Application of a social cognitive theory model to analyse hypoglycaemic risk factors in older patients with type 2 diabetes in two rural primary healthcare clinics in Selangor, Malaysia

The confluence of the aging population and rise in prevalence of Type 2 Diabetes Mellitus (T2DM) among the younger adults will lead to an epidemic in the older adults. These older adults with T2DM are vulnerable to hypoglycaemia, and they suffer significantly from its adverse consequences. The main...

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Main Author:	Ooi, Cheow Peng
Format:	Thesis
Language:	English
Published:	2011
Subjects:	Social cognitive theory Hypoglycemia - Selangor Diabetes in old age - Selangor
Online Access:	http://psasir.upm.edu.my/id/eprint/27002/1/IG%202011%204R%20pdf.pdf
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id	my-upm-ir.27002
record_format	uketd_dc
spelling	my-upm-ir.270022024-08-19T07:26:03Z Application of a social cognitive theory model to analyse hypoglycaemic risk factors in older patients with type 2 diabetes in two rural primary healthcare clinics in Selangor, Malaysia 2011-02 Ooi, Cheow Peng The confluence of the aging population and rise in prevalence of Type 2 Diabetes Mellitus (T2DM) among the younger adults will lead to an epidemic in the older adults. These older adults with T2DM are vulnerable to hypoglycaemia, and they suffer significantly from its adverse consequences. The main objective of this study is to determine the specific putative modifiable factors that can significantly contribute to the hypoglycaemic risk amongst older people with T2DM, within two rural primary care clinics in Selangor, Malaysia. Social Cognitive Theory (SCT) is used to guide the translation of the modifiable risk factors of hypoglycaemia into the perspective useful for clinical practice. The hypotheses of the significant relationship between the putative risk factors as well as the determination of putative modifiable risk factors on the proportion of hypoglycaemia in the sample of older patients with T2DM were tested. A cross-sectional study was carried out amongst 170 young-old adults with T2DM. Consecutive patients who fulfilled both the inclusion and exclusion criteria were invited. Informed consent was sought prior to interview. Structured questionnaires consisting of a checklist of 20 self-reported symptoms of hypoglycaemia, awareness, fear and prevention of hypoglycaemia were used. Information from medical records was also used to compile the information required for the „Mini-Nutritional Assessment – short-form‟ and for quantifying the level of social engagement. Binary logistic regression analyses were used to analyse the data. The results revealed that these respondents had high social engagement, suboptimal glycaemic control, high proportion of mild hypoglycaemia, cardiovascular risk and risk factors for disability. Four modifiable risk factors significantly contributed to the hypoglycaemia in the respondents, namely; microvascular complications of T2DM, awareness of hypoglycaemia, nutritional risk and a lower level of social engagement. The significant association of the fear of hypoglycaemia with hypoglycaemia, and the suppression of the level of social engagement in the hierarchical logistic regression model, implies all constructs of the SCT (personal,social and psychological domains) are required to explain the inter-relationships of the risk factors in hypoglycaemia. This has not been shown in previous studies. The respondents are at risk for disability but not disabled. Thus, there are windows of opportunity to target potential interventions that extend beyond glycaemia control, to the maintenance of functional status, participation in social life and the prevention of disabilities. These potential interventions include developing education and management programs, emphasising hypoglycaemia in the care of older diabetics. Extending the understanding of mechanisms of the interrelationships of biological, medical, psychological and social domains, including the contributions of social support, is also important. Externally validating these risk factors of hypoglycaemia on a different set of older adults with T2DM will facilitate the development of a clinical support tool. Social cognitive theory Hypoglycemia - Selangor Diabetes in old age - Selangor 2011-02 Thesis http://psasir.upm.edu.my/id/eprint/27002/ http://psasir.upm.edu.my/id/eprint/27002/1/IG%202011%204R%20pdf.pdf text en public doctoral Universiti Putra Malaysia Social cognitive theory Hypoglycemia - Selangor Diabetes in old age - Selangor Institute of Gerontology Tengku Abdul Hamid, Tengku Aizan
institution	Universiti Putra Malaysia
collection	PSAS Institutional Repository
language	English
advisor	Tengku Abdul Hamid, Tengku Aizan
topic	Social cognitive theory Hypoglycemia - Selangor Diabetes in old age - Selangor
spellingShingle	Social cognitive theory Hypoglycemia - Selangor Diabetes in old age - Selangor Ooi, Cheow Peng Application of a social cognitive theory model to analyse hypoglycaemic risk factors in older patients with type 2 diabetes in two rural primary healthcare clinics in Selangor, Malaysia
