clinics ◽

Human Research Ethics

IntroductionPerson-centred care (PCC) has become a global movement in healthcare. Despite this, the level of PCC is not routinely assessed in clinical practice. This protocol describes the adaptation and validation of the Person-Centred Practice Inventory-Staff (PCPI-S) tool that will be used to assess person-centred practices of primary healthcare providers in Malaysia.Methods and analysisTo ensure conceptual and item equivalence, the original version of the PCPI-S will be reviewed and adapted for cultural context by an expert committee. The instrument will subsequently be translated into Malay language using the forward-backward translation method by two independent bilingual speaking individuals. This will be pretested in four primary care clinics and refined accordingly. The instrument will be assessed for its psychometric properties, such as test-retest reliability, construct and internal validity, using exploratory and confirmatory factor analysis.Ethics and disseminationStudy findings will be disseminated to healthcare professionals and academicians in the field through publication in peer-reviewed journals and conference presentations, as well as at managerial clinic sites for practice improvement. The study was approved by the Medical Research and Ethics Committee (MREC), Ministry of Health Malaysia (KKM/NIHSEC/ P18-766 (14) and Monash University Human Research Ethics Committee (2018-14363-19627).

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A Cross-Sectional Evaluation of Illness Perception About Asthma Among Asthma Patients at a Referral Tertiary Care Public Chest Hospital in Delhi, India

International Journal of User-Driven Healthcare ◽

10.4018/ijudh.2012070104 ◽

2012 ◽

Vol 2 (3) ◽

pp. 32-43

Author(s):

Sushil Shendge ◽

Barnali Deka ◽

Anita Kotwani

Keyword(s):

Inhaled Corticosteroids ◽

Tertiary Care ◽

Illness Perception ◽

Clinical History ◽

Self Management ◽

Cross Sectional ◽

The Public ◽

Co Morbidity ◽

Asthma Patients ◽

History Of

Adult patients visiting emergency room (March 2009-December 2009) of the public chest hospital for asthma exacerbation completed interviewer-administered questionnaires on sociodemographics, clinical history, disease beliefs, use of inhaled corticosteroids (ICS), and self-management of asthma after stabilization of their condition. Overall 87% patients believed that they had asthma when they are having symptoms, which is called as no symptoms, no asthma belief. No association was found between no symptoms, no asthma belief with gender, income, family history of asthma, and co-morbidity. Younger patients in the age group 18-29 years had four to five-fold greater odds and patients with education above 10th grade had three to four-fold greater odds of having the no symptoms, no asthma belief or the acute episodic belief. Acute episodic belief was negatively associated with beliefs about always having asthma, asthma being a serious condition, having lung inflammation, or the importance of using ICS, and was positively associated with expecting to be cured. All patients irrespective of their belief of acute or chronic nature of asthma had poor adherence to the treatment and other self-management behaviors.

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Coping Methods among Medicos during COVID-19 Pandemic in India - A Cross-Sectional Study among Medical Undergraduates in a Tertiary Care Teaching Hospital in Chennai

Journal of Evidence Based Medicine and Healthcare ◽

10.18410/jebmh/2021/256 ◽

2021 ◽

Vol 8 (19) ◽

pp. 1341-1346

Author(s):

Sree T. Sucharitha ◽

Balaji Sivaram Mahendran ◽

Chakrapani Chatla ◽

Aravind Manoharan ◽

Pradeep R

Keyword(s):

Factor Structure ◽

Tertiary Care ◽

Self Management ◽

Positive Thinking ◽

Cross Sectional ◽

French Version ◽

Coping Methods ◽

Care Teaching ◽

Medical Undergraduate ◽

Medical Undergraduates

BACKGROUND Severe acute respiratory syndrome (SARS-CoV-19) popularly known as COVID-19 is an emerging pandemic which resulted in varying degrees of lockdown in India. Medical undergraduates remain affected due to lockdown-imposed disruptions in medical education, an unprecedented event, which can cause significant academic stress in addition to psychological stress. Understanding the coping methods is essential to develop interventions and to minimise the adverse effects of stress during pandemics. We wanted to determine the major coping methods using French version of the Brief Coping Orientation to Problems Experienced (COPE), a novel 4 - factor structure among medical undergraduates of a private tertiary teaching institution during COVID-19 lockdown period and describe the selfmanagement of the stress as verbatim narrative statements. METHODS A cross-sectional, web-based survey based on French version of the Brief COPE, a novel 4-factor structure was used to assess the major coping methods among medical undergraduates of a private, tertiary care teaching medical institution in Chennai, South India. Self-management of stress was documented verbatim as narrative statements. After obtaining approval from institutional ethical committee and informed consent, the web-survey data from Google forms was collected from 223 medical undergraduate students and analysed using STATA (V 12.0) statistical package. The strategies for self-management of stress were identified and classified into themes. RESULTS Among total 223 respondents, 132 (59.2 %) were female medicos and 88 (39. 5 %) males, and mean age was 20.36 (SD +_1. 43) years. Major coping method adopted was positive thinking (115, 51.6 %), followed by avoidance (44, 19.7 %), seeking social support (37, 16.6 %) and problem solving (19, 8.5 %). Students with positive thinking had high levels of managing stress very well (33 %) followed by avoidance (10 %) compared to other methods but there was no significant difference in the self-rating of coping between different coping methods. CONCLUSIONS The coping mechanism of medical undergraduates reveals positive outlook while experiencing COVID-19 pandemic related extended lockdowns. KEYWORDS SARS-Cov-19, Medical Undergraduates, Coping, Cope Brief Inventory - 4 Scale, Positive Thinking

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Type 2 Diabetes Mellitus with Early Dry Skin Disorder: A Comparison Study between Primary and Tertiary Care in Indonesia

Current Diabetes Reviews ◽

10.2174/1573399817666210806102212 ◽

2021 ◽

Vol 17 ◽

Author(s):

Lili Legiawati ◽

Kusmarinah Bramono ◽

Wresti Indriatmi ◽

Em Yunir ◽

Aditya Indra Pratama

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Primary Care ◽

Type 2 Diabetes Mellitus ◽

Early Stage ◽

Tertiary Care ◽

Laboratory Data ◽

Dry Skin ◽

Cross Sectional

Background: The prevalence of type 2 diabetes mellitus (T2DM) in Indonesia has continued to increase over the years. Management of T2DM is challenging across clinical settings, including primary and tertiary care. Uncontrolled T2DM puts patients at risk of the development of T2DM complications, especially early-stage dry skin that is neglected by most of the patilents. This study aimed to investigate the comparison between the T2DM management profile and dry skin clinical profile of T2DM patients in primary care and tertiary care settings. Methods: The study was conducted as a cross-sectional epidemiological study by comparing T2DM patient profiles in primary and tertiary care. The data collected included sociodemographic, clinical, and laboratory data that were correlated with T2DM and early dry skin related-T2DM. This study included early dry skin within the SRRC score of 3-11 and excluded infection, ulcer, and severe erythema. Results: The patients in primary and tertiary care presented poorly controlled T2DM with median HbA1c levels of 7.8% and 7.6%. The patients in primary care also presented with high triglyceride, 179 mg/dl. Furthermore, several significant differences were found in the duration of T2DM, duration of dry skin, and DM treatment (OAD and insulin). Conclusions: Significant differences in the duration of T2DM, duration of dry skin, and DM treatment (OAD and insulin) might be affected by the parameter of T2DM glycemic control (Blood pressure (BP), body mass index (BMI), HbA1c, random blood glucose (RBG), and triglyceride).

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