BACKGROUND: Self-efficacy, diabetes distress, knowledge, and education level are likely the important factors affecting diabetes self-management (DSM) behaviors. However, the theoretical mechanisms underlying these variables remain unclear. AIMS: The study aimed to test a model including variables of self-efficacy, diabetes distress, knowledge, and education level and DSM behaviors that were informed by social cognitive theory and the literature review among adults with type 2 diabetes. METHODS: A cross-sectional study design was employed. Among a convenience sample of 320 adults with type 2 diabetes, 265 eligible participants (response rate = 82.81%) were investigated, using the demographic information questionnaire, the Summary of Diabetes Self-Care Activities, the Self-Efficacy for Diabetes Scale, the Diabetes-Related Knowledge Questionnaire, and the Diabetes Distress Scale. Structural equation modeling was performed with 10,000 bootstrap samples using AMOS 23.0. RESULTS: The final model provided a good fit to the data (χ2 [22, N = 265] = 9.192, df = 5, p = .102, NFI = 0.972, RMSEA = 0.056). Self-efficacy had the strongest direct effect on DSM behaviors (β = 0.550, p = .000). Knowledge (β = 0.167, p = .004) and employment status (β = -0.130, p = .009) had a direct effect on DSM behaviors. The association between knowledge and DSM behaviors was partially mediated by self-efficacy (bootstrap mean = 0.160, 95% CI: 0.088, 0.237), explaining 49.08% of the total effect of knowledge on DSM behaviors. The association between diabetes distress and DSM behaviors (bootstrap mean = -0.113, 95% CI: -0.192, -0.043) and education level and DSM behaviors (bootstrap mean = 0.102, 95% CI: 0.047, 0.165) were completely mediated by self-efficacy. CONCLUSIONS: Self-efficacy plays an important role in the mediation of the association between knowledge and DSM behaviors, diabetes distress and DSM behaviors, and education level and DSM behaviors, as well as a direct contributing role in the predication of DSM behaviors. LINKING EVIDENCE TO ACTION: Self-efficacy plays a direct contributing and mediating role in shaping DSM behaviors. The results of the model can help to develop evidence- and theory-based and culturally sensitive interventions. Strategies including goal setting, practicing, recording, peer models, persuasion, positive feedback, and encouragement can be used to address self-efficacy of patients. Interventions led by nurses that increase knowledge, reduce diabetes distress, and emphasize self-efficacy have the potential to promote changes in DSM behaviors.
BACKGROUND: Self-efficacy, diabetes distress, knowledge, and education level are likely the important factors affecting diabetes self-management (DSM) behaviors. However, the theoretical mechanisms underlying these variables remain unclear. AIMS: The study aimed to test a model including variables of self-efficacy, diabetes distress, knowledge, and education level and DSM behaviors that were informed by social cognitive theory and the literature review among adults with type 2 diabetes. METHODS: A cross-sectional study design was employed. Among a convenience sample of 320 adults with type 2 diabetes, 265 eligible participants (response rate = 82.81%) were investigated, using the demographic information questionnaire, the Summary of Diabetes Self-Care Activities, the Self-Efficacy for Diabetes Scale, the Diabetes-Related Knowledge Questionnaire, and the Diabetes Distress Scale. Structural equation modeling was performed with 10,000 bootstrap samples using AMOS 23.0. RESULTS: The final model provided a good fit to the data (χ2 [22, N = 265] = 9.192, df = 5, p = .102, NFI = 0.972, RMSEA = 0.056). Self-efficacy had the strongest direct effect on DSM behaviors (β = 0.550, p = .000). Knowledge (β = 0.167, p = .004) and employment status (β = -0.130, p = .009) had a direct effect on DSM behaviors. The association between knowledge and DSM behaviors was partially mediated by self-efficacy (bootstrap mean = 0.160, 95% CI: 0.088, 0.237), explaining 49.08% of the total effect of knowledge on DSM behaviors. The association between diabetes distress and DSM behaviors (bootstrap mean = -0.113, 95% CI: -0.192, -0.043) and education level and DSM behaviors (bootstrap mean = 0.102, 95% CI: 0.047, 0.165) were completely mediated by self-efficacy. CONCLUSIONS: Self-efficacy plays an important role in the mediation of the association between knowledge and DSM behaviors, diabetes distress and DSM behaviors, and education level and DSM behaviors, as well as a direct contributing role in the predication of DSM behaviors. LINKING EVIDENCE TO ACTION: Self-efficacy plays a direct contributing and mediating role in shaping DSM behaviors. The results of the model can help to develop evidence- and theory-based and culturally sensitive interventions. Strategies including goal setting, practicing, recording, peer models, persuasion, positive feedback, and encouragement can be used to address self-efficacy of patients. Interventions led by nurses that increase knowledge, reduce diabetes distress, and emphasize self-efficacy have the potential to promote changes in DSM behaviors.
Authors: Marcus Heise; Astrid Fink; Jens Baumert; Christin Heidemann; Yong Du; Thomas Frese; Solveig Carmienke Journal: PLoS One Date: 2021-03-19 Impact factor: 3.240
Authors: Van Bang Nguyen; Kim Huong Pham Thi; Thi Xuan Nguyen; Nguyen Tuyen Linh Pham; Van Vy Hau Nguyen; Chi Van Le Journal: PLoS One Date: 2022-07-08 Impact factor: 3.752
Authors: Maria Esther Irigoyen-Camacho; Maria Consuelo Velazquez-Alva; Marco Antonio Zepeda-Zepeda; Maria Fernanda Cabrer-Rosales; Irina Lazarevich; Antonio Castaño-Seiquer Journal: Int J Environ Res Public Health Date: 2020-10-12 Impact factor: 3.390