Effects of self-care, self-efficacy, social support on glycemic control in adults with type 2 diabetes

• Type of Material: Article
• Authors: Jingling Gao, Fudan University; Jingli Wang, Dachang Center of Primary Health Care; Pinpin Zheng, Fudan University; Regine Haardoerfer, Emory University; Michelle C Kegler, Emory University; Yaocheng Zhu, Emory University; Hua Fu, Fudan University
• Language: English
• Date: 2013-05-24
• Publisher: BioMed Central
• Publication Version: Final Published Version
• Copyright Statement: © 2013 Gao et al.; licensee BioMed Central Ltd.
• License: Creative Commons Attribution 2.0 Generic
• Final Published Version (URL): http://www.biomedcentral.com/1471-2296/14/66
• Title of Journal or Parent Work: BMC Family Practice
• ISSN: 1471-2296
• Volume: 14
• Issue: 66
• Start Page: 1
• End Page: 6
• Grant/Funding Information: This research was supported by the Fundamental Research Funds for the Central Universities [grant number: JJF201002] and Shanghai Municipal Health Bureau [grant number: KBF201149].
• Keywords: Social support; Patient-provider communication; Self-efficacy; Glycemic control
• Research Categories: Health Sciences, Education; Health Sciences, Public Health

Abstract

Background A 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. Methods We 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. Results Diabetes 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). Conclusions Having 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.