Factors Affecting Self-Care Performance in Adolescents with Type I Diabetes According to the PEN-3 Cultural Model
Open accessAbstract
BACKGROUND: Adolescence is the most difficult period to control and manage type 1 diabetes (T1D), and various perceptions, enablers, and nurturers influence self-care behaviors in these patients. OBJECTIVES: The purpose of this study was to identify factors affecting self-care performance in adolescents with T1D, according to the PEN-3 cultural model. METHODS: In this study, in-depth interviews were conducted initially with 26 participants, and one group discussion was held with 13 participants. Assessment domains of the PEN-3 model (key influence on health behaviors and impact of behavior on health) guided the analysis of qualitative study and focus group data. Finally, the data were classified to a 3 × 3 table, based on the PEN-3 model. RESULTS: The most common positive PEN included awareness of self-care behaviors, attitude towards the disease, impact of spirituality on self-care, easy access to needed medical services, and maternal support. The negative PEN included attitude of patients and parents towards reasons of becoming sick (why me), awareness about the disease and its causes, low self-efficacy, limited training, high cost of blood glucose test strips, lack of educational therapeutic curricula based on spirituality, ignoring the role of spirituality in treatment and self-care, and conflict between parents and patients. CONCLUSIONS: The results of this study can be used to guide the development of cultural group therapy interventions aimed at increasing adherence to self-care behaviors among Iranian adolescents with T1D.
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Existing health education and promotion models do not consider culture at their core.
“There are different models in health education and promotion to design, implement and evaluate preventive health programs, but none of them consider the culture of preventive behavior or health-promoting behavior at their core.”
From Effectiveness of educational intervention on women’s participation to cervical cancer screening: a quasi-experimental study based on PEN-3 model (2022) · cites this paper as [14]
The Theoretical Framework (§2.1; page unavailable) says the PEN-3 health-promotion model is designed to put culture at the core of health-behavior determinants. That is a counterexample to the unqualified claim that no existing health education or promotion model does so. (LLM, conf=0.86)
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Experimental — accuracy not yet measuredThe PEN-3 model focuses on culture in preventive behavior or health promotion at its core.
“One health education and promotion model that focuses on culture in preventive behavior or health promotion at its core is the PEN-3 model.”
From Effectiveness of educational intervention on women’s participation to cervical cancer screening: a quasi-experimental study based on PEN-3 model (2022) · cites this paper as [14]
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- Authors
- Shahbazi, H., Ghofranipour, F., Amiri, P., & Rajab, A.
- Affiliations
- Tarbiat Modares University (IR)
- Research Institute for Endocrine Sciences (IR)
- Corresponding author
- Ghofranipour, Fazlollah
- Venue
- International Journal of Endocrinology and Metabolism
- Publisher
- Brieflands
- Published
- 2018-09-18
- Volume
- In Press
- Issue
- In Press
- Pages
- e62582-e62582
- ISSN
- 1726-913X (ISSN-L)
- 1726-9148
- PMC
- PMC6216475
- OpenAlex
- W2891019870
- Cited by
- 23
- References
- 38
- Citations by year
- 2026: 3 · 2025: 2 · 2024: 4 · 2023: 2 · 2022: 7 · 2021: 3 · 2020: 1 · 2017: 1
- FWCI
- 0.80
- Type
- journal article
- Language
- en
- Open access
- diamond
- doi.org
- Licence
- cc-by-nc
- Locations
- Intern J Endocrinol Metab (publishedVersion, cc-by-nc)
- Europe PMC (PubMed Central) (publishedVersion, cc-by-nc)
- PubMed Central (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- Funders
- Tarbiat Modares University
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Health Sciences › Health Professions › Speech and Hearing › Adolescent and Pediatric Healthcare
- Keywords
- type 1 diabetes, adolescents, self-care behavior, PEN-3 cultural model, diabetes self-management, spirituality, parental support, self-efficacy, barriers to self-care, Iranian adolescents
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