Diabetes Self-Management Practice of Older Koreans Based on AADE-7 (American Association of Diabetes Educatiors 7 Behaviors) Domains

Friday, 25 July 2014

Misoon Song, RN, PhD1
Suyoung Choi, PhD, GNP, RN2
Sun Ju Chang, PhD, RN3
Soo Jin Lee, RN, MSN1
Kyoungsan Seo, RN, MSN1
Se-an Kim, RN, MSN1
(1)College of Nursing, Seoul National University, Seoul, South Korea
(2)Research Institute of Nursing Science, College of Nursing Seoul National University, Seoul, South Korea
(3)Department of nursing, Chungbuk University, Chungju City, Chungbuk, South Korea

Purpose:  American Association of Diabetes Educators identified 7 domains of self-care behaviors essential for effective diabetes-self-management from the extensive review of evidences and expert consensus. But measurement tool for self-management behaviors based on this framework has not been developed in Korea. The purposes of this study were to develop the diabetes self-management behavior scale for older Koreans (DSMS-OK) based on AADE-7 domains and to describe current status of diabetes self-management behaviors of Korean older adults in the community measured by the scale.

Methods: The AADE-7 domains were utilized in developing the DSMS-OK items: healthy eating, being active, monitoring, taking medication, problem solving, reducing risks, and healthy coping. The scale was developed with consideration of feasibility and readability for targeting older adults with type 2 diabetes. The preliminary 10 items of 4-point (0-3) Likert type DSMS-OK were evaluated by ten diabetes education experts. The content validity index evaluated by the experts was 1.0 for all items in the scale, and all items were retained. Then the DSMS-OK was applied to 150 older adults (mean age 76.5 ±5.8 years) with diabetes in a senior center. Criterion related validity was evaluated by correlation with alternate form of Diabetes self-care behavior scale (Korean version of Summary of Diabetes Self-care Activities Questionnaire, K-SDSCA) which includes only 5 domains of AADE-7 domains.

Results: There was a significant relationship between totla scores of the DSMS-OK and the K-SDSCA (r=.502, p<.001), thus the criterion validity was supported. The most practicing self-management behavior was domain of taking medication (2.85/3, ±0.51), and the least practicing self-management behavior was domain of healthy coping (1.59/3, ±1.59).

Conclusion: The DSMS-OK is a useful tool for measuring diabetes self-management behaviors based on AADE-7 framework for older Koreans. The scale is short and easy to use for older adults, but further validation is required for psychometric properties. It is recommended that behaviors related to healthy coping domain need attention when designing diabetes self-management education program for older Koreans.