Determinants of adherence to self-care behavior among women with type 2 diabetes: an explanation based on health belief model

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Abstract

Background: Self-care is an essential element in treating a person with diabetes; and managing diabetes is of prime importance. The aim of this study was to investigate the predictors of adherence to self-care behavior among women with Type 2 diabetes.

Methods: This cross-sectional study was conducted on 210 female patients aged 30 to 60. Data collection tool was an anonymous valid and reliable questionnaire designed based on the Health Belief Model (HBM), which acquired information about the followings: Perceived susceptibility, severity, benefits, barriers, self-efficacy and diabetes self-care behavior. Data were analyzed by t-test, chisquare and regression analysis.

Results: The multiple regression models revealed 59.9% of the variance of self-care behavior with self-efficacy, perceived barrier, benefit and susceptibility. Additionally, the highest weight for β (β=0.87) was found for self-efficacy. Self-care behavior was positively correlated with all HBM variables except for perceived barriers showing a negative correlation.

Conclusion: The Health Belief Model may be used as a framework to design intervention programs in an attempt to improve adherence to self-care behaviors of women with diabetes. In addition, the results indicated that self-efficacy might play a more crucial role in developing self-care behaviors than t other HBM components. Therefore, if the focus is placed on self-efficacy when developing educational programs, it may increase the likelihood of adherence to self-care behavior.

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The Health Belief Model: a decade later.

N K Janz, M H Becker (1984)

Since the last comprehensive review in 1974, the Health Belief Model (HBM) has continued to be the focus of considerable theoretical and research attention. This article presents a critical review of 29 HBM-related investigations published during the period of 1974-1984, tabulates the findings from 17 studies conducted prior to 1974, and provides a summary of the total 46 HBM studies (18 prospective, 28 retrospective). Twenty-four studies examined preventive-health behaviors (PHB), 19 explored sick-role behaviors (SRB), and three addressed clinic utilization. A "significance ratio" was constructed which divides the number of positive, statistically-significant findings for an HBM dimension by the total number of studies reporting significance levels for that dimension. Summary results provide substantial empirical support for the HBM, with findings from prospective studies at least as favorable as those obtained from retrospective research. "Perceived barriers" proved to be the most powerful of the HBM dimensions across the various study designs and behaviors. While both were important overall, "perceived susceptibility" was a stronger contributor to understanding PHB than SRB, while the reverse was true for "perceived benefits." "Perceived severity" produced the lowest overall significance ratios; however, while only weakly associated with PHB, this dimension was strongly related to SRB. On the basis of the evidence compiled, it is recommended that consideration of HBM dimensions be a part of health education programming. Suggestions are offered for further research.

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Third national surveillance of risk factors of non-communicable diseases (SuRFNCD-2007) in Iran: methods and results on prevalence of diabetes, hypertension, obesity, central obesity, and dyslipidemia

Alireza Esteghamati, Alipasha Meysamie, Omid Khalilzadeh … (2009)

Background The burden of non-communicable diseases is rising globally. This trend seems to be faster in developing countries of the Middle East. In this study, we presented the latest prevalence rates of a number of important non-communicable diseases and their risk factors in the Iranian population. Methods The results of this study are extracted from the third national Surveillance of Risk Factors of Non-Communicable Diseases (SuRFNCD-2007), conducted in 2007. A total of 5,287 Iranian citizens, aged 15–64 years, were included in this survey. Interviewer-administered questionnaires were applied to collect the data of participants including the demographics, diet, physical activity, smoking, history of hypertension, and history of diabetes. Anthropometric characteristics were measured and serum biochemistry profiles were determined on venous blood samples. Diabetes (fasting plasma glucose ≥ 126 mg/dl), hypertension (systolic blood pressure ≥ 140 mmHg, diastolic blood pressure ≥ 90 mmHg, or use of anti-hypertensive drugs), dyslipidemia (hypertriglyceridemia: triglycerides ≥ 150 mg/dl, hypercholesterolemia: total cholesterol ≥ 200 mg/dl), obesity (body mass index ≥ 30 kg/m2), and central obesity (waist circumference ≥ 80 cm in females and ≥ 94 cm in males) were identified and the national prevalence rates were estimated. Results The prevalence of diabetes, hypertension, obesity, and central obesity was 8.7% (95%CI = 7.4–10.2%), 26.6% (95%CI = 24.4–28.9%), 22.3% (95%CI = 20.2–24.5%), and 53.6% (95%CI = 50.4–56.8%), respectively. The prevalence of hypertriglyceridemia and hypercholesterolemia was 36.4% (95%CI = 34.1–38.9%) and 42.9% (95%CI = 40.4–45.4%), respectively. All of the mentioned prevalence rates were higher among females (except hypertriglyceridemia) and urban residents. Conclusion We documented a strikingly high prevalence of a number of chronic non-communicable diseases and their risk factors among Iranian adults. Urgent preventive interventions should be implemented to combat the growing public health problems in Iran.

