Investigating Relationships between Diabetes Distress, Diabetes Self-Care Behaviors, Intention to Use and Actual Use of a Personal Health Record within 30 Days of Hospital Discharge in Persons with Type 2 Diabetes

Background: Diabetes distress (DD) is defined by emotional and behavioral challenges caused from diabetes and its management. Diabetes self-care behaviors can be compromised by DD. Personal Health Record (PHR) use has been associated with improvements in HbA1c, blood pressure, and LDL-C, but the relationship between DD and PHR use is unknown. Aims: 1) to determine differences between sociodemographic variables and intention to use and actual use of PHR in hospitalized persons with Type 2 Diabetes Mellitus (T2DM), 2) to investigate the relationship between DD, intention to use a PHR and actual use of a PHR within 30 days of hospital discharge, 3) to investigate the relationship between DD, self-care behaviors, and clinical indicators of diabetes self- management, and 4) to investigate the relationship between DD and PHR-related performance expectancy, effort expectancy, social influence, and facilitating conditions. Method: Using a cross-sectional survey design, 99 inpatients reported their level of DD, self-care behaviors, and intention to use a PHR. Results: The mean intention to use the PHR score was 3.4; however, 85.9% did not use the PHR after discharge. Higher levels of DD were associated with higher HbA1c, rho= 0.26, p= 0.01, but DD was not related to intention to use or actual use of a PHR, p= 0.26 and p=0.66. Limitations and Implications: The small number of PHR users and possible recall or social desirability biases are limitations. Nurses should recognize that hospitalization might contribute to DD. Conclusion: Future research is needed to understand associations between diabetes distress and PHR use