title: Structural model of self-care agency in patients with diabetes: A path analysis of the Instrument of Diabetes Self-Care Agency and body self-awareness.
abstract: OBJECTIVE
  The aim of this study was to examine a causal model of self-care agency by exploring the relationship between the structure of "body self-awareness" and the structure of the Instrument of Diabetes Self-Care Agency (IDSCA).
  
  
  METHODS
  The participants were 353 patients with diabetes. The internal consistency of the six items for body self-awareness was examined by calculating the factor structure using principal factor analysis and Cronbach's alpha. In order to examine the relationship between the seven factors in the IDSCA, a path analysis was conducted.
  
  
  RESULTS
  With regard to the factor structure, the factor loading of these five items was 0.511-0.743 (α = 0.739). In the path analysis, "body self-awareness" was influenced by the "ability to acquire knowledge" and had a direct effect (0.33) on the "motivation to self-manage", while "motivation to self-manage" had an effect (-0.32) on the "ability to self-manage". The Goodness-of-Fit Index was 0.974.
  
  
  CONCLUSIONS
  "Body self-awareness" plays a part in the self-care operation process and serves as an intermediary factor to enable the performance of self-care operations by making the most use of self-care agency. Moreover, striking a proper balance between self-management that is focused on the treatment of diabetes and a person's ability for self-management of diabetes was found to be important.
authors.affiliation: School of Nursing, Faculty of Medicine, Oita University, Oita, Japan. syamasit@oita-u.ac.jp.
authors.forename: Sachiko
authors.initials: S
authors.lastname: Waki
authors.affiliation: Division of Health Sciences, Graduate Shool of Medicine, Osaka University, Osaka, Japan.
authors.forename: Yasuko
authors.initials: Y
authors.lastname: Shimizu
authors.affiliation: School of Nursing, Dokkyo Medical University, Tochigi, Japan.
authors.forename: Kyoko
authors.initials: K
authors.lastname: Uchiumi
authors.affiliation: School of Nursing, Faculty of Medical Sciences, Fukui University, Fukui, Japan.
authors.forename: Kawai
authors.initials: K
authors.lastname: Asou
authors.affiliation: Graduate School of Nursing, Chiba University, Chiba, Japan.
authors.forename: Kumiko
authors.initials: K
authors.lastname: Kuroda
authors.affiliation: School of Nursing, Kanazawa Medical University, Ishikawa, Japan.
authors.forename: Naoko
authors.initials: N
authors.lastname: Murakado
authors.affiliation: Division of Health Sciences, Graduate Shool of Medicine, Osaka University, Osaka, Japan.
authors.forename: Natsuko
authors.initials: N
authors.lastname: Seto
authors.affiliation: Graduate School of Nursing, Chiba University, Chiba, Japan.
authors.forename: Harue
authors.initials: H
authors.lastname: Masaki
authors.affiliation: Department of Psychology and Human Developmental Sciences, Nagoya University, Aichi, Japan.
authors.forename: Hidetoki
authors.initials: H
authors.lastname: Ishii
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001364:Awareness; D003920:Diabetes Mellitus / Q000628:therapy*; D005163:Factor Analysis, Statistical; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008960:Models, Psychological; D012648:Self Care
keywords: body self-awareness; causal model; path analysis; patients with type 1 and type 2 diabetes mellitus; self-care agency