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Self-efficacy, self-management, and glycemic control in adults with type 2 diabetes mellitus.

Omar Al-Khawaldeh, Mousa Ali Al-Hassan, Erika Sivarajan Froelicher (2012)

The objective was to evaluate the relationships between diabetes management self-efficacy and diabetes self-management behaviors and glycemic control. A cross-sectional design was used. A convenience sample of 223 subjects with type 2 diabetes, ≥25 years old, who sought care at the National Diabetes Center in Amman, Jordan, was enrolled. A structured interview and medical records provided the data. The instruments included a sociodemographic and clinical questionnaire, a diabetes management self-efficacy scale, and a diabetes self-management behaviors scale. Glycosylated hemoglobin was used as an index for glycemic control. The analyses are presented as proportions, means (±S.D.), odds ratios, and 95% confidence intervals obtained from logistic regressions. Diet self-efficacy and diet self-management behaviors predicted better glycemic control, whereas insulin use was a statistically significant predictor for poor glycemic control. In addition, subjects with higher self-efficacy reported better self-management behaviors in diet, exercise, blood sugar testing, and taking medication. The findings showed that more than half of the subjects did not have their diabetes under control and that only 42% had attended diabetes education programs. The majority of subjects did not have their diabetes controlled; their self-efficacy was low, and they had suboptimal self-management behaviors. Therefore, strategies to enhance and promote self-efficacy and self-management behaviors for patients are essential components of diabetes education programs. Furthermore, behavioral counseling and skill-building interventions are critical for the patients to become confident and be able to manage their diabetes. Copyright © 2012 Elsevier Inc. All rights reserved.

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Author and article information

Journal

Journal ID (nlm-ta): Med J Islam Repub Iran

Journal ID (iso-abbrev): Med J Islam Repub Iran

Journal ID (publisher-id): MJIRI

Journal ID (publisher-id): Med J Islam Repub Iran

Title: Medical Journal of the Islamic Republic of Iran

Publisher: Iran University of Medical Sciences

ISSN (Print): 1016-1430

ISSN (Electronic): 2251-6840

Publication date Collection: 2016

Publication date (Electronic): 14 May 2016

Volume: 30

Page: 368

Affiliations

¹ Assistant Professor, Public Health Department, Faculty of Health, Saveh University of Medical Sciences, Saveh, Iran. karimymahmoo@ 123456yahoo.com

² Assistant Professor, Public Health Department, Faculty of Health, Ahvaz University of Medical Sciences, Ahvaz, Iran. araban62@ 123456gmail.com

³ Assistant Professor, Health education Department, Faculty of Health, Health Promotion Research Center, Zahedan University of Medical Sciences, Zahedan, Iran. zareban@ 123456yahoo.com

⁴ MSc, Nursing Department, Faculty of Nursing and Midwifery, Saveh University of Medical Sciences, Saveh, Iran. tahermohammad38@ 123456gmail.com

⁵ Assistant Professor, Nursing Department, Faculty of Nursing and Midwifery, Arak University of Medical Sciences, Arak, Iran. abedi.a@ 123456arakmu.ac.ir

Author notes

(Corresponding author) Assistant Professor, Health education Department, Faculty of Health, Health Promotion Research Center, Zahedan University of Medical Sciences, Zahedan, Iran. zareban@ 123456yahoo.com

Article

DOI: 10.1136/bmjopen-2020-044369

PMC ID: 4972051

PubMed ID: 27493912

SO-VID: 3f214311-c020-4fad-b0b3-2d50193cfe65

License:

This is an open-access article distributed under the terms of the Creative Commons Attribution NonCommercial 3.0 License (CC BY-NC 3.0), which allows users to read, copy, distribute and make derivative works for non-commercial purposes from the material, as long as the author of the original work is cited properly.

History

Date received : 29 April 2015

Date accepted : 12 September 2015

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Tables: 2, References: 39, Pages: 8

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Determinants of adherence to self-care behavior among women with type 2 diabetes: an explanation based on health belief model

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Most cited references 34

The Health Belief Model: a decade later.

Third national surveillance of risk factors of non-communicable diseases (SuRFNCD-2007) in Iran: methods and results on prevalence of diabetes, hypertension, obesity, central obesity, and dyslipidemia

Self-efficacy, self-management, and glycemic control in adults with type 2 diabetes mellitus.

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