title: Health value & perceived control over health: behavioural constructs to support Type 2 diabetes self-management in clinical practice.
abstract: OBJECTIVE
  To explore health value and perceived control over health in relation to self-management behaviours in adults with Type 2 diabetes mellitus.
  
  
  BACKGROUND
  Helping people to modify health related behaviour in diabetes is complex due to a multitude of factors. Exploring the meaning of the constructs of Modified Social Learning Theory could be beneficial to identifying people at risk of poor diabetes self-management.
  
  
  METHODS
  An exploratory qualitative study.
  
  
  METHODS
  Thirteen adults with insulin-treated Type 2 diabetes mellitus were purposively sampled. Data were collected through semi-structured interviews. An in-depth thematic analysis was carried out.
  
  
  RESULTS
  Health became a value priority on diagnosis of Type 2 diabetes mellitus. Participants described holding both terminal (relating to desired end states) and instrumental (a means to an end) health values pre-diagnosis but these became instrumental post-diagnosis to meet new lifestyle needs and maintain their quality of life. Descriptions of 'conflicts' in locus of control beliefs when managing Type 2 diabetes mellitus demonstrated influences on levels of self-efficacy and health value. Common themes that impacted on diabetes self-management included co-morbidities, medication management, blood glucose monitoring and reasoning for Type 2 diabetes mellitus.
  
  
  CONCLUSIONS
  Locus of control beliefs, levels of self-efficacy and health value were influenced by complications associated with Type 2 diabetes mellitus. The findings on Modified Social Learning Theory and instrumental health value as a moderator to health behaviour resulted in the development of a proposed framework with potential practical utility.
  
  
  CONCLUSIONS
  This research demonstrates the relevance of exploring the constructs of Modified Social Learning Theory (MSLT) in relation to diabetes self-management behaviours in Type 2 diabetes mellitus. The proposed Type 2 diabetes mellitus Self-management Behaviour Support framework incorporates Modified Social Learning Theory and instrumental health value as the theoretical basis for development and could provide clinical nurses and doctors with a tool that will allow for in-depth assessment and planning of Type 2 diabetes mellitus patients' self-management behaviours.
authors.affiliation: RCSI Faculty of Nursing & Midwifery, Royal College of Surgeons in Ireland.
authors.forename: Linda Elizabeth
authors.initials: LE
authors.lastname: Nugent
authors.affiliation: School of Health in Social Sciences, The University of Edinburgh, Edinburgh, UK.
authors.forename: Maggie
authors.initials: M
authors.lastname: Carson
authors.affiliation: The University of Edinburgh and The Royal Infirmary of Edinburgh, Edinburgh, UK.
authors.forename: Nicola Naomi
authors.initials: NN
authors.lastname: Zammitt
authors.affiliation: School of Nursing Midwifery and Social Care, Edinburgh Napier University, Edinburgh, UK.
authors.forename: Graeme Drummond
authors.initials: GD
authors.lastname: Smith
authors.affiliation: Vanderbilt University, School of Nursing, Nashville, TN, USA.
authors.forename: Kenneth A
authors.initials: KA
authors.lastname: Wallston
mesh_terms: D000368:Aged; D003924:Diabetes Mellitus, Type 2 / Q000451:nursing / Q000523:psychology*; D005260:Female; D015438:Health Behavior; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D012648:Self Care / Q000523:psychology*
keywords: Modified Social Learning Theory; Type 2 diabetes mellitus; health behaviour; health value; perceived control