Download or read book The Impact of Illness Perception Diabetes Management Self efficacy and Emotional Distress on Type 2 Diabetes Self management Among Americans with Chinese Backgrounds written by Ya-Ching Huang and published by . This book was released on 2018 with total page 392 pages. Available in PDF, EPUB and Kindle. Book excerpt: This descriptive correlational study explored the relationships of diabetes illness perception (consequences, personal control, treatment control, and cause), emotional distress (diabetes distress and depressive symptoms), and diabetes management self-efficacy with diabetes self-management activities; the mediator effects of diabetes management self-efficacy on the relationship between diabetes illness perception (consequences, personal control, treatment control, and cause) and self-management activities; and the moderator effects of emotional distress (diabetes distress and depressive symptoms) on the relationship between diabetes illness perception and self-management activities among Americans with Chinese backgrounds. The conceptual framework was based on an adaptation of Leventhal’s Common- Sense Model of self-regulation. A hundred and fifty-three survey participants with Type 2 diabetes were recruited from Chinese speaking communities in three major metropolitan areas in Texas. Participants average age was 69.1 years old, female (52.3%), and had at least a high school education. Their average acculturation score was 14.82 ± 7.66 (relatively low). The average number of comorbidities was 1.30 ± 1.27; participants were diagnosed with T2DM for an average of 13.43 ± 10.20 years; 14.4% were prescribed insulin. A mean item score for diabetes self-management self-efficacy was 7.4 out of 10. Diabetes distress mean score was 2.36, indicating a moderate level of distress. The average score of depressive symptoms was 11.25, and 24.8% of the participants met the clinical definition of depression. Participants performed diabetes management activities about 4.3 days out of the preceding 7 days. The significant bivariate correlations among variables included older age, longer years of diabetes, insulin usage, lower acculturation level; and participants with higher self-efficacy were more likely to report having better self-management activities. Neither illness perceptions nor emotional distress were found to be significant predictors of diabetes self-management in hierarchical multiple models. However, age, duration of diabetes, and self-efficacy were shown to significantly predict self-management. Self-efficacy also significantly mediated the relationship between illness perceptions and self-management activities; and the relationship between emotional distress and self-management activities. These findings contribute to our understanding of the factors that facilitate patients of Chinese American backgrounds to perform self-management activities on a daily basis

Download or read book Illness Representations Emotional Distress Coping Strategies and Coping Efficacy as Predictors of Patient Outcomes for Type 2 Diabetes written by Patricia Lynn Hart and published by . This book was released on 2006 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: Diabetes mellitus affects 20.8 million Americans in the United States and is the fifth leading cause of death in the United States. Acute and chronic disease-related complications can have a devastating effect on the life of individuals with Type 2 diabetes. Reduction in acute and chronic complications can be best achieved by individuals' adhering to appropriate lifestyle changes and maintaining tight glycemic control through a process of self-regulation. Self-regulation treatment decisions and lifestyle behavioral changes can be influenced by physiological and psychosocial factors. The purpose of this study was to examine the relationship between illness representations, emotional distress, coping strategies, and coping efficacy as predictors of outcomes (self-care behavior and A1c levels) in individuals with type 2 diabetes. A descriptive, correlational design was used to examine the relationship between illness representations, emotional distress, coping strategies, and coping efficacy as predictors of outcomes for self-care behavior and metabolic control in individuals with Type 2 diabetes as it relates to diabetes management. A convenience sample of 119 men (46.2%) and women (53.8%) between the ages of 22 and 93 years of age living in two urban cities located in a southeastern state with documented type 2 diabetes were recruited. Participants were recruited from four endocrinology offices, one internal medicine office, two medical clinics, and three diabetes education centers. The majority of the participants were caucasian (74.8%). Inclusion criteria were that participants a) had been diagnosed with type 2 diabetes for at least 1 year or more, (b) were able to read and write in English, (c) were 18 years of age or older, and (d) had an A1c level drawn within the past 30 days. Questionnaire booklets were mailed to participants. Participants' A1c levels were obtained from their medical records. Data were analyzed with descriptive and inferential statistics including frequencies, percentages, means, standard deviations, bivariate correlations, multiple linear regressions, and hierarchical multiple linear regressions. Participants perceived their diabetes to be a chronic, moderately cyclical condition with negative consequences and with moderate amounts of symptomatology that greatly influenced their emotional status. Hierarchical multiple linear regression analysis revealed that coping efficacy uniquely accounted for 9% of the variance in self-care behavior. Perceptions of higher coping efficacy were associated with higher beliefs of personal control and treatment control, a greater understanding of diabetes, engagement in higher levels of self-care behavior, and lower A1c levels. In addition, hierarchical multiple linear regression analysis revealed illness representations, particularly timeline cyclical, accounted for 12% of the variance in A1c levels. Perceptions of a more cyclical disease course were predicted of higher A1c levels. Interestingly, a perception of diabetes being a less chronic illness was associated with higher self-care behavior. This study affirms the importance of how illness representations and coping efficacy influence self-care behavior and A1c levels. The findings from this study have important implications for nursing practice in the areas of assessment, diabetes management, coping skills training, behavior modification, motivational interviewing, and diabetes education. Further research is needed to expand the knowledge base and develop targeted interventions related to illness representations, especially timeline cyclical, and coping efficacy in the diabetes population.

