Self-efficacy, self-care and glycemic control in individuals with noninsulin dependent diabetes mellitus

Abstract

Self-Efficacy, Self-Care and Glycemic control in Individuals with Noninsulin Dependent Diabetes -- The purpose of this study was to investigate the relationships among diabetes self-efficacy, diabetes self-care and glycemic control in a sample of individuals, with a diagnosis of noninsulin dependent diabetes mellitus. Bandura's self-efficacy theory was used to guide the study. -- A convenience sample of 136 subjects participated in the study. All participants completed the three questionnaires: (a) the modified Insulin Management Diabetes Self-Efficacy Scale (modified IMDSES), (b) the modified Insulin Management Diabetes Self-Care Scale (modified IMDSCS) and (c) the Demographic Questionnaire. Glycemic control was assessed by the participants' glycosylated hemoglobin (HbAlc) levels. -- The results of the study demonstrated statistically significant relationships among diabetes self-care, diabetes self-efficacy and glycemic control. Diabetes self--efficacy beliefs were highly correlated with diabetes self-care behaviors. Each of the subscale scores and the total score of the modified IMDSES correlated with its counterpart of the modified IMDSCS (r values ranged from .77 to .89, p<.01). Diabetes self-care behaviors (general, diet, exercise and total) were negatively correlated with glycemic control (r values ranged from -.21 to -.38, p<.01). Diabetes self-efficacy (general and diet) were negatively correlated with glycemic control: general (r = -.26, p<.01) and diet (r = -.19, p<.05). Diabetes self-efficacy and gender contributed significantly to the prediction of diabetes self-care (F(5,130) = 31.74, p<.0001) accounting for 55% of the variance in total self-care. Total self-efficacy (Beta = .72) was a stronger predictor of self-care than was gender (Beta = .12). Each of the subscale scores (general, diet, exercise, insulin and medication) of the modified IMDSES emerged as the best predictor of their counterpart of the modified IMDSCS. Total self-care behaviors and gender together accounted for 15% of the variance in glycemic control. -- The findings of this study indicated that incorporating the concept of self-efficacy in diabetes education programs may be of benefit. Further research is warranted using nursing interventions to increase self-efficacy and examining its impact on both diabetes self-care behaviors and glycemic control.