TY - JOUR

T1 - Determinants of glycaemic control among patients with type 2 diabetes

T2 - testing a process model based on self-determination theory

AU - Grønnegaard, Cecilia

AU - Varming, Annemarie

AU - Skinner, Timothy

AU - Olesen, Kasper

AU - Willaing, Ingrid

PY - 2020/10

Y1 - 2020/10

N2 - Aims: To investigate a hypothesised process model based on self-determination theory (SDT) in a population of people with type 2 diabetes. The model suggests that autonomy support from healthcare professionals is an important determinant of autonomous motivation and perceived competence in diabetes, which correlate positively in turn with wellbeing and negatively with HbA1c. Methods: This cross-sectional study used baseline questionnaire data and HbA1c levels from a randomised controlled trial investigating the effects of a person-centred consultation program. The questionnaire used validated scales and items assessing autonomy support, wellbeing, motivation, self-care activities, diabetes distress and perceived competence. Pearson correlations were calculated, and mediation analysis was conducted by multivariate linear regression analysis. Results: 116 participants completed the questionnaire. Autonomy support was significantly correlated with perceived competence and controlled motivation. Perceived competence correlated negatively with diabetes distress and positively with self-care activities. Diabetes distress correlated negatively with wellbeing. Controlled motivation correlated positively with autonomous motivation, which correlated positively with both wellbeing and self-care activities. Self-care activities correlated negatively with HbA1c. Conclusion: As suggested by the hypothesised SDT process model, autonomy support, autonomous motivation and perceived competence are associated with better wellbeing and improved HbA1c.

AB - Aims: To investigate a hypothesised process model based on self-determination theory (SDT) in a population of people with type 2 diabetes. The model suggests that autonomy support from healthcare professionals is an important determinant of autonomous motivation and perceived competence in diabetes, which correlate positively in turn with wellbeing and negatively with HbA1c. Methods: This cross-sectional study used baseline questionnaire data and HbA1c levels from a randomised controlled trial investigating the effects of a person-centred consultation program. The questionnaire used validated scales and items assessing autonomy support, wellbeing, motivation, self-care activities, diabetes distress and perceived competence. Pearson correlations were calculated, and mediation analysis was conducted by multivariate linear regression analysis. Results: 116 participants completed the questionnaire. Autonomy support was significantly correlated with perceived competence and controlled motivation. Perceived competence correlated negatively with diabetes distress and positively with self-care activities. Diabetes distress correlated negatively with wellbeing. Controlled motivation correlated positively with autonomous motivation, which correlated positively with both wellbeing and self-care activities. Self-care activities correlated negatively with HbA1c. Conclusion: As suggested by the hypothesised SDT process model, autonomy support, autonomous motivation and perceived competence are associated with better wellbeing and improved HbA1c.

KW - Autonomy support

KW - Diabetes self-management

KW - Endocrinology

KW - Glycemic control

KW - HbA1c

KW - Health care climate

KW - Mental health

KW - Physical activity

KW - Quality of life

KW - Self-determination theory

KW - Well-being

U2 - 10.1016/j.heliyon.2020.e04993

DO - 10.1016/j.heliyon.2020.e04993

M3 - Journal article

C2 - 33083586

AN - SCOPUS:85092291761

VL - 6

JO - Heliyon

JF - Heliyon

SN - 2405-8440

IS - 10

M1 - e04993

ER -