Download or read book Understanding the Factors Influencing Diabetes Self management in Chinese People with Type 2 Diabetes Using Structural Equation Modeling written by and published by . This book was released on 2005 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: Background: It China, more than 20 million people were diagnosed with diabetes in 2000 and it was estimated there would be 42.3 million people with diabetes by 2030 (Wild, Roglic, Green, Sicree, & King, 2004). Diabetes mellitus self-management (DMSM) is considered the cornerstone for controlling diabetes and preventing diabetic complications. To develop effective interventions to promote DMSM in China, it is critical to identify the factors influencing DMSM relevant to this population. The purposes of this study were to test a hypothesized model describing the effects of individual and environmental factors on DMSM in patients with type 2 diabetes in China, and to test if the estimated effects are the same between two subgroups, patients treated with insulin vs. patients treated without insulin. The individual factors included diabetes knowledge, beliefs of treatment effectiveness, and diabetes self-efficacy. Environmental factors included social support from family members and provider-patient communication. Methods: A cross-sectional survey research design was used in this study. The study was conducted at a major hospital in Beijing China. A convenience sample of 201 Chinese adult patients with type 2 diabetes mellitus who attended the outpatient department of the Endocrinology unit at the hospital from September 2004 to November 2004 was obtained for this study. Data were collected using a self-reported questionnaire. Structural equation modeling (SEM) analysis was conducted to test the hypothesized model, and examine and explore the relationships between and among the individual and environmental factors and DMSM. Findings: The initial hypothesized model did not fit the observed data. Based on statistical findings and theoretical soundness, the model was modified. The final model had a good fit to the data. The key findings were that belief in treatment effectiveness and diabetes self-efficacy were key proximal factors affecting DMSM. Knowledge and the environmental factors indirectly affected DMSM through belief in treatment effectiveness and self-efficacy. The findings based on the multi-group SEM analysis indicated that patient-provider communication was a more important factor affecting DMSM for the insulin-treated subgroup, while family support was more important for the non-insulin treated subgroup. Conclusions: The good fit of the final model indicated that significant determinants of DMSM described in American studies were also important predictors of DMSM in Chinese with diabetes. The model illustrated that individual and environmental factors affected DMSM both directly and indirectly. Understanding the complex relationships between and among the individual and environmental factors and DMSM helps the practitioner to design intervention programs promoting DMSM using a more comprehensive approach. The practitioner should also be aware of the differences between the subgroups when developing intervention programs.

Download or read book Motivational Interviewing in Diabetes Care written by Marc P. Steinberg and published by Guilford Publications. This book was released on 2015-08-14 with total page 257 pages. Available in PDF, EPUB and Kindle. Book excerpt: People with diabetes often struggle to make healthy choices and stay on top of managing their illness. Filling a vital need, this is the first book to focus on the use of motivational interviewing (MI) in diabetes care. The uniquely qualified authors--physician Marc P. Steinberg has devoted much of his career to diabetes care, and renowned clinical psychologist William R. Miller is the codeveloper of MI--present proven counseling techniques that can make any conversation with a patient more efficacious and motivating. Numerous sample dialogues illustrate specific ways to elicit patients' strengths and help them overcome barriers to change in such areas as eating habits, physical activity, medication use, insulin treatment, substance abuse, psychological issues, and more. This book is in the Applications of Motivational Interviewing series, edited by Stephen Rollnick, William R. Miller, and Theresa B. Moyers. Winner (First Place)--American Journal of Nursing Book of the Year Award, Adult Primary Care Category

