title: Relationships of illness representation, diabetes knowledge, and self-care behaviour to glycemic control in incarcerated persons with diabetes.
abstract: Purpose The purpose of this paper is to examine relationships of self-care behavior, illness representation and diabetes knowledge with A1C (level of glycemic control) in 124 incarcerated persons. Design/methodology/approach Using a cross-sectional design, summary scores and items from the self-care inventory revised, brief illness perception questionnaire and the spoken knowledge for low literacy in diabetes were evaluated using linear regression to assess their relationship to A1C. Findings Metabolic control was suboptimal for the majority of inmates with diabetes. The final regression model was statistically significant ( F (3, 120)=9.51, p=0.001, R(2)=19.2 percent). Higher log10 HbA1C (A1C) was associated with lower personal control beliefs ( B=-0.007, t (122)=-2.42, p=<0.02), higher self-report of diabetes understanding ( B=0.009, t (122)=3.12, p=0.00) and using insulin ( B=0.062, t (122)=2.45, p=0.02). Research limitations/implications Similar to findings with community dwelling participants, enhancing diabetes personal control beliefs among inmates may lead to lower A1C. Social implications Highly structured environments with limited options for self-care, personal choices and readily available health care may give some incarcerated persons with diabetes no motivation to improve diabetes control even if they have an understanding of what to do. Originality/value While there is abundant research in the community describing how these factors influence A1C levels, research of this nature with incarcerated persons with diabetes is limited. Findings will inform diabetes programming during incarceration to better prepare inmates for reentry.
authors.affiliation: School of Nursing, University of Connecticut , Storrs, Connecticut, USA.
authors.forename: Louise A
authors.identifier: 0000-0002-4728-2215
authors.initials: LA
authors.lastname: Reagan
authors.affiliation: School of Nursing, University of Connecticut , Storrs, Connecticut, USA.
authors.forename: Stephen J
authors.initials: SJ
authors.lastname: Walsh
authors.affiliation: School of Nursing, University of Connecticut , Storrs, Connecticut, USA.
authors.forename: Deborah
authors.initials: D
authors.lastname: Shelton
mesh_terms: D001786:Blood Glucose / Q000032:analysis; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000453:epidemiology / Q000523:psychology / Q000628:therapy*; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000453:epidemiology / Q000523:psychology / Q000628:therapy*; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D007722:Health Knowledge, Attitudes, Practice; D057220:Health Literacy / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D017146:Models, Organizational; D015999:Multivariate Analysis; D015995:Prevalence; D011329:Prisoners / Q000706:statistics & numerical data*; D011330:Prisons / Q000458:organization & administration; D012648:Self Care / Q000523:psychology / Q000706:statistics & numerical data*; D019966:Substance-Related Disorders / Q000453:epidemiology; D014481:United States / Q000453:epidemiology
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin; C517652:hemoglobin A1c protein, human
keywords: Correctional health care; Diabetes; Health beliefs; Inmates; Prisoners; Self-care