24-LB: Using Q-Methodology to Inform Personalized Diabetes Education for Koreans with Type 2 Diabetes on Insulin Therapy Free

Background: This study classified the profiles of Koreans with type 2 diabetes (T2D) on insulin therapy regarding their perceptions and self-management behaviors in order to inform personalized diabetes education.

Methods: Q-methodology, a semi-qualitative methodology and semi-quantitative technique, was used. Six steps of Q-methodology included: (1) development of Q-population, representative viewpoint statements on diabetes, (2) Q-sample, final statements selected from Q-population, (3) P-sample (Q-sorter) selection, (4) Q sorting, (5) factor analysis, (6) factor extraction. The Summary of Diabetes Self-Care Activity measure and A1C in the past 6 months were used to examine self-care behaviors in each Q-sorter. Of 160 statements, 33 Q-samples were selected. Then, 37-P-samples (24 men; 13 women; 30 to 80 years old) were recruited from a university-affiliated diabetes clinic in South Korea. Q-sorts were analyzed using the PQ method. Varimax rotation revealed five factors while 8 P-samples fell into the confounding factor (loaded on more than one factor); 2 P-samples were non-significant.

Findings: A total of 40.0% variance was explained with 5 factors: Factor 1(n=6): those showing education need with inadequate health literacy (age=59.1±18.9; A1C=7.89±0.53), Factor 2 (n=4): those trying to control diabetes with lifestyle (age= 62.8±8.4; A1C=7.94±2.12 ), Factor 3 (n=5): those controlling diabetes with medical treatment (age=58.0±12.6; A1C=7.74±1.27), Factor 4 (n=6): those not afraid of uncontrolled diabetes due to insufficient diabetes knowledge (age= 65.7±9.9; A1C= 8.06 ±1.27) and Factor 5(n=6): those who overestimated their knowledge and capability to control diabetes (age= 57.0±10.2; A1C=8.20±1.47).

Conclusions: Educational intervention for Koreans with T2D on insulin therapy should be designed depending on patients’ characteristics (knowledge, health literacy, behaviors, emotions) to improve clinical outcomes and quality of life.