Psychiatric factors, self-efficacy, and glycemic control among adults with serious mental illness and type 2 diabetes

Ample evidence suggests that social support, self-efficacy, and adherence significantly, independently, and together affect glycemic control in patients with type 2 diabetes mellitus (T2DM), but the pathway from social support to glycemic control remains unclear. This study hypothesized that the effect of social support on glycemic control was mediated sequentially by self-efficacy and adherence. Patients with T2DM were recruited from two hospitals in Guangzhou, China, from January 1 to July 31, 2014, and their sociodemographic clinical data and their assessments on social support, self-efficacy, and adherence were obtained from medical records and self-completed questionnaires. Of the 532 patients who participated, 35% achieved glycemic control (i.e., HbA1c < 7%). Social support, self-efficacy, and adherence had significant correlations with each other and with glycemic control (P<0.05). Regression analyses and structural equation modeling showed that better social support was associated to better patient self-efficacy, which, in turn, was associated with better medical adherence, which was associated with improved glycemic control, and the relationship between social support and glycemic control was sequentially and completely mediated by self-efficacy and adherence. The five goodness-of-fit indices confirmed that our data fitted the hypothesized pathway model strongly.

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Pathways of empowerment perceptions, health literacy, self-efficacy, and self-care behaviors to glycemic control in patients with type 2 diabetes mellitus

Patient Education and Counseling ◽

10.1016/j.pec.2015.08.021 ◽

2016 ◽

Vol 99 (2) ◽

pp. 287-294 ◽

Cited By ~ 64

Author(s):

Yau-Jiunn Lee ◽

Shyi-Jang Shin ◽

Ruey-Hsia Wang ◽

Kun-Der Lin ◽

Yu-Li Lee ◽

...

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Health Literacy ◽

Glycemic Control ◽

Self Efficacy ◽

Self Care

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A comparison of adherence to hypoglycemic medications between Type 2 diabetes patients with and without serious mental illness

Psychiatry Research ◽

10.1016/j.psychres.2011.03.013 ◽

2011 ◽

Vol 188 (1) ◽

pp. 109-114 ◽

Cited By ~ 16

Author(s):

Julie Kreyenbuhl ◽

Jaclyn Leith ◽

Deborah R. Medoff ◽

LiJuan Fang ◽

Faith B. Dickerson ◽

...

Keyword(s):

Type 2 Diabetes ◽

Mental Illness ◽

Serious Mental Illness ◽

Diabetes Patients

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Quality of Life in Individuals With Serious Mental Illness and Type 2 Diabetes

Psychosomatics ◽

10.1176/appi.psy.49.2.109 ◽

2008 ◽

Vol 49 (2) ◽

pp. 109-114 ◽

Cited By ~ 24

Author(s):

Faith Dickerson ◽

Clayton H. Brown ◽

LiJuan Fang ◽

Richard W. Goldberg ◽

Julie Kreyenbuhl ◽

...

Keyword(s):

Quality Of Life ◽

Type 2 Diabetes ◽

Mental Illness ◽

Serious Mental Illness

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Self-Efficacy, Self-Care and Glycemic Control among Canadian South Asians with Type 2 Diabetes

Canadian Journal of Diabetes ◽

10.1016/j.jcjd.2016.08.207 ◽

2016 ◽

Vol 40 (5) ◽

pp. S71 ◽

Cited By ~ 1

Author(s):

Rowshanak Afshar ◽

Fardowsa Yusuf ◽

Tricia S. Tang

Keyword(s):

Type 2 Diabetes ◽

Glycemic Control ◽

Self Efficacy ◽

South Asians ◽

Self Care

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Predictors of mortality in patients with serious mental illness and co-occurring type 2 diabetes

Psychiatry Research ◽

10.1016/j.psychres.2010.01.004 ◽

2010 ◽

Vol 177 (1-2) ◽

pp. 250-254 ◽

Cited By ~ 13

Author(s):

Clayton Brown ◽

Jaclyn Leith ◽

Faith Dickerson ◽

Deborah Medoff ◽

Julie Kreyenbuhl ◽

...

Keyword(s):

Type 2 Diabetes ◽

Mental Illness ◽

Serious Mental Illness ◽

Predictors Of Mortality

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Diabetes Distress, Depressive Symptoms and Type 2 Diabetes Management and Glycemic Control: the Mediating Role of Self-efficacy

10.21203/rs.3.rs-135244/v1 ◽

2020 ◽

Author(s):

Yuexia Gao ◽

Yarong Han ◽

Xin Zou ◽

Judy Xu ◽

Dean Getrude Mawen ◽

...

Keyword(s):

Type 2 Diabetes ◽

Depressive Symptoms ◽

Glycemic Control ◽

Self Efficacy ◽

Diabetes Management ◽

Diabetes Distress ◽

Hierarchical Regression ◽

Psychological Variables ◽

Diabetes Outcomes

Abstract Background: Diabetes distress has been distinguished from depressive symptoms in the linkages to type 2 diabetes management and glycemic control. There are few evidences in rural China untangled the underlying pathways among them. The aim of our study was to examine whether self-efficacy reduced the detrimental effects of psychological variables on diabetes outcomes such as self-care behaviors, glycemic control and health-related quality of life (HRQoL).Methods: 1574 adults diagnosed with type 2 diabetes from 31 rural clinics in China were assessed for psychological variables, self-management and HRQoL. Hemoglobin A1c (HbA1c) data at 6 months after the survey were extracted from electronic medical records. Hierarchical regression model examined independent effects of psychological variables, self-efficacy on diabetes outcomes. KHB method and bootstrapping confidence intervals were employed to test the mediating effect of self-efficacy.Results: Hierarchical regression analysis showed both diabetes distress and depressive symptoms were significantly related to diet and HRQoL, but not related to glycemic control and medication adherence. Depressive symptoms, but not diabetes distress, was directly associated with physical activity. Mediation analysis demonstrated self-efficacy mediated the relationships of both diabetes distress and depressive symptoms on self-care behaviors, glycemic control and HRQoL.Conclusions: Self-efficacy may contribute to better diabetes outcome by ameliorating the effects of diabetes distress and depressive symptoms. Patients with psychological conditions may need tailored intervention that enhance self-efficacy to improve diabetes management.

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