Self-Efficacy, Depression, and Self-Care Activities in Adult Jordanians with Type 2 Diabetes: The Role of Illness Perception

Abstract

Diabetes mellitus is reaching epidemic levels worldwide. In a developing country like Jordan, type 2 diabetes mellitus (T2DM) has reached a prevalence rate of 17.1%. This cross-sectional study examined the relationship between self-care activities and: illness perception, depression, social support, religiosity and spiritual coping, and self-efficacy among patients with T2DM. A random sample of 220 patients with T2DM, who attended Jordan University Hospital in Jordan were enrolled. The data were collected through a structured interview and the medical files. The instruments consisted of a sociodemographic and clinical standardised questionnaires: Brief Illness Perception Questionnaire, Patients' Health Questionnaire-9; ENRICH Social Support Instrument; Religious and Spiritual Coping Subscale; Diabetes Management Self-Efficacy Scale; and Summary of Diabetes Self-Care Activities. Bivariate analysis investigated the relationship between variables. Structure Equation Modelling (SEM) was performed to test the proposed conceptual model. The study found that approximately 70% of the respondents suffered some form of depressive symptoms. The SEM showed a direct relationship between self-efficacy and self-care activities (β = 0.40; p < 0.001). Depression was indirectly related to self-care activities through self-efficacy (β = -0.20; p = 0.003); nevertheless, it was directly related to perception of: treatment control, consequences, and emotional representations. Overall, the sequence between illness perception and self-efficacy was mediated by depression. Strategies to promote self-efficacy and illness perception are vital in customising a diabetes health plan to meet Arabic cultural expectations.

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

“…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, ).…”

A systematic review of adherence to diabetes self‐care behaviours: Evidence from low‐ and middle‐income countries

“…Ten included studies evaluated foot care among diabetes patients from which two studies investigated foot care only (Shown in Table ). Six studies (Al‐Amer et al, ; Ashur et al, ; Assah et al, ; Bhandari & Kim, ; Mogre, Abanga, et al, ; Mosha & Rashidi, ) reported foot care adherence according to the mean number of days diabetes patients adhered to foot care recommendations; mean days ranged from 2.2–4.3 days in a week. Huang et al () reported a mean foot care practice score of 77.47% among Chinese persons with diabetes (higher scores indicate better self‐perceived overall foot care).…”

Impact of Educational Self-efficacy Enhancement Program on Quality of Life, Pain Management, Self-efficiency Behaviors, and Its Impact of Satisfaction Among Adult Diabetic Patients With Peripheral Neuropathy Pain

“…The validity and reliability were performed by Al-Amer et.al (2016) in Jordan and were taken into consideration. The DSES was translated into Arabic, with the Cronbach's alpha of the revised scale was 0.81 [22].…”