Motivation and diabetes self-management

Objective: To examine the relationship between autonomous motivation and diabetes self-care activities among individuals with diabetes. Methods: Seventy-seven individuals recruited from outpatient clinic registries (64% female, 77% Caucasian, mean age 63 years) completed measures of diabetes-related self-care (Summary of Diabetes Self-care Activities), motivation (Treatment Self-regulation Questionnaire), health literacy (Rapid Estimate of Adult Literacy in Medicine, Newest Vital Sign), health (SF-36v2), social support (Social Support Survey) and self-efficacy (Perceived Competence Scale). Results: Autonomous motivation was the only variable significantly associated with maintaining diet (p<0.0001) and blood glucose testing (p<0.04) in regression analyses. No significant associations were identified for exercise. The variable of age approached significance (p = 0.06), with older individuals being less likely to have exercised in the past week. Discussion: Individuals in this study had difficulty in maintaining self-care demands, especially exercise. Meeting recommended levels of self-care activity was challenging, even for patients with adequate levels of health literacy. Individuals with higher levels of autonomous motivation reported higher frequencies for maintaining diet and testing blood glucose, however, which supports the utility of Self-Determination Theory in promoting diabetes self-care.

[1]  B. Weiss,et al.  Quick Assessment of Literacy in Primary Care: The Newest Vital Sign , 2005, The Annals of Family Medicine.

[2]  W. Miller,et al.  Motivational interviewing: preparing people for change. , 2002 .

[3]  Eve A Kerr,et al.  The impact of comorbid chronic conditions on diabetes care. , 2006, Diabetes care.

[4]  K. Sheldon,et al.  Self-Determination Theory and Physical Health , 2003 .

[5]  D. Kavanagh,et al.  Prediction of adherence and control in diabetes , 1993, Journal of Behavioral Medicine.

[6]  Edward L. Deci,et al.  Intrinsic Motivation and Self-Determination in Human Behavior , 1975, Perspectives in Social Psychology.

[7]  E. J. Mayeaux,et al.  Rapid estimate of adult literacy in medicine: a shortened screening instrument. , 1993, Family medicine.

[8]  E. Deci,et al.  Testing a self-determination theory process model for promoting glycemic control through diabetes self-management. , 2004, Health psychology : official journal of the Division of Health Psychology, American Psychological Association.

[9]  James G Wright,et al.  The development of a comorbidity index with physical function as the outcome. , 2005, Journal of clinical epidemiology.

[10]  Judy A Shea,et al.  Association of health literacy with self-management behavior in patients with diabetes. , 2004, Diabetes care.

[11]  E. Deci,et al.  Supporting Autonomy to Motivate Patients With Diabetes for Glucose Control , 1998, Diabetes Care.

[12]  Marylène Gagné,et al.  Facilitating autonomous motivation for smoking cessation. , 2002, Health psychology : official journal of the Division of Health Psychology, American Psychological Association.

[13]  R. Glasgow,et al.  Where Is the Patient in Diabetes Performance Measures? , 2008, Diabetes Care.

[14]  C. Sherbourne,et al.  The MOS social support survey. , 1991, Social science & medicine.

[15]  Martin F. Lynch,et al.  Computer-assisted intervention improves patient-centered diabetes care by increasing autonomy support. , 2007, Health psychology : official journal of the Division of Health Psychology, American Psychological Association.

[16]  B. Weiss,et al.  Measuring adult literacy in health care: performance of the newest vital sign. , 2007, American journal of health behavior.

[17]  R. Glasgow,et al.  Diabetes Regimen Behaviors: Predicting Adherence , 1987, Medical care.

[18]  A. Bandura Health Promotion by Social Cognitive Means , 2004, Health education & behavior : the official publication of the Society for Public Health Education.

[19]  D. Schillinger,et al.  Association of health literacy with diabetes outcomes. , 2002, JAMA.

[20]  C. Sénécal,et al.  Motivation and dietary self-care in adults with diabetes: are self-efficacy and autonomous self-regulation complementary or competing constructs? , 2000, Health psychology : official journal of the Division of Health Psychology, American Psychological Association.

[21]  E. Deci,et al.  Motivational predictors of weight loss and weight-loss maintenance. , 1996, Journal of personality and social psychology.

[22]  Kennon M. Sheldon,et al.  There's nothing more practical than a good theory: integrating motivational interviewing and self-determination theory. , 2006, The British journal of clinical psychology.

[23]  E. Deci,et al.  Motivation for behavior change in patients with chest pain , 2005 .

[24]  R. Glasgow,et al.  The summary of diabetes self-care activities measure: results from 7 studies and a revised scale. , 2000, Diabetes care.

[25]  R. Ryan,et al.  Perceived locus of causality and internalization: examining reasons for acting in two domains. , 1989, Journal of personality and social psychology.

[26]  E. Deci,et al.  Testing a self-determination theory intervention for motivating tobacco cessation: supporting autonomy and competence in a clinical trial. , 2006, Health psychology : official journal of the Division of Health Psychology, American Psychological Association.

[27]  Christopher M Callahan,et al.  Six-Item Screener to Identify Cognitive Impairment Among Potential Subjects for Clinical Research , 2002, Medical care.