title: Factors that affect health outcomes in adults with type 2 diabetes: a cross-sectional study.
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.
  
  
  OBJECTIVE
  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.
  
  
  METHODS
  A descriptive correlational design was used to examine a theoretical model of risk factors, protective factors, and adaptive outcomes.
  
  
  METHODS
  This study was conducted at the endocrine outpatient departments of three hospitals in Taiwan.
  
  
  METHODS
  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 (beta=0.68, p<0.001); however, risk factors did not predict adaptive outcomes (beta=-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.
authors.affiliation: Department of Nursing, Yuanpei University, 306 Yuanpei Street, Hsinchu 300, Taiwan. minfeng@mail.ypu.edu.tw
authors.forename: Min-Feng
authors.initials: MF
authors.lastname: Huang
authors.forename: Mary
authors.initials: M
authors.lastname: Courtney
authors.forename: Helen
authors.initials: H
authors.lastname: Edwards
authors.forename: Jan
authors.initials: J
authors.lastname: McDowell
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001786:Blood Glucose / Q000032:analysis; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000209:etiology / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008962:Models, Theoretical; D011788:Quality of Life; D012307:Risk Factors; D012648:Self Care; D012944:Social Support; D013315:Stress, Psychological; D011795:Surveys and Questionnaires
chemical_list: D001786:Blood Glucose