Predictors for self-management in older adults with type 2 diabetic nephropathy

Aim and Objectives: To investigate factors related to self-management and predictors of self-management in older adult patients with type 2 diabetic nephropathy. Background: Diabetic patients suffer many comorbidities during their lifetime, and the process of self-management is complex. Self-management and an integrated care experience are extremely important for older adults with diabetic nephropathy. Design: A cross-sectional correlation design was adopted. Methods: A total of 123 older patients were enrolled in the study from June 2016 to November 2017. Data collection involved a demographic questionnaire, the Patients' Experience of Integrated Care Questionnaire and the Partners in Health Scale to measure the integrated care experience and self-management. Data analysis included descriptive statistics, independent t tests, Pearson product-moment correlation and multiple linear regression. The methods are consistent with the STROBE criteria (Data S1). Results: The results showed that the majority of the sample was female (56.9%). The average age was 77 years old. Stepwise regression analysis showed that re-admission during the past year (p <.001), physical function (p <.001) and integrated care experience (p <.001) are predictors of self-management in older adult patients with type 2 diabetic nephropathy and explained 42.8% of the variation in self-management behaviour. Conclusion: The results can be used to enhance the awareness of clinicians of the importance of an integrated care experience and self-management among older patients with type 2 diabetic nephropathy. Clinicians also should pay attention to physical function and the integrated care experience to promote self-management. Relevance to Clinical Practice: Studies on the integrated care experience and self-management of diabetic neuropathy in older adults are limited in Taiwan. The results of this study provide valuable information to support the importance of integrated care among this specific population.