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Ethnic differences and socio-demographic predictors of illness perceptions, self-management, and metabolic control of type 2 diabetes.

Abubakari AR, Jones MC, Lauder W, Kirk A, Anderson J, Devendra D, Naderali EK - Int J Gen Med (2013)

Bottom Line: White-British participants had high diabetes-specific knowledge compared to their black-African and black-Caribbean counterparts.Clearly, there is disease (diabetes) knowledge-perception variation between different ethnic groups in the UK which may partly influence overall disease outcome.It is plausible to recommend screening, identifying, and dispelling misconceptions about diabetes among ethnic minority patients by health care professionals as well as emphasizing the importance of self-management in managing chronic diseases such as diabetes.

View Article: PubMed Central - PubMed

Affiliation: School of Health Sciences, Liverpool Hope University, Hope Park, Liverpool.

ABSTRACT

Objectives: This study investigated ethnic differences in diabetes-specific knowledge, illness perceptions, self-management, and metabolic control among black-African, black-Caribbean,and white-British populations with type 2 diabetes. The study also examined associations between demographic/disease characteristics and diabetes-specific knowledge, illness perceptions, self-management, and metabolic control in each of the three ethnic groups.

Design: Cross-sectional.

Setting: Diabetes/retinal screening clinics in Hackney and Brent, London.

Methods: Black-African, black-Caribbean and white-British populations with type 2 diabetes were asked to participate. Questionnaires measuring demographic/disease characteristics, diabetes-specific knowledge, self-management, and illness perceptions were used for data collection. Data for glycated hemoglobin (HbA1c) and microvascular complications were obtained from medical records. Ethnic differences in diabetes-related measures were estimated using analysis of variance/covariance. Multiple regression techniques were used to determine relationships between demographic/disease characteristics and measured diabetes-related outcomes.

Results: Three hundred and fifty-nine patients participated in the study. White-British participants had high diabetes-specific knowledge compared to their black-African and black-Caribbean counterparts. Black-Africans reported better adherence to self-management recommendations than the other ethnic groups. Compared to the white-British patients, black-African and black-Caribbean participants perceived diabetes as a benign condition that could be cured. Educational status and treatment category were determinants of diabetes-specific knowledge in all three ethnic groups. However, different demographic/disease characteristics predicted adherence to self-management recommendations in each ethnic group.

Conclusion: Clearly, there is disease (diabetes) knowledge-perception variation between different ethnic groups in the UK which may partly influence overall disease outcome. It is plausible to recommend screening, identifying, and dispelling misconceptions about diabetes among ethnic minority patients by health care professionals as well as emphasizing the importance of self-management in managing chronic diseases such as diabetes.

No MeSH data available.


Related in: MedlinePlus

Perceived psychological causes of diabetes by ethnicity.Notes:†Significant linear trend; *P ≤ 0.03; **P ≤ 0.01; for significant differences between ethnic groups (P-values are from chi-square tests).
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f1-ijgm-6-617: Perceived psychological causes of diabetes by ethnicity.Notes:†Significant linear trend; *P ≤ 0.03; **P ≤ 0.01; for significant differences between ethnic groups (P-values are from chi-square tests).

Mentions: Data were entered into SPSS (v 16; SPSS, Inc, Chicago, IL, USA) for statistical analysis. For continuous variables such as age and HbA1c, group differences were investigated using analysis of variance (ANOVA). Bonferroni post-hoc procedures were performed to reveal specific differences between individual groups in ANOVA. To minimize the potential for confounding, analysis of covariance (ANCOVA) was used to adjust for statistically significant between-group differences in demographic variables such as age and duration of diabetes. Bivariate correlations were used to investigate relationships between variables. The enter method was used for identifying potential demographic/disease characteristics that predicted various outcomes in multiple regression analysis. In order to reduce losses in degrees of freedom and statistical power, only independent variables that were significantly correlated (or had a correlation coefficient ≥0.15) with the appropriate outcome variables were entered into the regression model.27 Dummy variables were created for independent ordinal categorical variables with ≤4 states (eg, education status, treatment category), and all comparison options were entered together into the model. In order to investigate ethnic differences in the proportion of participants who attributed their diabetes to individual causal items, responses for each item on the cause subscale were coded into binary categorical variables: agree (strongly agree + agree) and disagree (strongly disagree + disagree). Ethnic differences were then investigated using the chi-square test (see results in Figures 1–3). To minimize the potential for type 1 errors due to multiple testing, we considered P-values ≤0.03 as significant. As reported elsewhere,19 the initial determination of sample size based on the effect size of 0.30 for correlations between illness perceptions and self-management, found that a minimum of 82 participants were required for each ethnic group to achieve 80% power.