Download or read book Communities in Action written by National Academies of Sciences, Engineering, and Medicine and published by National Academies Press. This book was released on 2017-04-27 with total page 583 pages. Available in PDF, EPUB and Kindle. Book excerpt: In the United States, some populations suffer from far greater disparities in health than others. Those disparities are caused not only by fundamental differences in health status across segments of the population, but also because of inequities in factors that impact health status, so-called determinants of health. Only part of an individual's health status depends on his or her behavior and choice; community-wide problems like poverty, unemployment, poor education, inadequate housing, poor public transportation, interpersonal violence, and decaying neighborhoods also contribute to health inequities, as well as the historic and ongoing interplay of structures, policies, and norms that shape lives. When these factors are not optimal in a community, it does not mean they are intractable: such inequities can be mitigated by social policies that can shape health in powerful ways. Communities in Action: Pathways to Health Equity seeks to delineate the causes of and the solutions to health inequities in the United States. This report focuses on what communities can do to promote health equity, what actions are needed by the many and varied stakeholders that are part of communities or support them, as well as the root causes and structural barriers that need to be overcome.

Download or read book Evidence Helping people help themselves written by Debra de Silva and published by The Health Foundation. This book was released on 2011 with total page 52 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Download or read book Psychosocial Care for People with Diabetes written by Deborah Young-Hyman and published by American Diabetes Association. This book was released on 2012-12-25 with total page 330 pages. Available in PDF, EPUB and Kindle. Book excerpt: Psychosocial Care for People with Diabetes describes the major psychosocial issues which impact living with and self-management of diabetes and its related diseases, and provides treatment recommendations based on proven interventions and expert opinion. The book is comprehensive and provides the practitioner with guidelines to access and prescribe treatment for psychosocial problems commonly associated with living with diabetes.

Download or read book Environmental Barriers Self efficacy and the Direct and Indirect Effects of Diabetes specific Cultural Beliefs on Health Status in a Community Sample of Diabetic Patients written by Lise Flores and published by . This book was released on 2004 with total page 182 pages. Available in PDF, EPUB and Kindle. Book excerpt: Type 2 diabetes mellitus represents a daunting self-management challenge due to its complicated daily treatment regimen which includes adhering to diet, exercise, and medication recommendations. Little research has evaluated perceived barriers to diabetes self-care in a group that is at particular risk for diabetic complications: U.S. Latinos. This study had two aims. The first was to provide evidence that experimental and validated self-report instruments selected for this study functioned in a comparable manner in both Spanish and English in a sample of low income, predominantly Spanish-speaking diabetic patients (n = 77). The second aim was to examine hypothesized relationships of selected predictors to two criterion variables measuring health status (i.e., glycosylated hemoglobin A1c and Diabetes Impact) using a method described by Baron & Kenny (1986). Predictors included age, education, and income as covariates, and perceived environmental barriers to self-care, self-efficacy for treatment adherence, fatalistic beliefs (external health locus of control), and Latino cultural diabetes beliefs. Potential moderator and mediator variables of the relationship between perceived barriers to self care and criterion variables included self-efficacy for treatment adherence, fatalistic beliefs and Latino cultural diabetes beliefs. Scales used in this study had coefficient alpha values ranging from .82-.96 in Spanish and .74-.97 in English and also demonstrated strong factor structure integrity. Bivariate correlations indicated that higher scores on perceived barriers to self-care were significantly related to lower self-efficacy scores [r = −.34, p

Download or read book The Self regulation of Health and Illness Behaviour written by Linda Diane Cameron and published by Psychology Press. This book was released on 2003 with total page 364 pages. Available in PDF, EPUB and Kindle. Book excerpt: Self-regulation theory focuses on the ways in which individuals direct and monitor their activities and emotions in order to attain their goals. This text presents recent developments in health psychology research, covering topics such as representational beliefs, anxiety and personality.

