The Sense of Responsibility for Health in Diabetic Patients: is it Important?
Authored by Mariusz Jaworski
Introduction
In the World a significant percentage of people are
characterized by unhealthy lifestyle, especially bad food habits, and
physical inactivity. This unhealthy lifestyle could be a cause of many
lifestyle diseases or diseases of civilization. If epidemiological date
is anything to go by the most common lifestyle diseases are obesity, and
diabetes [1,2].
Epidemiological data suggest that about 8.5% of adults aged 18 and
older had diabetes in 2014. In the same year, high blood glucose was the
cause of another 2.2 million deaths. Moreover, it is reported that
overweight and obesity account for an estimated 8%-15% of the burden of
disease in industrialized countries. What is more, World Health
Organization (WHO) estimated that more than 1.9 billion adults aged 18
and older were overweight in 2014. In the same year, about 13% of the
world's adult population (11% of men and 15% of women) were obese in
2014. According to this WHO aims to stimulate and support the adoption
of effective measures for the surveillance, prevention and control of
diabetes and its complications [3].
The main problem is associated with the analysis of
the effectiveness of lifestyle modification programs. Probably, the one
of the important predictors of the effectiveness of these programs could
be psychosocial factors which have a strong influence on shaping health
behavior, attitude towards health and disease, and lifestyle [4-6].
One of the interesting psychological factors, which can be important in
case of the effectiveness of lifestyle modification programs, is the
sense of responsibility for the health [5,6].
Sense of responsibility for health is a relatively new framework in
health sciences. In the main, this psychological factor is defined as
selfperceptions relating to motivation and the use of various behavioral
strategies to keep good health [7].
This perception is related to the assessment of health as an important
value in a lifetime. For this reason, ^sense of responsibility for
health is an important factor in health-related behavior. The highest
level of this psychological factor is associated with the need for
greater knowledge about health-related activities which can keep optimal
body state, and reduce the risk of the disease [8-10].
The empirical verification of sense of responsibility for health framework was taken by Adamus & Jaworski [8].
These authors have demonstrated the existence of two aspects of this
type of responsibility: first, active involvement, and second - adequate
behavior. Whereas active involvement concerns cognitive and
motivational aspects related to the need for undertaking appropriate
actions to maintain good health, adequate behaviors concern actions
taken to maintain health or make improvements [7,8].
These authors prepared a specific research tool which allows the
assessment of the severity of sense of responsibility for health [8].
Jaworski & Adamus [7]
observed that an appropriate level of responsibility for health
determines the higher level of motivation to treatment. It is reported
particularly in preliminary analysis, which were carried out in diabetic
patients' (n=110) [8].
Very similar observations were reported in patients7' with diabetes
with complications and accompanying diseases. Using the method of
structural equation modeling (SEM), it was developed model which
analyzed the relationship between some psychological characteristics
(e.g. optimism) and sense of responsibility for health. In this study,
it was observed that there are four main factors which influence on the
formation of sense of responsibility for health in diabetic patients,
such as: the health suggestibility, the dispositional optimism, the
duration of therapy and the number of used drugs [9].
These preliminary studies have shown that there are
sense of responsibility for health framework has practical implications
in clinical practice with diabetic patients [8,9].
According to this, diabetic patients should be encouraged by doctors to
be more active in the treatment and health promotion process. What is
important, the effectiveness of treatment depends on patients motivation
have for a given activity, and their expectations concerning health and
medical care. This can be achieved by adequate doctors^ behaviors
related to improve the patients' sense of responsibility for health.
What is more, sense of responsibility for health
could be an important element of the patients^ motivation to change
unhealthy lifestyle and has a positive impact on their selfefficacy.
Probably, it is related to the fact that the high level of sense of
responsibility for health is associated with the need for the greatest
knowledge about health-related activities, and reduces the risk of the
disease [11].
The important role of sense of responsibility for health could be
supported by results of some study which analyzed patients^ expectations
related to medical visits. The most important patients expectations are
associated with information about disease and treatment [12,13].
According to this, doctors should discuss accurate and balanced
information about treatment with patients, providing the opportunity to
develop realistic expectations and make informed decisions.
Additionally, doctor should stress during medical
visit that the therapy effectiveness depends on the patients^
involvement. The patient should be aware of this. At the beginning, the
patient may use the defense mechanisms which are an unconscious
psychological mechanism that reduces anxiety arising from unacceptable
or potentially harmful stimuli. For example, he/ she may think that a
doctor is only responsible for the therapy effectiveness, because he/she
proposes treatments. Patients do not see how he/she could be
responsibility for his/her health [14].
Additionally, it should be noted that the appropriate doctors^
communication skills can affect the increasing sense of responsibility
for health in patients with diabetes. This is particularly important in
the context of a motivational interview. The motivational interview is
defined as "a client- centered, directive method for enhancing intrinsic
motivation to change by exploring and resolving ambivalence." [15].
Sense of responsibility for health could be an important psychological
variable which has a relationship with a healthy lifestyle in diabetic
patients. For this reason, lifestyle modification programs should
strengthen the severity of sense of responsibility for health in this
patient. Thus, further study is needed to see if the current results are
replicated.
To Know More About Current Research in Diabetes & Obesity
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