Abstract
BackgroundA number of studies have examined the influence of self-efficacy, social support and patient-provider communication (PPC) on self-care and glycemic control. Relatively few studies have tested the pathways through which these constructs operate to improve glycemic control, however. We used structural equation modeling to examine a conceptual model that hypothesizes how self-efficacy, social support and patient-provider communication influence glycemic control through self-care behaviors in Chinese adults with type 2 diabetes.MethodsWe conducted a cross-sectional study of 222 Chinese adults with type 2 diabetes in one primary care center. We collected information on demographics, self-efficacy, social support, patient-provider communication (PPC) and diabetes self-care. Hemoglobin A1c (HbA1c) values were also obtained. Measured variable path analyses were used to determine the predicted pathways linking self-efficacy, social support and PPC to diabetes self-care and glycemic control.ResultsDiabetes self-care had a direct effect on glycemic control (β = −0.21, p = .007), No direct effect was observed for self-efficacy, social support or PPC on glycemic control. There were significant positive direct paths from self-efficacy (β = 0.32, p < .001), social support (β = 0.17, p = .009) and PPC (β = 0.14, p = .029) to diabetes self-care. All of them had an indirect effect on HbA1c (β =–0.06, β =–0.04, β =–0.03 respectively). Additionally, PPC was positively associated with social support (γ = 0.32, p < .001).ConclusionsHaving better provider-patient communication, having social support, and having higher self-efficacy was associated with performing diabetes self-care behaviors; and these behaviors were directly linked to glycemic control. So longitudinal studies are needed to explore the effect of self-efficacy, social support and PPC on changes in diabetes self-care behaviors and glycemic control.
Highlights
A number of studies have examined the influence of self-efficacy, social support and patient-provider communication (PPC) on self-care and glycemic control
The purpose of the current study is to explore the relationships of self-efficacy, social support and PPC, and their effects on self-care behaviors and glycemic control among Chinese patients with type 2 diabetes in a whole model
There were no significant differences among participants in assessments of their self-efficacy, social support, PPC, Summary of Diabetes Self-Care Activities (SDSCA) and Hemoglobin A1c (HbA1c) based on demographic differences
Summary
A number of studies have examined the influence of self-efficacy, social support and patient-provider communication (PPC) on self-care and glycemic control. We used structural equation modeling to examine a conceptual model that hypothesizes how self-efficacy, social support and patient-provider communication influence glycemic control through self-care behaviors in Chinese adults with type 2 diabetes. The main goals of diabetes management are to prevent microvascular and macrovascular complications [2] and to decrease mortality and economic costs due to diabetes. To achieve these goals, adequate glycemic control, including fasting blood glucose and glycosylated hemoglobin (HbA1c) has been recommended [3,4]. It is important that diabetes care providers should understand factors influencing selfcare behaviors
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