Download or read book Patient Knowledge Perceived Self efficacy and Self management Among Patients with Type II Diabetes Mellitus written by Razel Bacuetes Milo and published by . This book was released on 2017 with total page 130 pages. Available in PDF, EPUB and Kindle. Book excerpt: In the United States (U.S.), Type 2 Diabetes Mellitus (T2DM) has reached epidemic portions with a prevalence of approximately 29.1 million people and is the seventh-leading cause of death (Centers for Disease Control and Prevention [CDC], 2014; Healthy People 2020, n.d.). The U.S. spends an estimated $245 billion in direct and indirect medical costs. The indirect costs include disability and lost productivity (CDC, 2014). Previous studies focusing on diabetes education acknowledge the significance of self-management activities in managing T2DM. Extant studies examining self-management and treatment outcomes for persons with T2DM have paid limited attention to the relationship between patients' disease perceptions, diabetes knowledge, self-efficacy, self-management practices, and glycemic control. The purpose of this investigation was to identify factors and outcomes associated with healthy diabetes self-management practices among a cohort of individuals with T2DM residing in southern California. Nola Pender's Health Promotion Model (Pender et al., 2015) guided the study. Specific aims include: 1) Provide conceptual clarity for the phenomenon of perception through a concept analysis using Walker and Avant (2011) methodology, 2) Identify factors and outcomes associated with diabetes self-management through a systematic review of the literature, and 3) Examine relationships among perceived self-efficacy, specific patient characteristics, diabetic knowledge, self-management practices, and HbA1C values among a sample of individuals with T2DM living in southern California. The research aims provided the structure to generate new scientific data and evidence towards the improvement of self-management practices and those characteristics leading to improved HbA1C outcomes.

Download or read book Effects of a Peer led Educational Intervention on Support Resources Self effcacy Depression Beliefs and Self management Behaviors in Latinos with Type 2 Diabetes written by and published by . This book was released on 2013 with total page 47 pages. Available in PDF, EPUB and Kindle. Book excerpt: Type 2 diabetes mellitus (T2DM) affects roughly 20 million individuals in the US and this amount is projected to more than double by the year 2034. Latinos are at disproportionately greater risk for developing T2DM and often exhibit poorer adherence to diabetes self-management recommendations, and in turn, worse glycemic control and more diabetes-related complications, compared to non-Latino Whites. Project Dulce was a randomized controlled trial to investigate the effects of a peer-educator led, culturally-appropriate intervention designed to improve diabetes self-management and glycemic control among Latinos with poorly controlled diabetes. The current project investigated the effects of the Project Dulce intervention on diabetes self-management behavior, support resources, self-efficacy, depressive symptomatology, and culture-based beliefs about diabetes, using the Resources and Supports for Self-Management (RSSM) as a conceptual framework. Study participants (N = 207) completed clinical and self-report assessments at baseline, post-intervention (4 months), and follow-up (10 months). Study hypotheses were evaluated via multi-level models using Hierarchical Linear Modeling (HLM) 6.08. The study aimed to assess whether the Project Dulce peer-education group exhibited greater improvements over time in diabetes self-management behaviors, depressive symptoms, support resources for disease management and self-efficacy, as well as culture-based beliefs about diabetes, compared to the control ("care as usual") group. An exploratory aim of the study investigated whether "dosage" (i.e., classes attended) was associated with greater improvements in the Project Dulce intervention group. Analyses revealed improvements in dietary self-management behaviors, depressive symptomatology, self-efficacy, culture-based beliefs about diabetes, support resources for disease management (i.e., friends and family, healthcare providers, neighborhood, and personal support), and self-efficacy, over time, across groups. Analyses also revealed that Project Dulce group participants showed greater improvements in personal support resources for disease management and endorsed fewer culture-based beliefs about diabetes over time, compared to the control group. Furthermore, "dosage" (attendance) analyses, including only Project Dulce group participants, revealed that greater dosage (i.e., attending more sessions) led to greater improvements over time in support resources for disease management (self and neighborhood support), as well as exercise and blood-glucose checking self-management behaviors, compared to those who attended fewer classes. Although analyses revealed that Project Dulce group participants showed improvements over time with increased attendance, this was not significantly greater than improvements experienced by the control group. Possible explanations for improvements in the control group may relate to participants' motivation for change, or contact with the peer-educator during assessments which may have conveyed support or may have created expectancy effects (i.e., "social desirability effects") leading to biased self-report responding. Findings from "Dosage" analyses (including Project Dulce group participants only) indicate that individuals with type 2 diabetes who enroll in the Project Dulce intervention and attend more classes may experience greater support resources from their neighborhood and self-support, which may lead to improved self-management behavior, compared to individuals who attend fewer classes. Distinction of assessor and interventionist roles, and use of objective behavioral data collection methods, may shed light on the degree to which interventions such as Project Dulce can modify health behavior among this high-risk population.

