Abstract
BackgroundSelf-efficacy has been shown to be positively correlated with self-care behaviour and glycaemic control among patients with type 2 diabetes mellitus. However, such evidence is lacking in the Malaysian primary care setting. The objectives of this study were to i) determine the levels of self-efficacy, self-care behaviour and glycaemic control among patients with type 2 diabetes mellitus in the Malaysian primary care setting ii) determine the relationship between self-efficacy, self-care behaviour and glycaemic control iii) determine the factors associated with glycaemic control.MethodsThis was a cross-sectional study involving patients with type 2 diabetes mellitus from two public primary care clinics in Malaysia. Self-efficacy and self-care behaviour levels were measured using previously translated and validated DMSES and SDSCA questionnaires in Malay versions, respectively. Glycaemic control was measured using HbA1c.ResultsA total of 340 patients with type 2 diabetes mellitus were recruited. The total mean (±SD) of self-efficacy and self-care behaviour scores were 7.33 (±2.25) and 3.76 (±1.87), respectively. A positive relationship was found between self-efficacy and self-care behaviour (r 0.538, P < 0.001). Higher self-efficacy score was shown to be correlated with lower HbA1c (r − 0.41, P < 0.001). Multiple linear regression analysis demonstrated that higher self-efficacy scores (b − 0.398; 95% CI: -0.024, − 0.014; P < 0.001), shorter duration of diabetes (b 0.177; 95% CI: 0.002, 0.007; P < 0.001) and smaller waist circumference (b 0.135; 95% CI: 0.006, 0.035; P = 0.006), were significantly associated with good glycaemic control.ConclusionThis study demonstrated that higher self-efficacy was correlated with improved self-care behaviour and better glycaemic control. Findings of this study suggest the importance of including routine use of self-efficacy measures in the management of type 2 diabetes mellitus in primary care.
Highlights
Self-efficacy has been shown to be positively correlated with self-care behaviour and glycaemic control among patients with type 2 diabetes mellitus
Levels of self-efficacy, self-care behaviour, and glycaemic control This study demonstrated a moderately high mean selfefficacy score (7.33) and participants were found to be most self-efficacious in tasks relating to medication intake and least self-efficacious in blood glucose testing
Factors associated with good glycaemic control This study shows that better self-efficacy, shorter duration of Type 2 Diabetes Mellitus (T2DM) and smaller waist circumference (WC) were significantly associated with good glycaemic control
Summary
Self-efficacy has been shown to be positively correlated with self-care behaviour and glycaemic control among patients with type 2 diabetes mellitus. Such evidence is lacking in the Malaysian primary care setting. The NDR project showed that the mean HbA1c among patients with T2DM was 8.1% and only 23.8% achieved the glycaemic target of < 6.5% [3] This highlights that it is important to look at patient factors as a mean to improve glycaemic control and the control of other associated CV risk factors to reduce complications alongside other aspects of the health care system
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