The Impact of Barriers and Self-Efficacy on Self-Care Behaviors in Type 2 Diabetes

PURPOSE this cross-sectional, correlational study examined the relationships of diabetes-specific treatment barriers and self-efficacy with self-care behaviors. METHODS A total of 309 people with type 2 diabetes participated in this study. All of the factors were assessed by selfreport questionnaires. Self-care behaviors included exercise, diet, skipping medication, testing blood for glucose, adjusting insulin to avoid or correct hyperglycemia, and adjusting diet to avoid or correct hypoglycemia. RESULTS Perceived barriers to carrying out self-care behaviors were associated with worse diet and exercise behavior. Greater selfefficacy predicted more frequent blood glucose testing, less frequent skipping of medication and binge eating, and closer adherence to an ideal diet. Nontraditional dimensions of selfefficacy were associated with worse self-care. Self-efficacy explained 4% to 10% of the variance in diabetes self-care behaviors beyond that accounted for by patient characteristics and health beliefs about barriers. CONCLUSIONS The findings of this study provided support for Rosenstock's proposal that a person's self-perceived capability to carry out a behavior should be incorporated into an expanded health belief model.

[1]  M. Becker,et al.  The Health Belief Model: A Decade Later , 1984, Health education quarterly.

[2]  S. Kurtz.  Adherence to Diabetes Regimens: Empirical Status and Clinical Applications , 1990, The Diabetes educator.

[3]  R. Glasgow,et al.  Diabetes Regimen Behaviors: Predicting Adherence , 1987, Medical care.

[4]  Differential Effect of Diabetes Education on Self-Regulation and Life-Style Behaviors , 1991, Diabetes Care.

[5]  R. Rubin,et al.  Structure and Correlates of Diabetes-Specific Locus of Control , 1994, Diabetes Care.

[6]  R. Bauer,et al.  Correlates of Medication Compliance in Non-Insulin-Dependent Diabetes Mellitus , 1987, Southern medical journal.

[7]  Morton B. Brown,et al.  Understanding Young Children's Health Beliefs and Diabetes Regimen Adherence , 1993, The Diabetes educator.

[8]  A. Bandura.  Self-efficacy mechanism in human agency , 2024, Psihologìâ ì suspìlʹstvo.

[9]  R. Rubin,et al.  Levels and Risks of Depression and Anxiety Symptomatology Among Diabetic Adults , 1997, Diabetes Care.

[10]  M. Alogna.  Perception of Severity of Disease and Health Locus of Control in Compliant and Noncompliant Diabetic Patients , 1980, Diabetes Care.

[11]  B. Given,et al.  Development of scales to measure beliefs of diabetic patients. , 1983, Research in nursing & health.

[12]  D. Cox,et al.  Major developments in behavioral diabetes research. , 1992, Journal of consulting and clinical psychology.

[13]  S. Hauser,et al.  Self-Efficacy in Adolescent Girls and Boys With Insulin-Dependent Diabetes Mellitus , 1987, Diabetes Care.

[14]  R. Rubin,et al.  The Effect of a Diabetes Education Program Incorporating Coping Skills Training on Emotional Well-Being and Diabetes Self-Efficacy , 1993 .

[15]  R. Glasgow,et al.  Self-efficacy and outcome expectations in the self-regulation of non-insulin dependent diabetes mellitus. , 1989, Health education.

[16]  R. Glasgow,et al.  Regimen Adherence: A Problematic Construct in Diabetes Research , 1985, Diabetes Care.

[17]  D. Padgett.  Correlates of self-efficacy beliefs among patients with non-insulin dependent diabetes mellitus in Zagreb, Yugoslavia , 1991 .

[18]  Rhonda K. Polly.  Diabetes Health Beliefs, Self-Care Behaviors, and Glycemic Control Among Older Adults With Non-Insulin-Dependent Diabetes Mellitus , 1992, The Diabetes educator.

[19]  R. Glasgow,et al.  psychosocial Predictors of Self-Care Behaviors (Compliance) and Glycemic Control in Non-Insulin-Dependent Diabetes Mellitus , 1986, Diabetes Care.

[20]  R. Rubin,et al.  Modeling The Effect of Diabetes Education on Glycemic Control , 1994, The Diabetes educator.

[21]  C. Kilo,et al.  The role of health beliefs in the regimen adherence and metabolic control of adolescents and adults with diabetes mellitus. , 1987, Journal of consulting and clinical psychology.

[22]  R. Rubin,et al.  Effect of Diabetes Education on Self-Care, Metabolic Control, and Emotional Well-Being , 1989, Diabetes Care.

[23]  A. Hurley,et al.  Self-Efficacy: Strategy for Enhancing Diabetes Self-Care , 1992, The Diabetes educator.

[24]  A. O'Leary,et al.  Self-efficacy and health. , 1985, Behaviour research and therapy.

[25]  M. W. Linn,et al.  Health Beliefs, Compliance, and Control of Diabetes Mellitus , 1985, Southern medical journal.