Homepage > Research abstracts > The Contribution of Digital and Emotional Factors to T2DM Self-Management: A Mixed-Methods Study
The Contribution of Digital and Emotional Factors to T2DM Self-Management: A Mixed-Methods Study
Researchers: Ora Peleg1, Efrat Hadar1, Meyran Boniel-Nissim1, Afif Nakhleh2
- Max Stern Yezreel Valley College
- Rambam Medical Center
Background: Type 2 diabetes mellitus (T2DM) is a global epidemic, disproportionately affecting minorities, such as Israeli Arabs. Although digital tool use for diabetes (DTU-D) was found associated with effective self-management, there is paucity of research regarding DTU-D and emotional distress contribution to managing the illness.
Objectives: 1) identify DTU-D in T2DM patients
2) assess DTU-D, eHealth literacy, and distress contributions to self-management
3) examine ethnic differences
4) describe patient experience and barriers to effective self-management
2) assess DTU-D, eHealth literacy, and distress contributions to self-management
3) examine ethnic differences
4) describe patient experience and barriers to effective self-management
Method: A mixed-methods study: the quantitative phase-the DTUQ-D was developed and validated with 367 patients, followed by a main survey of 1,002 (684 Jews, 318 Arabs; 52% men) using questionnaires assessing eHealth literacy, DTU-D, emotional distress (depression, anxiety, stress), diabetes distress, and T2DM self-management. The qualitative phase included 42 interviews (22 Jews, 20 Arabs). Analyses included factor analyses, MANOVAs, logistic regression, and PROCESS; qualitative data were analyzed phenomenologically.
Findings: Among Jews, higher eHealth literacy predicted greater DTU-D, partially mediating self-management; emotional distress increased DTU-D but did not moderate its link to eHealth literacy. DTU-D mediated emotional distress
effects, though frequent DTU-D did not improve glycemic control. Findings yielded ethnic gaps in eHealth literacy, DTU-D, self-management, and emotional distress. Among Arabs, eHealth literacy and DTU-D were lower;
patients trusted physicians and preferred face-to-face guidance. Both Jews and Arabs described their life with the illness as complex and challenging.
effects, though frequent DTU-D did not improve glycemic control. Findings yielded ethnic gaps in eHealth literacy, DTU-D, self-management, and emotional distress. Among Arabs, eHealth literacy and DTU-D were lower;
patients trusted physicians and preferred face-to-face guidance. Both Jews and Arabs described their life with the illness as complex and challenging.
Conclusions: Cultural disparities shape coping with T2DM. Emotional distress, linked to higher A1C, can motivate DTU-D. DTU-D alone is insufficient without culturally sensitive support.
Recommendations: It is recommended that policymakers implement training to raise awareness among physicians and medical staff of
emotional distress and its role in self-management and possibly the onset of the illness. Enhancing eHealth literacy and providing guided DTU-D with emotional support can improve patient self-management, and glycemic control.
emotional distress and its role in self-management and possibly the onset of the illness. Enhancing eHealth literacy and providing guided DTU-D with emotional support can improve patient self-management, and glycemic control.
Research number: R.120.2021
Research end date: 09/2025