description	The confluence of the aging population and rise in prevalence of Type 2 Diabetes Mellitus (T2DM) among the younger adults will lead to an epidemic in the older adults. These older adults with T2DM are vulnerable to hypoglycaemia, and they suffer significantly from its adverse consequences. The main objective of this study is to determine the specific putative modifiable factors that can significantly contribute to the hypoglycaemic risk amongst older people with T2DM, within two rural primary care clinics in Selangor, Malaysia. Social Cognitive Theory (SCT) is used to guide the translation of the modifiable risk factors of hypoglycaemia into the perspective useful for clinical practice. The hypotheses of the significant relationship between the putative risk factors as well as the determination of putative modifiable risk factors on the proportion of hypoglycaemia in the sample of older patients with T2DM were tested. A cross-sectional study was carried out amongst 170 young-old adults with T2DM. Consecutive patients who fulfilled both the inclusion and exclusion criteria were invited. Informed consent was sought prior to interview. Structured questionnaires consisting of a checklist of 20 self-reported symptoms of hypoglycaemia, awareness, fear and prevention of hypoglycaemia were used. Information from medical records was also used to compile the information required for the „Mini-Nutritional Assessment – short-form‟ and for quantifying the level of social engagement. Binary logistic regression analyses were used to analyse the data. The results revealed that these respondents had high social engagement, suboptimal glycaemic control, high proportion of mild hypoglycaemia, cardiovascular risk and risk factors for disability. Four modifiable risk factors significantly contributed to the hypoglycaemia in the respondents, namely; microvascular complications of T2DM, awareness of hypoglycaemia, nutritional risk and a lower level of social engagement. The significant association of the fear of hypoglycaemia with hypoglycaemia, and the suppression of the level of social engagement in the hierarchical logistic regression model, implies all constructs of the SCT (personal,social and psychological domains) are required to explain the inter-relationships of the risk factors in hypoglycaemia. This has not been shown in previous studies. The respondents are at risk for disability but not disabled. Thus, there are windows of opportunity to target potential interventions that extend beyond glycaemia control, to the maintenance of functional status, participation in social life and the prevention of disabilities. These potential interventions include developing education and management programs, emphasising hypoglycaemia in the care of older diabetics. Extending the understanding of mechanisms of the interrelationships of biological, medical, psychological and social domains, including the contributions of social support, is also important. Externally validating these risk factors of hypoglycaemia on a different set of older adults with T2DM will facilitate the development of a clinical support tool.
format	Thesis
qualification_level	Doctorate
author	Ooi, Cheow Peng
author_facet	Ooi, Cheow Peng
author_sort	Ooi, Cheow Peng
title	Application of a social cognitive theory model to analyse hypoglycaemic risk factors in older patients with type 2 diabetes in two rural primary healthcare clinics in Selangor, Malaysia
title_short	Application of a social cognitive theory model to analyse hypoglycaemic risk factors in older patients with type 2 diabetes in two rural primary healthcare clinics in Selangor, Malaysia
title_full	Application of a social cognitive theory model to analyse hypoglycaemic risk factors in older patients with type 2 diabetes in two rural primary healthcare clinics in Selangor, Malaysia
title_fullStr	Application of a social cognitive theory model to analyse hypoglycaemic risk factors in older patients with type 2 diabetes in two rural primary healthcare clinics in Selangor, Malaysia
title_full_unstemmed	Application of a social cognitive theory model to analyse hypoglycaemic risk factors in older patients with type 2 diabetes in two rural primary healthcare clinics in Selangor, Malaysia
title_sort	application of a social cognitive theory model to analyse hypoglycaemic risk factors in older patients with type 2 diabetes in two rural primary healthcare clinics in selangor, malaysia
granting_institution	Universiti Putra Malaysia
granting_department	Institute of Gerontology
publishDate	2011
url	http://psasir.upm.edu.my/id/eprint/27002/1/IG%202011%204R%20pdf.pdf
_version_	1811767714550644736

Application of a social cognitive theory model to analyse hypoglycaemic risk factors in older patients with type 2 diabetes in two rural primary healthcare clinics in Selangor, Malaysia

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