Living with type 2 diabetes: A social cognitive perspective on adherence

Patient Educ Couns. 2024 Jul:124:108275. doi: 10.1016/j.pec.2024.108275. Epub 2024 Mar 26.

Abstract

Objective: This mixed methods study examines the relationship between outcome expectations, self-efficacy, and self-care behaviors in individuals with type 2 diabetes (T2DM). It also explores the personal values motivating these behaviors through in-depth interviews.

Methods: Adults with T2DM (n = 108, M age = 57 years, 58% female, 48% Black) completed questionnaires and participated in in-depth interviews using a laddering technique.

Results: Ordinary least squares regression models were used to analyze the relationships between self-efficacy, outcome expectations, and four self-care behaviors (physical activity, dietary choices, blood glucose monitoring, and medication usage). The findings indicate that self-efficacy is significantly and positively associated with diet and physical activity. Both outcome expectations for blood glucose testing and self-efficacy are significantly and positively associated with self-reported monitoring. However, neither outcome expectation nor self-efficacy is associated with medication usage. The in-depth interviews revealed three common values related to self-care behaviors: maintaining health and longevity, agentic values of self-control, achievement, and self-esteem, and a sense of belonging.

Conclusions: This study sheds light on the complexity of diabetes self-management, offering insights into individuals' values, behavioral strategies, and the influence of control perceptions on this relationship, revealing both differences and commonalities in stated values.

Practice implications: By understanding how personal values drive diabetes self-care behaviors, practitioners can assist patients in establishing meaningful connections between their values and the challenges of living with diabetes.

Keywords: Adherence; Diabetes; Outcome expectation; Personal values; Self-efficacy.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Aged
  • Blood Glucose Self-Monitoring / psychology
  • Cognition
  • Diabetes Mellitus, Type 2* / psychology
  • Diabetes Mellitus, Type 2* / therapy
  • Exercise / psychology
  • Female
  • Health Behavior
  • Humans
  • Interviews as Topic*
  • Male
  • Middle Aged
  • Patient Compliance / psychology
  • Qualitative Research
  • Self Care* / psychology
  • Self Efficacy*
  • Surveys and Questionnaires