A systematic review of the effects of self-efficacy-based interventions on self-management and health behaviour change in patients with diabetes

Abstract

Objective To synthesis evidence of self-efficacy-based interventions to improve self-management and health behaviour change in patients with diabetes. Methods PubMed, Cochrane, MEDLINE, CINAHL, EBSCO and Web of Science were searched from 1977 to August 2018. The primary outcomes were self-efficacy and self-care ability. Pooled effect sizes of standardised mean difference (SMD) were calculated if outcome measurements and the units were different, and if outcome measurements and the units were the same, such as measuring blood glucose by HbA1c, weighted mean difference (WMD) were used to calculate pooled effect sizes. Results Nine eligible randomised control trials (RCTs) including 1578 participants were identified. The results showed that interventions based on self-efficacy significantly improved patients′ self-efficacy (SMD=0.69, 95%CI:0.58 to 0.80, P<0.05) and self-management (SMD=0.93,95%CI: 0.74 to 1.12, P<0.05), helped them control blood glucose (WMD=-0.69, 95%CI:-0.85 to-0.52, P<0.05), reduced hospitalisation and emergency times, and improved their quality of life (SMD=0.52,95%CI: 0.32 to 0.72, P<0.05). Conclusions Even though the results showed significant improvement in self-efficacy and self-management after interventions, the conclusion needs to be generalised with caution because of the quality of RCTs and high heterogeneity. Future trials could consider RCTs with high quality, appropriate sample size, specific component of diabetes management, and reliable and valid scales or objective measures as outcomes. Key words: Self-efficacy; Self-management; diabetes; Quality of life; Systematic review; Meta analysis