Depression, distress and self-efficacy: The impact on diabetes self-care practices

Abstract

The prevalence of type 2 diabetes is increasing in Malaysia, and people with diabetes have been reported to suffer from depression and diabetes distress which influences their self-efficacy in performing diabetes self-care practices. This interviewer administered, cross sectional study, conducted in the district of Hulu Selangor, Malaysia, involving 371 randomly selected patients with type 2 diabetes, recruited from 6 health clinics, aimed to examine a conceptual model regarding the association between depression, diabetes distress and self-efficacy with diabetes self-care practices using the partial least square approach of structural equation modeling. In this study, diabetes self-care practices were similar regardless of sex, age group, ethnicity, education level, diabetes complications or type of diabetes medication. This study found that self-efficacy had a direct effect on diabetes self-care practice (path coefficient = 0.438, p<0.001). Self-care was not directly affected by depression and diabetes distress, but indirectly by depression (path coefficient = -0.115, p<0.01) and diabetes distress (path coefficient = -0.122, p<0.001) via self-efficacy. In conclusion, to improve self-care practices, effort must be focused on enhancing self-efficacy levels, while not forgetting to deal with depression and diabetes distress, especially among those with poorer levels of self-efficacy.

The Mediating Role of Self‐Efficacy in Shaping Self‐Management Behaviors Among Adults With Type 2 Diabetes

“…Although the association between diabetes distress and self‐efficacy was significant in the regression and correlation analysis, the current study showed that self‐efficacy played a completely mediating role in diabetes distress and self‐management behaviors. This was consistent with that of two previous studies suggesting that self‐efficacy mediates the association between diabetes distress and DSM behaviors (Devarajooh & Chinna, ; Lin et al., ). The main reason may be the influence of sociocultural norms on people's perception of disease.…”

“…The results in the final model further confirmed that self‐efficacy was a strong predictor of DSM behaviors. This is consistent with the results of numerous prior investigations (Al‐Amer et al., ; Bhandari & Kim, ; Cosansu & Erdogan, ; Devarajooh & Chinna, ; Gao et al., ; Hu, Dong et al., ; Kav et al., ; Ku & Kegels, ; Lin et al., ; Walker et al., ; Yang et al., ; Yuan et al., ; Yue et al., ; Zhao et al., ; Zhong et al., ).…”

“…Self‐efficacy, which refers to the belief in one's capability to perform specific behaviors, plays a central role in the change of individuals’ behavior (Bandura, ). Cross‐sectional studies suggest that higher self‐efficacy is also associated with better DSM behaviors (Al‐Amer, Ramjan, Glew, Randall, & Salamonson, ; Bhandari & Kim, ; Cosansu & Erdogan, ; Devarajooh & Chinna, ; Gao et al., ; Hu, Dong, Wei, & Huang, ; Kav, Yilmaz, Bulut, & Dogan, ; Ku & Kegels, ; Lin et al., ; Walker, Gebregziabher, Martin‐Harris, & Egede, ; Yang et al., ; Yuan, Sun, Yu, Zhao, & Dong, ; Yue, Chen, Wang, Su, & Wu, ; Zhao et al., ; Zhong, Wang, Zhang, Ji, & Wang, ). Social cognitive theory also suggests that sources of information can influence behavior by affecting self‐efficacy, emotional status can affect the judgment of individuals’ self‐efficacy, and personal characteristics might have an impact on self‐efficacy (Bandura, ).…”

“…Social cognitive theory also suggests that sources of information can influence behavior by affecting self‐efficacy, emotional status can affect the judgment of individuals’ self‐efficacy, and personal characteristics might have an impact on self‐efficacy (Bandura, ). In empirical investigations on diabetes, the relationships between knowledge and DSM behaviors (Formosa & Muscat, ; Geng & Zhang, ; Hu, Gruber, Liu, Zhao, & Garcia, ; Huang, Zhao, Li, & Jiang, ; Kassahun, Gesesew, Mwanri, & Eshetie, ; Ku & Kegels, ; Xu, Toobert, Savage, Pan, & Whitmer, ; Zhang et al., ; Zhong et al., ) and diabetes distress and DSM behaviors (Asuzu, Walker, Williams, & Egede, ; Devarajooh & Chinna, ; Lin et al., ) remains controversial. Personal characteristics (e.g., education level) have been reported to have an association with self‐efficacy and DSM behaviors (Bai, Chiou, & Chang, ; Cosansu & Erdogan, ; Kassahun et al., ).…”

Effect of Counseling on Self-Efficacy in Iranian Middle-Aged Women: A Randomized Controlled Clinical Trial

“…A sense of high self-efficacy leads to greater effort, resilience, and flexibility. People with high self-efficacy feel more capable than those with poor self-efficacy (19). Also, self-efficacy affects one's healthy behaviors and the management of chronic diseases (20).…”