Self-management education and support from health professionals and diabetes related organisations are the mainstay of current health care practices. A cross-sectional study involving 1023 people with diabetes was conducted, with the aim of determining the relative importance of these services as predictors of self-management through the validation of an integrated biopsychosocial model.
Quantitative survey methodology was used to elicit opinions from males (n = 504) and females (n = 519), aged over 18 years (M = 63.90, SD = 13.89) who had a diagnosis of either type 1 (20%), or type 2 diabetes (80%) and who resided in Western Australia.
Health professionals provided advice on a range of topics; leading topics were pathophysiology (25.4%), managing diabetes with medications and blood glucose monitoring (18.4%), health eating (14.8%) and being active (14.8%). Self-regulatory skills, such as goal setting (6.9%) and problem solving (5.0%) were less commonly discussed. The preferred source of education and support was one-on-one, face-to-face consultations, closely followed by group sessions, although access to these services was affected by unsuitable scheduling times (35.3%) and their unavailability locally (24.9%). These barriers were associated with perceived financial hardship (p = .012). Structural equation modelling confirmed two different models of diabetes self-management for type 1 [χ2 (N = 195, df = 46), = 68.95, p = .016, Bollen-Stine p =.303] and type 2 [χ2 (N = 386, df = 35), = 50.33, p = .045, Bollen-Stine p =.327]. Self-determination support by health care professionals was a predictive factor for attaining diabetes self-management behaviours in both type 1 (p = .034) and type 2 (p = .017) diabetes.
The findings make explicit the distinguishing contribution of educative services in successful diabetes self-management. Refinements in service delivery, informed by these findings, may better target predictors of self-management.