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Frontiers of Medicine

ISSN 2095-0217

ISSN 2095-0225(Online)

CN 11-5983/R

Postal Subscription Code 80-967

2018 Impact Factor: 1.847

Front. Med.    2016, Vol. 10 Issue (2) : 219-227     DOI: 10.1007/s11684-016-0441-3
RESEARCH ARTICLE |
Perceived resource support for chronic illnesses among diabetics in north-western China
Huiqin Zhong1,2,Ya Shao2,Ling Fan3,Tangshen Zhong1,Lu Ren1,Yan Wang1,*()
1. Department of Nursing, School of Medicine, Shihezi University, Shihezi 832003, China
2. Taihe Hospital, Hubei University of Medicine, Shiyan 442000, China
3. The First Affiliated Hospital of School Medicine, Shihezi University, Shihezi 832000, China
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Abstract  

A high level of social support can improve long-term diabetes self-management. Support from a single source has been evaluated. This study aims to analyze support from multiple and multilevel sources for diabetic patients by using the Chronic Illness Resources Survey (CIRS). Factors influencing the utilization of the CIRS were also evaluated. A total of 297 patients with diabetes were investigated using the CIRS and Perceived Diabetes Self-management Scale in Shihezi City, China. Descriptive statistics were used to explain demographic variables and scores of the scales. Factors affecting the utilization of chronic illness resources were determined through univariate analysis and then examined by multivariate logistic regression analysis. Of the 297 diabetic patients surveyed, 67% failed to reach the standard (more than 3 points) of utilizing chronic illness resources. Moreover, utilization of chronic illness resources was positively moderately correlated with self-management of diabetes (r = 0.75, P <0.05). According to the multivariate logistic regression analysis, age (OR, 3.42; 95%CI, 1.19–9.84) and monthly income (OR, 5.27; 95%CI, 1.86–14.90) were significantly positively associated with the CIRS score. Individuals with high school (OR, 2.61; 95%CI, 1.13–6.05) and college (OR, 3.02; 95%CI, 1.13–8.04) degrees obtained higher scores in the survey than those with elementary school education. Results indicated that utilization of resources and support for chronic illness self-management, particularly personal adjustment and organization, were not ideal among diabetics in the communities of north-western China. Improved utilization of chronic illness resources was conducive for proper diabetes self-management. Furthermore, the level of utilization of chronic illness resources increased with age, literacy level, and monthly income.

