International Journal of Nursing Studies
Volume 47, Issue 5 , Pages 542-549, May 2010

Factors that affect health outcomes in adults with type 2 diabetes: A cross-sectional study

  • Min-Feng Huang

      Affiliations

    • Department of Nursing, Yuanpei University, 306 Yuanpei Street, Hsinchu 300, Taiwan
    • School of Nursing and Midwifery, Institute of Health and Biomedical Innovation, Queensland University of Technology, Queensland, Australia
    • Corresponding Author InformationCorresponding author at: Department of Nursing, Yuanpei University, 306 Yuanpei Street, Hsinchu 300, Taiwan. Tel.: +886 3 5381183x8622.
  • ,
  • Mary Courtney

      Affiliations

    • Faculty of Health, Queensland University of Technology, Queensland, Australia
  • ,
  • Helen Edwards

      Affiliations

    • School of Nursing and Midwifery, Institute of Health and Biomedical Innovation, Queensland University of Technology, Queensland, Australia
  • ,
  • Jan McDowell

      Affiliations

    • School of Nursing and Midwifery, Institute of Health and Biomedical Innovation, Queensland University of Technology, Queensland, Australia

Received 8 July 2009; received in revised form 9 October 2009; accepted 17 October 2009.

Abstract 

Background

Factors that individually influence blood sugar control, health-related quality of life, and diabetes self-care behaviors have been widely investigated; however, most previous diabetes studies have not tested an integrated association between a series of factors and multiple health outcomes.

Objectives

The purposes of this study are to identify risk factors and protective factors and to examine the impact of risk factors and protective factors on adaptive outcomes in people with type 2 diabetes.

Design

A descriptive correlational design was used to examine a theoretical model of risk factors, protective factors, and adaptive outcomes.

Settings

This study was conducted at the endocrine outpatient departments of three hospitals in Taiwan.

Participants

A convenience sample of 334 adults with type 2 diabetes aged 40 and over.

Methods

Data were collected by a self-reported questionnaire and physiological examination. Using the structural equation modeling technique, measurement and structural regression models were tested.

Results

Age and life events reflected the construct of risk factors. The construct of protective factors was explained by diabetes symptoms, coping strategy, and social support. The construct of adaptive outcomes comprised HbA1c, health-related quality of life, and self-care behaviors. Protective factors had a significant direct effect on adaptive outcomes (β=0.68, p<0.001); however, risk factors did not predict adaptive outcomes (β=0.48, p=0.118).

Conclusions

Identifying and managing risk factors and protective factors are an integral part of diabetes care. This theoretical model provides a better understanding of how risk factors and protective factors work together to influence multiple adaptive outcomes in people living with type 2 diabetes.

Keywords: Protective factors, Risk factors, Structural equation modeling, Type 2 diabetes

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PII: S0020-7489(09)00348-4

doi:10.1016/j.ijnurstu.2009.10.012

International Journal of Nursing Studies
Volume 47, Issue 5 , Pages 542-549, May 2010