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The influences of income and education on the illness perception and self-management of Thai adults with type 2 diabetes
Department of nursing science, Rangsit University, Pathum Thani, Thailand.
Malmö högskola, Faculty of Health and Society (HS), Department of Social Work (SA).ORCID iD: 0000-0002-0619-5326
Malmö högskola, Faculty of Health and Society (HS), Department of Social Work (SA).
Malmö högskola, Faculty of Health and Society (HS), Department of Social Work (SA).
2016 (English)In: Journal of Diabetes and Metabilic Disorders, ISSN 2381-201X, Vol. 3, no 2, article id 017Article in journal (Refereed) Published
Abstract [sv]

En studie som undersöker socio-ekonomiska faktorers betydelse för människors hantering av diabetes

Abstract [en]

Illness perception and self-management might be of importance in proactive care for patients with type 2 diabetes.

Objective: The aim of the study was to examine the influences of socioeconomic status on the illness perception and self-management of Thai people with diabetes.

Methods: A cross-sectional descriptive method was used to study 220 people with type 2 diabetes in a suburban area in Thailand. The participants were selected using a multistage sampling method. Data were collected through the structured interviews using the revised versions of the Diabetes Illness Perception scale and Diabetes Self-Management scale. Independent sample t test or Mann-Whitney U test was used for income and education subgroups comparisons as well as multiple logistic regression was analyzed the predictors of illness perception and self-management.

Results: The results indicated that socioeconomic status, defined by income and educational level, showed the effects on some aspects of illness perception and self-management strategies in a type 2 diabetes population. Educational level demonstrated more effects on many subscales of illness perception and self-management than on income and was also shown to be a predictor of self-management (OR 2.047, 95% CI 1.014-4.131, p-value 0.046). 

Conclusion: The study found that socioeconomic status had an impact on the illness perception and self-management of people with type 2 diabetes. Educational level demonstrated a significant influence on the perceptions and management of Thai people with diabetes, which was also true concerning income level, although to a lesser extent. Illuminating socioeconomic status in the context of religious beliefs may increase health care professionals’ understanding of patients’ experiences and management of their diabetes. This is especially important when designing appropriate interventions for patients of low education.

Place, publisher, year, edition, pages
Herald , 2016. Vol. 3, no 2, article id 017
Keywords [en]
social vulerability, socio-economic status, diabetes type 2
National Category
Endocrinology and Diabetes
Identifiers
URN: urn:nbn:se:mau:diva-4324DOI: 10.24966/DMD-201X/100017Local ID: 22376OAI: oai:DiVA.org:mau-4324DiVA, id: diva2:1401154
Available from: 2020-02-28 Created: 2020-02-28 Last updated: 2024-05-07Bibliographically approved
In thesis
1. Living with type 2 diabetes in a Thai population: excperiences and socioeconomic characteristics
Open this publication in new window or tab >>Living with type 2 diabetes in a Thai population: excperiences and socioeconomic characteristics
2016 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Type 2 diabetes is a matter of global concern, and has been shown to have an impact on an individual’s way of living, family, and social life. In addition, there is limited knowledge concerning the life experiences of Thai people with diabetes. The aim of this thesis was to explore the experiences of people with type 2 diabetes who live in partly low socioeconomic suburban areas of Thailand. Both qualitative analyses with 19 women of low socioeconomic status with diabetes and quantitative analyses, including 220 people with diabetes, were conducted in the suburban communities near Bangkok between 2012 and 2015. The thesis consists of the results of four studies described in four papers. In paper I the aim was to explore how Thai women of low socioeconomic status handled their lives with diabetes. The findings showed that the women went through many stages of changes in the process of adaptation in handling their vulnerable situation influenced by diabetes and socioeconomic status. A threatened loss of status was sometimes seen as a barrier to handling their disease, whereas empowerment by one’s family helped them to feel powerful and gave them a sense of hope in living with this disease. Paper II illuminated the life experience of Thai women of low socioeconomic status living with diabetes. The findings revealed that women confronted susceptible feelings such as worrying about an unpredictable future and fears of being a burden to their family. However, they were able to maintain a balance through empowerment via the inner and outer sources of their beliefs. In paper III the aims were to investigate and compare the illness perception and self-management among women and men with diabetes, examine the association between illness perception and self-management, and to investigate the psychometric properties of the translated instruments. Both Thai versions of the measurement tools (the revised illness perception, diabetic version questionnaire and the new revision of the diabetes self-management questionnaire) demonstrated acceptable content validity and reliability, includinginternal consistency, inter-rater, and test-retest reliability. The findings showedthat the illness perception and self-management strategies among the womenand men had similar patterns, except for three aspects of illness perception.Whereas the women more often perceived the consequences of diabetes andfluctuating symptoms, the men felt more confident about efficiency of thetreatment prescribed by the healthcare professionals. Furthermore, the illnessperception, especially the confidence in controlling diabetes by themselves andthe confidence about treatment effectiveness, in both women and men showeda weak possitive association with many aspects of self-management strategies.Paper IV examined the illness perception and self-management of Thai peoplewith diabetes according to their socioeconomic status, as defined by income andeducational level. The participants of the low-income and low-education groupsperceived more negative consequences of diabetes, and the participants in the highincomeand high-education group felt more confident in controlling the diabetesby themselves and were more confident about the treatment effectiveness. Theparticipants in the low-education group perceived more fluctuating symptomsof the disease, and the high-education group showed greater understanding oftheir disease conditions. Furthermore, the participants in the low-education group demonstrated less effective self-care in terms of overall self-management strategiesand physical activity.The Thai people with type 2 diabetes demonstrated an ability to be able toadjust to their life situation and to keep a balance in their minds to continuetheir usual life with the disease. Their experiences of living with diabetes werepartially affected by sex differences and socioeconomic characteristics. It may behelpful to take educational level into consideration when designing specific andproper interventions for people with diabetes in low socioeconomic areas. TheThai sociocultural context, especially in terms of family closeness and Buddhistbeliefs, might also have an effect on the life of people with diabetes.

Place, publisher, year, edition, pages
Malmö högskola, Hälsa och samhälle, 2016. p. 78
Series
Malmö University Health and Society Dissertations, ISSN 1653-5383 ; 4
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:mau:diva-7352 (URN)20373 (Local ID)978-91-7104-688-8 (ISBN)978-91-7104-689-5 (ISBN)20373 (Archive number)20373 (OAI)
Note

Paper III and IV not included in the fulltext online.

Paper IV in dissertation as manuscript with title "Socioeconomic status - influences on illness perception and selfmanagement in a Thai type 2 diabetes population"

Available from: 2020-02-28 Created: 2020-02-28 Last updated: 2024-03-16Bibliographically approved

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Boonsatean, WimonrutDychawy Rosner, IrenaCarlsson, AnnaÖstman, Margareta

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