Keywords chronic illness resources survey      diabetes      community      north-western China     
Corresponding Authors: Yan Wang   
Just Accepted Date: 29 March 2016   Online First Date: 13 April 2016    Issue Date: 27 May 2016
URL:  
http://academic.hep.com.cn/fmd/EN/10.1007/s11684-016-0441-3     OR     http://academic.hep.com.cn/fmd/EN/Y2016/V10/I2/219
Variables N Mean SD Percent (%)
Gender
Male 123 41.4
Female 174 58.6
Age (year) 67.67 9.54
Education
Elementary school or less 135 45.4
Secondary education 87 29.3
High school 40 13.5
College 35 11.7
Marital status
Married 254 85.5
Divorced 8 2.7
Widowed 35 11.8
Incomes
Less than 3000 RMB 167 56.2
3000?5000 RMB 107 36.4
More than 5000 RMB 22 7.4
Type of diabetes
Type 1 12 4.0
Type 2 285 96.0
Duration (year) 9.83 6.54
Therapy
Non-medicine treatment 13 4.4
Oral medicine 179 60.3
Insulin 52 17.5
Oral medicine and insulin 53 17.8
Family history of diabetes
Yes 72 24.2
No 225 75.8
Tab.1  Description of demographic and diabetes-related variables
Scale or subscale Mean SD <3 points [n ( %)] ≥3 points [n ( %)]
CIRS
Personal 2.78 0.93 135 (45.45) 162 (54.55)
Family and friends 3.33 0.99 62 (20.88) 235 (79.12)
Health care team 3.18 0.84 73 (24.58) 224 (75.42)
Neighborhood/community 2.94 0.87 152 (51.12) 145 (48.82)
Media and policy 2.83 0.98 167 (56.23) 130 (43.77)
Organizations 2.22 0.93 232 (78.11) 65 (21.89)
Total 2.88 0.62 199 (67.00) 98 (33.00)
DSCS
Exercise 3.65 1.02 61 (20.54) 236 (79.46)
Diet 3.25 0.74 88 (29.63) 209 (70.37)
Medicine 3.95 0.88 22 (7.41) 275 (92.59)
Glucose monitoring 2.96 0.87 157 (52.86) 140 (47.14)
Foot care 3.15 0.91 107 (36.03) 190 (63.97)
Deal with hyperglycemia and hypoglycemia 2.96 0.59 157 (52.86) 140 (47.14)
Total 3.35 0.59 74 (24.92) 223 (75.08)
Tab.2  Scores of CIRS and DSCS
Subscales Exercise Diet Medicine Glucose monitoring Foot care Deal with hyperglycemia and hypoglycemia DSCS
Personal 0.42 0.51 0.30 0.43 0.27 0.51 0.55
Family and friend 0.27 0.51 0.29 0.36 0.42 0.40 0.57
Health care team 0.11a 0.19 0.20 0.25 0.28 0.25 0.33
Neighborhood/community 0.66 0.40 0.25 0.32 0.27 0.40 0.56
Media and policy 0.44 0.40 0.28 0.50 0.18 0.42 0.50
Organizations 0.37 0.39 0.27 0.32 0.31 0.43 0.50
CIRS 0.56 0.60 0.40 0.55 0.43 0.60 0.75
Tab.3  Correlation between CIRS and DSCS
Character Categories Score of CIRS
Mean±SD t/F Median (P25, P75) Z/ χ2 P value
Gender Male 2.85±0.67 -0.68 0.50
Female 2.90±0.59
Age (year) <60 2.62 (2.19,3.02) 5.75 0.05
60?74 2.84 (2.53,3.28)
75?90 2.74 (2.36,3.26)
Education Elementary school or less 2.84±0.59 6.25 <0.01
Middle school 2.72±0.56
High school 3.10±0.63
College 3.15±0.73
Marital status Married 2.81 (2.45,3.30) 3.84 0.15
Divorced 2.45 (2.23,2.68)
Widowed 2.78 (2.53,3.01)
Incomes <3000 RMB 2.74±0.56 11.20 <0.01
3000?5000 RMB 3.01±0.62
>5000 RMB 3.25±0.77
Type of diabetes Type 1 2.89 (2.60,3.29) -0.65 0.52
Type 2 2.78 (2.45,3.21)
Duration (year) <5 2.68±0.53 4.83 0.01
5?10 2.89±0.66
>10 2.98±0.59
Therapy Non-medicine treatment 2.72 (2.08,2.99) 7.74 0.05
Oral medicine 2.76 (2.39,3.12)
Insulin 2.96 (2.68,3.39)
Oral medicine and insulin 2.80 (2.48,3.19)
Family history Yes 2.87±0.62 -0.10 0.92
No 2.88±0.62
Tab.4  Univariate analysis of factors influencing the utilization of chronic illness resources
Factors Control group B S.E. Wald χ2 OR (95%CI) P
Age (year) 60?74 <60 1.20 0.45 6.97 3.32 (1.36,8.09) 0.01
75?90 1.23 0.54 5.19 3.42 (1.19,9.84) 0.02
Education Middle school Elementary school 0.07 0.34 0.04 1.07 (0.55,2.07) 0.84
High school 0.96 0.43 5.00 2.61 (1.13,6.05) 0.03
College 1.10 0.50 4.88 3.02 (1.13,8.04) 0.03
Incomes (RMB) 3000?5000 <3000 0.93 0.31 9.32 2.54 (1.40,4.62) <0.01
>5000 1.66 0.53 9.83 5.27 (1.86,14.90) <0.01
Duration (year) 5?10 <5 0.47 0.38 1.51 1.60 (0.76,3.41) 0.22
>10 0.48 0.41 1.34 1.61 (0.72,3.61) 0.25
Therapy Oral drug Non-drug treatment 0.57 0.74 0.60 1.77 (0.42,7.52) 0.44
Insulin 0.94 0.78 1.45 2.57 (0.55,11.89) 0.23
Oral drug and insulin 0.86 1.17 0.04 2.37 (0.50,11.30) 0.28
Constant -3.60 0.93 14.83 0.03 <0.01
Tab.5  Multivariate logistic regression analysis of influencing factors of utilizing chronic illness resources
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