Health Literacy and Self-efficacy as correlates of Self-Management of Type 2 Diabetes in Middle-Aged and Older Adults

Health literacy is considered to be an emerging determinant of health behaviors and outcomes. The underlying mechanisms linking health literacy to diabetes self-management are currently unclear. This study assessed a mediation model consisting of a direct pathway between health literacy and self-management, and indirect pathways via social isolation only, self-efficacy only, and social isolation and self-efficacy serially in people with type 2 diabetes. A cross-sectional design was employed, and a total of 524 participants were recruited from outpatient clinics of multi-institutions from June 2020 to February 2021. The mediation model was analyzed using the PROCESS macro on SPSS with bootstrap bias-corrected 95% confidence intervals (CIs) with 10,000 bootstrapping iterations. Health literacy positively affected self-management. The estimated indirect effect of health literacy on self-management via social isolation was significant, at 0.018 (95% CI = 0.004–0.036). The indirect effect via self-efficacy was estimated at 0.214 (95% CI = 0.165–0.266). The indirect effect via social isolation and self-efficacy serially was 0.013 (95% CI = 0.006–0.023). The findings of this study suggest that clinical practice can be improved through more comprehensive diabetes self-management interventions that promote all of the components of health literacy, social contacts/networks, and self-efficacy in particular.

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DIABETES, SELF-EFFICACY TOWARD DIABETES PREVENTIVE BEHAVIORS, AND DEPRESSIVE SYMPTOMS AMONG KOREAN AMERICANS

Innovation in Aging ◽

10.1093/geroni/igz038.2612 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

pp. S711-S711

Author(s):

Soyeon Cho

Keyword(s):

Type 2 Diabetes ◽

Older Adults ◽

Depressive Symptoms ◽

Asian Americans ◽

Self Efficacy ◽

Korean Americans ◽

Community Dwelling ◽

Self Management ◽

Preventive Behaviors

Abstract Type 2 diabetes is a largely preventive chronic disease, which requires persevering self-management by maintaining healthy life style. Prevalence of Type 2 diabetes among Asian Americans are rapidly increasing, yet little is known about Asian Americans’ self-efficacy towards diabetes preventive behaviors. Thus, the present study examined self-efficacy on diabetes preventive behaviors (DPB) as a potential mediator in the association between diabetes and depressive symptoms among older Korean Americans. Data were driven from a cross-sectional study of 235 community-dwelling Korean American older adults (aged 60 and older) in 2013. The direct significant relation between diabetes and depressive symptoms became insignificant after self-efficacy on DPB was introduced, which demonstrates a full mediation effect of self-efficacy on DPB. Results suggest that even in the presence of diabetes, mental well-being such as depression of older adults can be maintained by having competence in self-management of their own health.

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Self-management Experience of Middle-aged and Older Adults With Type 2 Diabetes: A Qualitative Study

Asian Nursing Research ◽

10.1016/j.anr.2019.06.002 ◽

2019 ◽

Vol 13 (3) ◽

pp. 209-215 ◽

Cited By ~ 3

Author(s):

Fei-Ling Wu ◽

Hsiu-Chen Tai ◽

Jui-Chiung Sun

Keyword(s):

Type 2 Diabetes ◽

Older Adults ◽

Qualitative Study ◽

Self Management ◽

Middle Aged ◽

Management Experience

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Self-management and Self-rated Health Among Middle-aged and Older Adults with Type 2 Diabetes in China: A Structural Equation Model

Social Indicators Research ◽

10.1007/s11205-014-0575-0 ◽

2014 ◽

Vol 120 (1) ◽

pp. 247-260 ◽

Cited By ~ 2

Author(s):

Xi Pan ◽

Rose Marie Ward

Keyword(s):

Type 2 Diabetes ◽

Older Adults ◽

Structural Equation Model ◽

Structural Equation ◽

Equation Model ◽

Self Management ◽

Middle Aged ◽

Self Rated Health

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Mediating role diet self-efficacy plays in the relationship between social support and diet self-management for patients with type 2 diabetes

Archives of Public Health ◽

10.1186/s13690-021-00533-3 ◽

2021 ◽

Vol 79 (1) ◽

Author(s):

Li Yang ◽

Kun Li ◽

Yan Liang ◽

Qiuli Zhao ◽

Dan Cui ◽

...