Download or read book The Relationships Between Mindfulness Diabetes related Distress Selected Demographic Variables and Self management in Adults with Type 2 Diabetes written by Jennifer Bell Brown and published by . This book was released on 2014 with total page 304 pages. Available in PDF, EPUB and Kindle. Book excerpt: "Type 2 diabetes is a disease of worldwide scope and epidemic proportion. Two hundred and eighty-five million individuals have been diagnosed worldwide--a number expected to rise to 330 million by 2025 (Unwin, Whiting, & Roglic, 2010) and to 366 million by 2030 (Adriaanse et al., 2008). It is estimated that 18.8 million diagnosed and 7.0 million undiagnosed Americans have type 2 diabetes, numbers expected to rise to a total of 48.3 million by 2050 (Centers for Disease Control [CDC], 2011; Geiss & Cowie, 2011; Narayan, Williams, Gregg, & Cowie 2011). A recent American Diabetes Association (ADA) report estimated that the total costs of diabetes related health care rose from $174 billion in 2007 to $245 billion in 2012--figures that underscore the significant social costs associated with the disease (ADA, 2013). The considerable personal, social, and financial tolls of type 2 diabetes make effective self-management imperative./DISS_para Diabetes-related distress (DRD) and mindfulness are two variables that are believed to significantly impact effective diabetes self-management yet more research is needed to better understand and empirically confirm these relationships. DRD is characterized by the negative emotional reactions to the diabetes diagnosis, threat of complications, self-management demands, and unsupportive interpersonal relationships (Polonsky et al., 1995, 2005; Gonzalez, Fisher, & Polonsky, 2011). Recent studies indicate the relevance of mindfulness, the mindfulness components of awareness and acceptance, and the use of mindfulness-based interventions to enhance the self-management behaviors of individuals with type 2 diabetes (Gregg, Callaghan, Hayes, & Glenn-Lawson, 2007; Hernandez, Bradish, Rodger, & Rybansky, 1999; Ingadottir & Halldorsdottir, 2008). However, to date the literature is incomplete in drawing an explicit connection between mindfulness, diabetes-related distress, and diabetes self-management. This study was designed to address this gap in the literature. The prevalence of type 2 diabetes, its related debilitating conditions (e.g., cardiovascular disease, vascular dementia, kidney disease, and diabetic retinopathy), and mental health implications, make the exploration of self-management pathways imperative so that counselors and counselor educators may develop a greater understanding of the type 2 diabetes condition and appropriate counseling approaches. Greater understanding of the mechanisms to better diabetes self-management, with mindfulness as the theoretical foundation, may pave the way for improved prevention and intervention efforts among health care and mental health professionals. DISS_para The results of the current study indicated that mindfulness is a statistically significant predictor of self-management. Further, the results indicated social support as a significant predictor of self-management. The results suggest the potential value of the clinical application of mindfulness-based interventions with the type 2 diabetes population and continued development of resources that provide positive social support for the millions of people who are affected by this disease."--Abstract from author supplied metadata.

Download or read book Towards an Understanding of Type 2 Diabetes Self management written by Jerad Erikson and published by . This book was released on 2007 with total page 338 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Download or read book Social Isolation and Loneliness in Older Adults written by National Academies of Sciences, Engineering, and Medicine and published by National Academies Press. This book was released on 2020-05-14 with total page 317 pages. Available in PDF, EPUB and Kindle. Book excerpt: Social isolation and loneliness are serious yet underappreciated public health risks that affect a significant portion of the older adult population. Approximately one-quarter of community-dwelling Americans aged 65 and older are considered to be socially isolated, and a significant proportion of adults in the United States report feeling lonely. People who are 50 years of age or older are more likely to experience many of the risk factors that can cause or exacerbate social isolation or loneliness, such as living alone, the loss of family or friends, chronic illness, and sensory impairments. Over a life course, social isolation and loneliness may be episodic or chronic, depending upon an individual's circumstances and perceptions. A substantial body of evidence demonstrates that social isolation presents a major risk for premature mortality, comparable to other risk factors such as high blood pressure, smoking, or obesity. As older adults are particularly high-volume and high-frequency users of the health care system, there is an opportunity for health care professionals to identify, prevent, and mitigate the adverse health impacts of social isolation and loneliness in older adults. Social Isolation and Loneliness in Older Adults summarizes the evidence base and explores how social isolation and loneliness affect health and quality of life in adults aged 50 and older, particularly among low income, underserved, and vulnerable populations. This report makes recommendations specifically for clinical settings of health care to identify those who suffer the resultant negative health impacts of social isolation and loneliness and target interventions to improve their social conditions. Social Isolation and Loneliness in Older Adults considers clinical tools and methodologies, better education and training for the health care workforce, and dissemination and implementation that will be important for translating research into practice, especially as the evidence base for effective interventions continues to flourish.

