Abstract
The prevalence of type 2 diabetes is increasing in Malaysia, and people with diabetes have been reported to suffer from depression and diabetes distress which influences their self-efficacy in performing diabetes self-care practices. This interviewer administered, cross sectional study, conducted in the district of Hulu Selangor, Malaysia, involving 371 randomly selected patients with type 2 diabetes, recruited from 6 health clinics, aimed to examine a conceptual model regarding the association between depression, diabetes distress and self-efficacy with diabetes self-care practices using the partial least square approach of structural equation modeling. In this study, diabetes self-care practices were similar regardless of sex, age group, ethnicity, education level, diabetes complications or type of diabetes medication. This study found that self-efficacy had a direct effect on diabetes self-care practice (path coefficient = 0.438, p<0.001). Self-care was not directly affected by depression and diabetes distress, but indirectly by depression (path coefficient = -0.115, p<0.01) and diabetes distress (path coefficient = -0.122, p<0.001) via self-efficacy. In conclusion, to improve self-care practices, effort must be focused on enhancing self-efficacy levels, while not forgetting to deal with depression and diabetes distress, especially among those with poorer levels of self-efficacy.
Highlights
IntroductionThe prevalence of diabetes has increased from 11.6% in 2006 to 15.2% in 2011 [1]
Diabetes mellitus is a common chronic disease in Malaysia
Factor analysis was performed to ensure that the translated Diabetes distress Scale measures what it was meant to while enabling the items to be reduced into a smaller set to save time and facilitate easier interpretation [20]
Summary
The prevalence of diabetes has increased from 11.6% in 2006 to 15.2% in 2011 [1]. People with diabetes suffer from a higher burden of psychosocial problems and psychological disorders [2]. The prevalence of depression is higher among people with diabetes, and is partly attributed by vascular damage which may induce cerebral pathology that constitutes vulnerability for depression [3]. Depression adds to the burden of managing diabetes, as those with depression perform poorer diabetes self-care [4]. An affective disorder, is a syndrome comprised of a multidimensional component, such as worry, conflict, frustration, and discouragement that can accompany living with diabetes, and is closely related to depression [5].
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