Examination of the relationship of knowledge of diabetes, attitude toward diabetes, and health literacy with diabetes management self-efficacy using hierarchical multiple regression modeling

Abstract

Background. Self-efficacy in diabetes management can empower patients and result in their more active participation in the treatment process. In addition, a patient’s behavior is influenced by their knowledge of and attitude toward their illness. Therefore, the goal of the present study was to examine the association of knowledge of diabetes, attitude toward diabetes, and health literacy with diabetes management self-efficacy in patients with type 2 diabetes. Methods. This descriptive-correlational study was conducted in 2019. The sample included 115 patients with diabetes (59 women and 56 men) attending diabetes centers of Sanandaj, Kurdistan, Iran, who were selected using a convenience sampling method. The Brief Diabetes Knowledge Test (DKT), the Diabetes Attitude Scale (DAS), the Health Literacy for Iranian Adults (HELIA) scale, and the Diabetes Management Self-Efficacy Scale (DMSES) were used to gather data. The data was analyzed using descriptive statistics, Pearson correlation coefficient, and stepwise regression analysis. All the analyses were perfumed using SPSS, version 16. The significance level was set at 0.05 for all the tests. Results. The mean age of participants was 46.61 ± 13.73 years. Health literacy (r = 0.585) and attitude (r = 0.396) were significantly correlated with self-efficacy (P = 0.001). According to the results of stepwise regression analysis, 34.3% and 36.6% of the variance of self-efficacy was explained by health literacy alone and health literacy together with attitude, respectively. One standard deviation change in health literacy and attitude was associated with 0.51 and 0.71 standard deviation change in self-efficacy, respectively. Conclusion. Health literacy and attitude toward diabetes are positively associated with self-efficacy in diabetes management, and improving these variables can improve self-efficacy in patients with type 2 diabetes.