Download or read book Pain Management and the Opioid Epidemic written by National Academies of Sciences, Engineering, and Medicine and published by National Academies Press. This book was released on 2017-09-28 with total page 483 pages. Available in PDF, EPUB and Kindle. Book excerpt: Drug overdose, driven largely by overdose related to the use of opioids, is now the leading cause of unintentional injury death in the United States. The ongoing opioid crisis lies at the intersection of two public health challenges: reducing the burden of suffering from pain and containing the rising toll of the harms that can arise from the use of opioid medications. Chronic pain and opioid use disorder both represent complex human conditions affecting millions of Americans and causing untold disability and loss of function. In the context of the growing opioid problem, the U.S. Food and Drug Administration (FDA) launched an Opioids Action Plan in early 2016. As part of this plan, the FDA asked the National Academies of Sciences, Engineering, and Medicine to convene a committee to update the state of the science on pain research, care, and education and to identify actions the FDA and others can take to respond to the opioid epidemic, with a particular focus on informing FDA's development of a formal method for incorporating individual and societal considerations into its risk-benefit framework for opioid approval and monitoring.

Download or read book Examining Biobehavioral Variables and Predictors Associated with Type 2 Diabetes Self Management written by Karin A. Emery and published by . This book was released on 2019 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: Type 2 diabetes mellitus self-management is a challenging process that brings forward a variety of emotional responses. The purpose of this work was to explore relationships between diabetes distress, self-efficacy and resilience and outcomes of glycosylated hemoglobin, quality of life and health status. A cross sectional descriptive design was used for this pilot study of 78 individuals enrolled from an Endocrine clinic in the Midwest United States and a Primary Care clinic in the southeast United States. Data were analyzed using descriptive statistics to characterize the sample and model variables. Spearman's correlation was completed to identify relationships among variables. A stepwise building approach was used to identify significant interactions and determine predictors of the study outcomes. The results of this study confirm the presence of facilitators and barriers in type 2 diabetes mellitus self-management and their relationships with distal outcomes. The findings demonstrate that diabetes distress is a predictor of health status and quality of life. The findings of this study provide a link to other facilitator and barrier variables such as provider collaboration, diabetes self-management education, treatment regimen, ethnicity and years since diagnosis which can be incorporated into the comprehensive theoretical model. This study contributes to the understanding of the emotional aspect of diabetes as it relates to self-management of T2DM. Continuing this work will allow researchers to examine and better understand important factors of self-management. This ongoing work will hopefully lead to improved support in self-management efforts and better outcomes.

Download or read book Self Management of Type 2 Diabetes in Appalachina Women written by and published by . This book was released on 2007 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: Gender, minority, and regional-related disparities have been documented in diabetes management. Self-efficacy, the belief in one's ability to carry out the actions mandated by a task, has been identified as a key predictor in glycemic control; however, it has not been investigated in rural, female populations. This crosssectional, correlation investigation examined the relationships among self-efficacy, depression, and diabetes self-care management in women living in Appalachia with type 2 diabetes. Using Banduraâs Social Cognitive Theory, 85 women ages âÆ 21 with type 2 diabetes for a minimum of 6 months who were residents in Appalachia completed the 1) Diabetes Self-Efficacy Scale, 2) Beck Depression Inventory-II, 3)Summary of Diabetes Self-Care Activities, and a 4) Diabetes Health-Related Demographics tool. Descriptive statistics detailed the sample characteristics. ANOVA, chi-square, and independent ttests were computed for between group differences as they related to depression, various physiologic states, presence of self-efficacy sources, and glycosylated hemoglobin. Pearson correlation coefficients were used to describe the relationships between selfefficacy, depression, and self-care management. Multiple linear regression analyses examined prediction models for glucose control while controlling for potential confounders. Eighty-four Caucasian and one African-American enrolled in the study with a mean age of 61. The mean time since diabetes diagnosis was 7 years with a mean glycosylated hemoglobin value of 6.9% (SD=1.3). Higher self-efficacy scores were associated with a lower glycosylated hemoglobin (r-.30, p=.005) and ability to choose foods best to maintain a healthy eating plan(r-.415, p=.001). The sources of self-efficacy associated with enhanced self-care management were mastery experience and vicarious experience. There were no significant relationships between self-efficacy and depression or depression and glycosylated hemoglobin. The diabetes self-c.