Associations between knowledge, illness perceptions, self-management and metabolic control of type 2 diabetes among African and European-origin patients

Abstract

Aims. Using Leventhal's Common-sense self-regulation model, this study investigated associations between illness perceptions, self-management and metabolic-control outcomes for diabetes among European and African-origin patients with type 2 diabetes.Background. Compared to the general populations of their host countries, African-origin populations in the diaspora are disproportionately affected by diabetes and its microvascular complications. However, comparatively little is known about how African-origin patients with type 2 diabetes perceive about their condition and whether such perceptions influence their self-management behaviours.Design. Cross-sectional design.Methods. Participants were recruited from diabetes clinics in London. Illness perceptions and adherence to self-management recommendations were assessed using questionnaires and data for metabolic-control outcomes were obtained from patient records. Associations between variables were investigated using correlations and multiple-regression techniques. Data collection for the study was conducted between February and June 2008.Results. In all, 359 patients participated in the study. The results indicated that perceiving diabetes with severe consequences was associated with poor self-management in both African-origin (black-African and black-Caribbean) and European-origin (white-British) patients with type 2 diabetes. However, personal control perceptions were associated with better self-management in African-origin patients. In multivariate analysis, illness perceptions explained significant proportions of the variations in self-management behaviours in both European-origin and African-origin patients. Perceived personal control over diabetes was a main determinant of the variations in self-management among European and African-origin patients. Other dimensions of illness perceptions, including consequences and emotional representations contributed to variations in self-management among African-origin patients. After controlling for demographic/disease characteristics, self-management of diabetes did not predict any metabolic-control outcome for diabetes in any ethnic group.Conclusion. Illness perceptions are important determinants of self-management among African-origin patients.Relevance to clinical practice. Illness perception-based interventions may be used to promote self-management among African-origin patients. Healthcare professionals should consider using patients' illness perceptions to inform service delivery.