Ethnic differences and socio-demographic predictors of illness perceptions, self-management, and metabolic control of type 2 diabetes.

Abubakari AR, Jones MC, Lauder W, Kirk A, Anderson J, Devendra D, Naderali EK - Int J Gen Med (2013)

Perceived psychological causes of diabetes by ethnicity.Notes:†Significant linear trend; *P ≤ 0.03; **P ≤ 0.01; for significant differences between ethnic groups (P-values are from chi-square tests).
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3735275&req=5

f1-ijgm-6-617: Perceived psychological causes of diabetes by ethnicity.Notes:†Significant linear trend; *P ≤ 0.03; **P ≤ 0.01; for significant differences between ethnic groups (P-values are from chi-square tests).
Mentions: Data were entered into SPSS (v 16; SPSS, Inc, Chicago, IL, USA) for statistical analysis. For continuous variables such as age and HbA1c, group differences were investigated using analysis of variance (ANOVA). Bonferroni post-hoc procedures were performed to reveal specific differences between individual groups in ANOVA. To minimize the potential for confounding, analysis of covariance (ANCOVA) was used to adjust for statistically significant between-group differences in demographic variables such as age and duration of diabetes. Bivariate correlations were used to investigate relationships between variables. The enter method was used for identifying potential demographic/disease characteristics that predicted various outcomes in multiple regression analysis. In order to reduce losses in degrees of freedom and statistical power, only independent variables that were significantly correlated (or had a correlation coefficient ≥0.15) with the appropriate outcome variables were entered into the regression model.27 Dummy variables were created for independent ordinal categorical variables with ≤4 states (eg, education status, treatment category), and all comparison options were entered together into the model. In order to investigate ethnic differences in the proportion of participants who attributed their diabetes to individual causal items, responses for each item on the cause subscale were coded into binary categorical variables: agree (strongly agree + agree) and disagree (strongly disagree + disagree). Ethnic differences were then investigated using the chi-square test (see results in Figures 1–3). To minimize the potential for type 1 errors due to multiple testing, we considered P-values ≤0.03 as significant. As reported elsewhere,19 the initial determination of sample size based on the effect size of 0.30 for correlations between illness perceptions and self-management, found that a minimum of 82 participants were required for each ethnic group to achieve 80% power.

Bottom Line: White-British participants had high diabetes-specific knowledge compared to their black-African and black-Caribbean counterparts.Clearly, there is disease (diabetes) knowledge-perception variation between different ethnic groups in the UK which may partly influence overall disease outcome.It is plausible to recommend screening, identifying, and dispelling misconceptions about diabetes among ethnic minority patients by health care professionals as well as emphasizing the importance of self-management in managing chronic diseases such as diabetes.

View Article: PubMed Central - PubMed

Affiliation: School of Health Sciences, Liverpool Hope University, Hope Park, Liverpool.

ABSTRACT

Objectives: This study investigated ethnic differences in diabetes-specific knowledge, illness perceptions, self-management, and metabolic control among black-African, black-Caribbean,and white-British populations with type 2 diabetes. The study also examined associations between demographic/disease characteristics and diabetes-specific knowledge, illness perceptions, self-management, and metabolic control in each of the three ethnic groups.

Design: Cross-sectional.

Setting: Diabetes/retinal screening clinics in Hackney and Brent, London.

Methods: Black-African, black-Caribbean and white-British populations with type 2 diabetes were asked to participate. Questionnaires measuring demographic/disease characteristics, diabetes-specific knowledge, self-management, and illness perceptions were used for data collection. Data for glycated hemoglobin (HbA1c) and microvascular complications were obtained from medical records. Ethnic differences in diabetes-related measures were estimated using analysis of variance/covariance. Multiple regression techniques were used to determine relationships between demographic/disease characteristics and measured diabetes-related outcomes.

Results: Three hundred and fifty-nine patients participated in the study. White-British participants had high diabetes-specific knowledge compared to their black-African and black-Caribbean counterparts. Black-Africans reported better adherence to self-management recommendations than the other ethnic groups. Compared to the white-British patients, black-African and black-Caribbean participants perceived diabetes as a benign condition that could be cured. Educational status and treatment category were determinants of diabetes-specific knowledge in all three ethnic groups. However, different demographic/disease characteristics predicted adherence to self-management recommendations in each ethnic group.

Conclusion: Clearly, there is disease (diabetes) knowledge-perception variation between different ethnic groups in the UK which may partly influence overall disease outcome. It is plausible to recommend screening, identifying, and dispelling misconceptions about diabetes among ethnic minority patients by health care professionals as well as emphasizing the importance of self-management in managing chronic diseases such as diabetes.

No MeSH data available.


Related in: MedlinePlus