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The Impact of Barriers and Self-Efficacy on Self-Care Behaviors in Type 2 Diabetes
Layla I. Aljasem, MD, DrPH
Health Education Division, Ministry of Health, Kuwait, and the Faculty of Medicine, Department of Community Medicine, Kuwait University, Baltimore, Maryland; Health Education Department, Ministry of Health, PO Box 33437, Rawda (73455), Kuwait wlcox{at}qualitynet.net
Mark Peyrot, PhD
Center for Social and Community Research, Loyola College, Baltimore, Maryland; School of Medicine, Department of Medicine, Baltimore, Maryland
Larry Wissow, MD, MPH
Department of Pediatrics, Johns Hopkins University, Baltimore, Maryland
Richard R. Rubin, PhD
School of Medicine, Department of Medicine, Baltimore, Maryland; Department of Pediatrics, Johns Hopkins University, Baltimore, Maryland
PURPOSE
this cross-sectional, correlational study examined the relationships of diabetes-specific treatment barriers and self-efficacy with self-care behaviors.
METHODS
A total of 309 people with type 2 diabetes participated in this study. All of the factors were assessed by selfreport questionnaires. Self-care behaviors included exercise, diet, skipping medication, testing blood for glucose, adjusting insulin to avoid or correct hyperglycemia, and adjusting diet to avoid or correct hypoglycemia.
RESULTS
Perceived barriers to carrying out self-care behaviors were associated with worse diet and exercise behavior. Greater selfefficacy predicted more frequent blood glucose testing, less frequent skipping of medication and binge eating, and closer adherence to an ideal diet. Nontraditional dimensions of selfefficacy were associated with worse self-care. Self-efficacy explained 4% to 10% of the variance in diabetes self-care behaviors beyond that accounted for by patient characteristics and health beliefs about barriers.
CONCLUSIONS
The findings of this study provided support for Rosenstock's proposal that a person's self-perceived capability to carry out a behavior should be incorporated into an expanded health belief model.
The Diabetes Educator, Vol. 27, No. 3,
393-404 (2001)
DOI: 10.1177/014572170102700309
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