Effects of self-care and self-efficacy on glycemic control in patients with type 2 diabetes: A cross sectional study from Palestine

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أبو بكر, ربا عباس سليم
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An-Najah National University
Background: Type 2 diabetes mellitus has become a significant public health problem in many countries including Palestine where it is considered the fourth cause of death. Self-care/self-efficacy has been shown to have strong correlation with glycemic control among patients with type 2 diabetes. However, such evidence is lacking in Palestinian primary health care centers. Objectives: To examine if there is any significant relationship between self-efficacy/self-care and blood glucose control, to determine factors associated with self-efficacy and self-care behavior, to determine factors associated with glycemic control, and to estimate the prevalence of glycemic control among diabetic patients. Method: This cross-sectional study involved 380 type 2 diabetes patients attending Al-Makhfeyyeh primary health care center in Nablus/Palestine during July to September, 2017. Patients were assessed for self-care/self-efficacy behaviors, and glycemic control (HbA1c). Results: of the total 380 patients, 82.4% had a poor glycemic control, as was indicated by HbA1c levels of > 6.5%. SES8C scale analysis revealed that high education level is a strong predictor for good type 2 diabetes self-efficacy behaviors (p value= 0.001). PEPPI scale analysis revealed positive direct effect between self-efficacy score with married participants (p-value was 0.034) and with high educated participants (p-value was <0.001). Significant correlation between participants in daily activities score was shown in participants <65years old (p-value <0.001), single or divorced (p-value 0.043), low educated (p-value 0.008), using monotherapy (p-value 0.034), using insulin injection (p-value <0.001), having ≥ 3 chronic diseases (p-value <0.001), and having high blood pressure (p-value 0.001). Physical activity shows positive correlation with young age, males, married, educated participants, not using insulin injection, and not suffering from any chronic diseases. No significant association was found between self-care/self-efficacy with glycemic control (p-values > 0.05). About half of the participants using insulin injection (48.7%). Only 12% of patients prepare a list of questions to ask their doctors about their illness and about 42% never discuss any personal problems that may related to their illness with their physicians. Conclusion: This study has found that higher self-efficacy behaviors were among high educated patients, and married participants. No relation between self-care/self-efficacy and glycemic control was found. Healthcare providers should encourage patients to increase their daily physical activity, having regular feet-care examination, and measure their blood glucose level regularly. Also patients should trust their physicians more and communicate with them to increase their knowledge about their illness and treatment.