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University of Iowa University of Iowa

Iowa Research Online Iowa Research Online

Theses and Dissertations

Fall 2014

The self-management of diabetes in older African American The self-management of diabetes in older African American

women caregivers of persons with dementia women caregivers of persons with dementia

Charlene Sue Aaron
University of Iowa

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Part of the Nursing Commons

Copyright 2014 Charlene Sue Aaron

This dissertation is available at Iowa Research Online: https://ir.uiowa.edu/etd/1525

Recommended Citation Recommended Citation
Aaron, Charlene Sue. "The self-management of diabetes in older African American women caregivers of
persons with dementia." PhD (Doctor of Philosophy) thesis, University of Iowa, 2014.
https://doi.org/10.17077/etd.tkti4wqj

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Part of the Nursing Commons

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Bivariate comparisons of good control verses poor control of glycemic status with

binary variables were analyzed. Dummy variable coding was used for the categorical

variables Income, caring for grandchildren, and medication use. The corresponding

hypothesis tests are for a difference of proportions between the two HbA1c groups.

"Caring for grandchildren is a binary variable, coded 0-1, income is a binary variable

coded 0-1. The analysis was performed to determine how much statistical evidence there

is to determine a true difference. The data is not surprising assuming there is no

difference in the groups (see Table 13).

Eleven caregivers with income under $30,000 were in good glycemic control,

where- as thirteen caregivers in the same income category were not in good control.

Thirteen caregivers making over $30,000 annually13 were in good control and 13 were

not. Caring for grandchildren, seven caregivers were in good control, while 18 were not.

Caregivers not caring for grandchildren, eleven were in good control, while 19 were in

poor control. Caring for children, six were in good control, while 18 were not.

Medication use was associated with 12 caregivers having good control while 12 were not

in control. Those caregivers who did not take medication, 20 were in good control, while

six were not in good control.

Dementia caregiving, time intensity and demographics were analyzed with

logistic regression. The variables remaining in the final model for HbA1c after

backwards selection are age, years with diabetes, years caring, comorbidities, and

caregiver performance difficulty. The outcome variables for logistic regression were

equal to 1 for participants who had well-controlled HbA1c with 0 for participants who

were not well- controlled. Therefore, positive parameter estimates are associated with

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better odds of having well controlled HbA1c. Negative parameter estimates are

associated with better odds of having poorly- controlled HbA1c.

Each additional year in age was associated with an increase of 0.12 in the odds of

a participant having good glycemic control. Experience with caregiving, where each

additional year of caregiving associated with an increase of 17.5% in the odds of having a

HbA1c less than or equal to seven. Each additional score of caregiving performance

difficulty was associated with a 5.1 fold increase in the odds of having a HbA1c less than

or equal to seven. This is a result of the multivariate analysis below.

In contrast, variables included in the model that were associated with a decreased

likelihood of having good control included comorbidities, where each additional

condition was associated with a decrease of 46% in the odds of a participant having a

well- controlled HbA1c, and time since diagnosis with diabetes, where each additional

year with diabetes was associated with a 7.4% decrease in the odds of having good

glycemic control (see Table 14).




Table 11. Bivariate Comparisons in Self-Management Behaviors between those with
Good Control vs Poor Control Glycemic Status (N=18)


Variable Name
Mean (SD)

<=7
Mean (SD)

>7 p-value
Glucose Testing 2.17(3.19) 3.77(3.20) 0.08

General Diet 4.75(1.91) 4.25(1.95) 0.36

Specific Diet 4.38(1.55) 4.48(1.69) 0.82

Exercise 1.83(2.33) 1.85(2.15) 0.98

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