Application of structural equation modeling in assessing the self-management activities of patients with type 2 diabetes.

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  • Additional Information
    • Source:
      Publisher: Sage Publications Country of Publication: United States NLM ID: 101518419 Publication Model: Print Cited Medium: Internet ISSN: 2150-1327 (Electronic) Linking ISSN: 21501319 NLM ISO Abbreviation: J Prim Care Community Health Subsets: MEDLINE
    • Publication Information:
      Original Publication: Thousand Oaks, CA : Sage Publications
    • Subject Terms:
      Diabetes Mellitus, Type 2*/therapy ; Self-Management*; Factor Analysis, Statistical ; Humans ; Latent Class Analysis ; Middle Aged ; Pakistan ; Reproducibility of Results ; Surveys and Questionnaires
    • Abstract:
      Objective: This study aimed at assessing the self-management activities of type 2 diabetes patients using Structural Equation Modeling (SEM) which measures and analyzes the correlations between observed and latent variables. This statistical modeling technique explored the linear causal relationships among the variables and accounted for the measurement errors.
      Methods: A sample of 200 patients was recruited from the middle-aged population of rural areas of Pakistan to explore the self-management activities of type 2 diabetes patients using the validated version of the Urdu Summary of Diabetes Self-care Activities (U-SDSCA) instrument. The structural modeling equations of self-management of diabetes were developed and used to analyze the variation in glycemic control (HbA1c).
      Results: The validated version of U-SDSCA instrument showed acceptable psychometric properties throughout a consecutive reliability and validity evaluation including: split-half reliability coefficient 0.90, test-retest reliability (r = 0.918, P   ≤  .001), intra-class coefficient (0.912) and Cronbach's alpha (0.79). The results of the analysis were statistically significant (α = 0.05, P -value < .001), and showed that the model was very well fitted with the data, satisfying all the parameters of the model related to confirmatory factor analysis with chi-squared = 48.9, CFI = 0.94, TLI = 0.95, RMSEA = 0.065, SPMR = 0.068. The model was further improved once the items related to special diet were removed from the analysis, chi-squared value (30.895), model fit indices (CFI = 0.98, TLI = 0.989, RMSEA = 0.045, SPMR = 0.048). A negative correlation was observed between diabetes self-management and the variable HbA1c (r = -0.47; P  < .001).
      Conclusions: The Urdu Summary of Diabetes Self-Care Activities (U-SDSCA) instrument was used for the patients of type 2 diabetes to assess their diabetes self-management activities. The structural equation models of self-management showed a very good fit to the data and provided excellent results which may be used in future for clinical assessments of patients with suboptimal diabetes outcomes or research on factors affecting the associations between self-management activities and glycemic control.
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    • Contributed Indexing:
      Keywords: Urdu SDSCA; factor analysis; hemoglobin HbA1c; instrument; self-management; structural equation; type 2 diabetes
    • Publication Date:
      Date Created: 20201121 Date Completed: 20210624 Latest Revision: 20210624
    • Publication Date:
      20240628
    • Accession Number:
      PMC7682198
    • Accession Number:
      10.1177/2150132720974204
    • Accession Number:
      33218262