Keyword(s):

Diabetes Mellitus ◽

Social Support ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Self Efficacy ◽

Self Management ◽

Mediating Role ◽

Diet Behavior ◽

The Relationship

Abstract Background It has previously been established that patients who have strong barriers to their diet self-management are more likely to have weak social support; however, the key mechanisms underlying the association between these two variables have not yet been established. This study aims to examine the potential role that diet self-efficacy plays in the relationship between social support and diet behavior in patients with type 2 diabetes mellitus (T2DM). Methods It was a cross-sectional survey. Three hundred-eighty patients diagnosed with T2DM were recruited for this study from five community health centers in China. The Chronic Disease Resource Scale (CIRS), Cardiac Diet Self-efficacy Scale (CDSE), and Food Control Behavior Scale (FCBS) were used to estimate participants’ utilization of social resources, diet self-efficacy, and diet self-management, respectively. The data were analyzed utilizing structural equation modelling. Results The results suggest that both higher levels of social support and diet self-efficacy are related to higher levels of diet self-management. The mediating effect that diet self-efficacy has on the relationship between social support and diet self-management was significant (β = .30, p < .05), explaining 55.68% of the total effect of social support on diet self-management. Conclusions Diet self-efficacy plays a mediating role in the association between social support and diet behavior in patients with type 2 diabetes mellitus.

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Type 2 diabetes self-management schemas across diverse health literacy levels: a qualitative investigation

Psychology and Health ◽

10.1080/08870446.2021.1909023 ◽

2021 ◽

pp. 1-21

Author(s):

Julie Ayre ◽

Carissa Bonner ◽

Danielle M. Muscat ◽

Sian Bramwell ◽

Sharon McClelland ◽

...

Keyword(s):

Type 2 Diabetes ◽

Health Literacy ◽

Self Management ◽

Qualitative Investigation

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Sex-specific association of BMI change with stroke in middle-aged and older adults with type 2 diabetes

Nutrition Metabolism and Cardiovascular Diseases ◽

10.1016/j.numecd.2021.07.007 ◽

2021 ◽

Author(s):

Cancan Cui ◽

Zhiyuan Wu ◽

Yunke Shi ◽

Zhonghang Xu ◽

Bing Zhao ◽

...

Keyword(s):

Type 2 Diabetes ◽

Older Adults ◽

Middle Aged ◽

Specific Association

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Impact of Health Literacy, Self-efficacy, and Outcome Expectations on Adherence to Self-care Behaviors in Iranians with Type 2 Diabetes

Oman Medical Journal ◽

10.5001/omj.2016.10 ◽

2016 ◽

Vol 31 (1) ◽

pp. 52-59 ◽

Cited By ~ 34

Author(s):

Mahnoush Reisi ◽

Firoozeh Mostafavi ◽

Homamodin Javadzade ◽

Behzad Mahaki ◽

Elahe Tavassoli ◽

...

Keyword(s):

Type 2 Diabetes ◽

Health Literacy ◽

Self Efficacy ◽

Self Care ◽

Outcome Expectations

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Non-health outcomes affecting self-care behaviors and medical decision-making preference in patients with type 2 diabetes: a cross-sectional study

10.21203/rs.2.21066/v2 ◽

2020 ◽

Author(s):

Ming-Jye Wang ◽

Hung-Ming Lin ◽

Li-Chen Hung ◽

Yi-Ting Lo

Keyword(s):

Type 2 Diabetes ◽

Decision Making ◽

Health Literacy ◽

Self Efficacy ◽

Patient Empowerment ◽

Self Care ◽

Cross Sectional Study ◽

Medical Decision ◽

Cross Sectional

Abstract Background: The effects of patient sustained self-care behaviors on glycemic control are even greater than the effects of medical treatment, indicating the value of identifying the factors that influence self-care behaviors. To date, these factors have not been placed in a single model to clarify the critical path affecting self-care behaviors. The aims of this study were to explore the relationships of these factors and the differences in patient preference for medical decision-making.Methods: A cross-sectional study was conducted among outpatients with type 2 diabetes at a regional teaching hospital. Purposive sampling was adopted to recruit 316 eligible patients via self-administered questionnaires. Partial least squares structural equation modeling was used for analysis.Results: Significant direct pathways were identified from health literacy to self-efficacy, patient empowerment, and self-care behaviors; from self-efficacy to self-care behaviors; and from patient empowerment to self-care behaviors. Indirect pathways were from health literacy to self-care behaviors via self-efficacy or patient empowerment. The pathway from health literacy to self-efficacy was significantly stronger in those preferring shared decision-making than in those who preferred physician decision-making. Conclusions: Health literacy is a critical factor in improving self-care behaviors in patients with type 2 diabetes, and the effect of health literacy on self-efficacy was more significant in the shared decision-making than in the physician decision-making. Therefore, developing an effective health strategy to strengthen health literacy awareness and designing friendly, diverse health literacy materials, and application tools is the most important factor to facilitate self-care behaviors in this population.

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