Associations of Self-Management Care and Shared Decision-Making with Glycemic Control and Psychosocial Outcomes in Type 2 Diabetes Mellitus.

IF 2 3区医学 Q2 MEDICINE, GENERAL & INTERNAL

Patient preference and adherence Pub Date : 2025-08-02 eCollection Date: 2025-01-01 DOI:10.2147/PPA.S534066

Mu'taman Jarrar, Mohammad Al-Bsheish, Bashair Khalid Alshahri, Manar Abdulrahman Bamashmoos, Mona I Alnaimi, Shaykhah A Alsayil, Shymaa A Basager, Mohammad Ahmad Al Rawashdeh, Ahmad Bahjat Al-Rawashdeh

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引用次数: 0

Abstract

Purpose: This study explored the associations of Self-Management Care (SMC) and Shared Decision-Making (SDM) with clinical outcomes, specifically glycated hemoglobin (HbA1c) levels, and non-clinical outcomes (psychosocial Outcomes) in patients with type 2 Diabetes Mellitus (T2DM).

Methods: A cross-sectional design was employed, involving 200 patients with T2DM, recruited through convenience sampling. Data were collected from the two healthcare facilities in Dammam, Saudi Arabia, between March and June 2020. Statistical analyses, including independent sample t-tests, one-way ANOVA, and multiple linear regression, were conducted using Statistical Package for the Social Sciences (SPSS) version 26.0.

Results: The findings showed that Increased SMC levels were associated with improved clinical outcomes, particularly lower HbA1c levels (p < 0.01). Additionally, SMC was positively associated with psychosocial outcomes (ie, quality of life and mental health; p < 0.05). In contrast, SDM was significantly associated with psychosocial outcomes (p < 0.05), its relationship with HbA1c was non-significant (p= 0.300), indicating only a minor explanatory effect. Additionally, demographic and clinical factors such as sex and lipid levels were found to influence glycemic outcomes, with males and patients with better lipid profiles showing lower HbA1c levels.

Conclusion: This study reinforces the pivotal role of SMC in achieving optimal glycemic control and improving the overall well-being of T2DM patients. While shared decision-making (SDM) enhances patient-reported outcomes, its impact on clinical outcomes such as HbA1c was not statistically significant. These findings support patient-centered approaches and highlight the need for further longitudinal research to confirm causal relationships. The results highlight the value of integrating comprehensive self-management support and patient-centered decision-making in diabetes care to optimize both clinical and psychosocial outcomes for patients.

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自我管理护理和共同决策与2型糖尿病患者血糖控制和社会心理结局的关系

目的：本研究探讨自我管理护理（SMC）和共同决策（SDM）与2型糖尿病（T2DM）患者临床结局，特别是糖化血红蛋白（HbA1c）水平和非临床结局（社会心理结局）的关系。方法：采用横断面设计，采用方便抽样方法招募200例T2DM患者。数据于2020年3月至6月期间从沙特阿拉伯达曼的两家卫生保健机构收集。统计分析采用SPSS 26.0版本进行，包括独立样本t检验、单因素方差分析和多元线性回归。结果：研究结果显示，SMC水平升高与临床结果改善相关，特别是HbA1c水平降低（p < 0.01）。此外，SMC与社会心理结果(即生活质量和心理健康；P < 0.05)。相比之下，SDM与心理社会结局显著相关（p < 0.05），其与HbA1c的关系不显著（p= 0.300），表明只有较小的解释作用。此外，人口统计学和临床因素，如性别和脂质水平也会影响血糖结局，男性和脂质较好的患者的HbA1c水平较低。结论：本研究强调了SMC在实现最佳血糖控制和改善T2DM患者整体健康方面的关键作用。虽然共同决策（SDM）增强了患者报告的结果，但其对临床结果（如HbA1c）的影响没有统计学意义。这些发现支持以患者为中心的方法，并强调需要进一步的纵向研究来确认因果关系。结果强调了综合自我管理支持和以患者为中心的决策在糖尿病护理中的价值，以优化患者的临床和社会心理结局。

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来源期刊

Patient preference and adherence MEDICINE, GENERAL & INTERNAL-

CiteScore

3.60

自引率

4.50%

发文量

354

审稿时长

6-12 weeks

期刊介绍： Patient Preference and Adherence is an international, peer reviewed, open access journal that focuses on the growing importance of patient preference and adherence throughout the therapeutic continuum. The journal is characterized by the rapid reporting of reviews, original research, modeling and clinical studies across all therapeutic areas. Patient satisfaction, acceptability, quality of life, compliance, persistence and their role in developing new therapeutic modalities and compounds to optimize clinical outcomes for existing disease states are major areas of interest for the journal. As of 1st April 2019, Patient Preference and Adherence will no longer consider meta-analyses for publication.