Objectives: Although prior research has shown that self-efficacy (SE), the belief that one has the ability to create change through behaviors, is associated with better clinical outcomes for Type 2 diabetes (DM) and coronary artery disease separately (CAD), little research has examined the role of SE in patients with both DM and CAD. The goal of this cross-sectional analysis was to describe the association between SE and glycosylated hemoglobin (HbA1c), systolic blood pressure (SBP), and low density lipids (LDL) in patients with comorbid CAD and DM. In addition, this analysis examined the demographic and clinical factors that are associated with SE in the management of DM and CAD.
Methods: Bivariate and multivariate analyses were conducted with 1,447 patients in the Bypass Angioplasty Revascularization Investigation 2 Diabetes (BARI 2D) study who completed a self-efficacy assessment. Only patients recruited at U.S. sites were included in the analyses. The majority of the patients were White non-Hispanic, male, and had a post high school education. The average age at enrollment was 63 years. The models were adjusted for sex, age, race/ethnicity, and education.
Results: Better HbA1c was positively associated with SE, even after adjusting for race/ethnicity, age, sex, and education. Better SBP was positively associated with SE, however this association was only marginally significant when adjusting for race/ethnicity, age, sex, and education. LDL was not associated with SE. Hispanic ethnicity, history of congestive heart failure, number of hypertension drugs, probable neuropathy, and insulin use were factors negatively associated with SE. A post high school education and history of cancer were positively associated with SE.
Conclusions: Psychosocial factors, such as self-efficacy, are of public health significance because they play a considerable role in the management of diabetes and cardiovascular disease. Self-efficacy was positively associated with better cardiac and diabetic factors in the BARI 2D population. Literacy skills, cardiac history, number of medications, and neuropathy are several other factors doctors should take into consideration when assessing and building up patients confidence in being able to manage their medical conditions.
| Identifer | oai:union.ndltd.org:PITT/oai:PITTETD:etd-05152008-175057 |
| Date | 26 June 2008 |
| Creators | Sansing, Veronica Vera |
| Contributors | Maria Mori Brooks, Nancy Day, Stephen B. Thomas, Gale A. Richardson |
| Publisher | University of Pittsburgh |
| Source Sets | University of Pittsburgh |
| Language | English |
| Detected Language | English |
| Type | text |
| Format | application/pdf |
| Source | http://etd.library.pitt.edu/ETD/available/etd-05152008-175057/ |
| Rights | restricted, I hereby certify that, if appropriate, I have obtained and attached hereto a written permission statement from the owner(s) of each third party copyrighted matter to be included in my thesis, dissertation, or project report, allowing distribution as specified below. I certify that the version I submitted is the same as that approved by my advisory committee. I hereby grant to University of Pittsburgh or its agents the non-exclusive license to archive and make accessible, under the conditions specified below, my thesis, dissertation, or project report in whole or in part in all forms of media, now or hereafter known. I retain all other ownership rights to the copyright of the thesis, dissertation or project report. I also retain the right to use in future works (such as articles or books) all or part of this thesis, dissertation, or project report. |
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