Vol 9, No 6 (2020)
Research paper
Published online: 2020-11-09

open access

Page views 787
Article views/downloads 856
Get Citation

Connect on Social Media

Connect on Social Media

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

Mona Zahedi1, Fazel Dehvan1, Sahar Dalvand2, Reza Ghanei Gheshlagh1
Clin Diabetol 2020;9(6):394-399.

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.

Article available in PDF format

View PDF Download PDF file

References

  1. Pashaki MS, Mezel JA, Mokhtari Z, et al. The prevalence of comorbid depression in patients with diabetes: A meta-analysis of observational studies. Diabetes Metab Syndr. 2019; 13(6): 3113–3119.
  2. Tharek Z, Ramli AS, Whitford DL, et al. Relationship between self-efficacy, self-care behaviour and glycaemic control among patients with type 2 diabetes mellitus in the Malaysian primary care setting. BMC Fam Pract. 2018; 19(1): 39.
  3. Olfatifar M, Karami M, Shokri P, et al. Prevalence of Chronic Complications and Related Risk Factors of Diabetes in Patients Referred to the Diabetes Center of Hamedan Province. Scientific Journal of Hamedan Nursing and Midwifery Faculty. 2017; 25(2): 69–74.
  4. Haghdoost AA, Rezazadeh-Kermani M, Sadghirad B, et al. Prevalence of type 2 diabetes in the Islamic Republic of Iran: systematic review and meta-analysis. East Mediterr Health J. 2009; 15(3): 591–599.
  5. Shomali M, Mohamadi S, Ervanloo S. An Investigation of Nurses’ Knowledge Regarding Diabetes Zanjan University of Medical Sciences. Journal of Diabetes Nursing. 2015; 3(1): 59–68.
  6. Rahimi MIN. Rezvan Madani F, Eghbalian A. Knowledge and Practice Level of Self-Directed Care among Diabetics in Kermanshah City in 2014: A Short Report. The Journal of Rafsanjan University of Medical Sciences. 2015; 14(2): 167–72.
  7. Shahraki RA, Kamrani AA, Sahaf R, et al. Effects of Nationwide Program for Prevention and Control of Diabetes Initiated by the Ministry of Health on Elderly Diabetic Patients’ Knowledge, Attitude and practice in Isfahan. Salmand. 2019: 84–95.
  8. Hatef M, Sharif Nia H, Mousavinasab N, et al. Self-efficacy and Prediction of Associated Factors in Patients with Chronic Diseases. Journal of Mazandaran University of Medical Sciences. 2018; 28(162): 86–94.
  9. Niguse H, Belay G, Fisseha G, et al. Self-care related knowledge, attitude, practice and associated factors among patients with diabetes in Ayder Comprehensive Specialized Hospital, North Ethiopia. BMC Res Notes. 2019; 12(1): 34.
  10. Huang YM, Shiyanbola OO, Smith PD. Association of health literacy and medication self-efficacy with medication adherence and diabetes control. Patient Prefer Adherence. 2018; 12: 793–802.
  11. Abedini Z. Shouri Bidgoli A, Ahmari Tehran H. Study of Knowledge and Practice of Patient Self directed Care among Diabetics Patients. Qom Univ Med Sci J. 2008; 2(2): 37–42.
  12. Moodley LM, Rambiritch V. An assessment of the level of knowledge about diabetes mellitus among diabetic patients in a primary healthcare setting. South African Family Practice. 2014; 49(10).
  13. Herath HMM, Weerasinghe NP, Dias H, et al. Knowledge, attitude and practice related to diabetes mellitus among the general public in Galle district in Southern Sri Lanka: a pilot study. BMC Public Health. 2017; 17(1): 535.
  14. Murata GH, Shah JH, Adam KD, et al. Factors affecting diabetes knowledge in Type 2 diabetic veterans. Diabetologia. 2003; 46(8): 1170–1178.
  15. Sheeran P, Maki A, Montanaro E, et al. The impact of changing attitudes, norms, and self-efficacy on health-related intentions and behavior: A meta-analysis. Health Psychol. 2016; 35(11): 1178–1188.
  16. Zahedi S, Darvishpoor Kakhaki A, Hosseini M, et al. The Correlation Between Self-Care And Health Literacy In Patients Undergoing Hemodialysis. Iranian Journal of Diabetes and Lipid Disorders. 2018; 17(4): 180–188.
  17. Abbaszadeh Bazzi M, Karimiaval M. Relationship between Health Literacy and Self-Care Behaviors in Diabetic Patients Type II Referred to the Center of Diabetes Control and Prevention in Zabol. Journal of Health Literacy. 2018; 3(1): 10–19.
  18. Schillinger D, Grumbach K, Piette J, et al. Association of health literacy with diabetes outcomes. JAMA. 2002; 288(4): 475–482.
  19. Fitzgerald JT, Funnell MM, Anderson RM, et al. The reliability and validity of a brief diabetes knowledge test. Diabetes Care. 1998; 21(5): 706–710.
  20. University of Michigan Health System: Michigan Diabetes Research Center (MDRC); 2019. http://diabetesresearch.med.umich.edu/Tools_SurveyInstruments.php.
  21. Mahjouri MY, Esfahani E, Larijani B. Evaluation of psychometric properties of the third version of the Iranian Diabetes Attitude Scale (IR-DAS-3). Iranian Journal of Diabetes and Lipid Disorders. 2011; 10(1): 1–6.
  22. Montazeri A, Tavousi M, et al. Health Literacy for Iranian Adults (HELIA): development and psychometric Properties. Payesh. 2014; 13(5): 589–599.
  23. Haghayegh AS, Ghasemi N, Neshatdoost HT, et al. Psychometric Properties Of Diabetes Management Self-Efficacy Scale (Dmses). IJEM. 2010; 12(2): 111–5.
  24. Osborn CY, Cavanaugh K, Wallston KA, et al. Self-efficacy links health literacy and numeracy to glycemic control. J Health Commun. 2010; 15 Suppl 2: 146–158.
  25. Masoompour M, Tirgari B, Ghazanfari Z. The Relationship between Health Literacy, Self-Efficacy, and Self-Care Behaviors in Diabetic Patients. Evidence Based Care. 2017; 7(3): 17–25.
  26. Pashaki MS, Eghbali T, Niksima SH, et al. Health literacy among Iranian patients with type 2 diabetes: A systematic review and meta-analysis. Diabetes Metab Syndr. 2019; 13(2): 1341–1345.
  27. Saeed H, Saleem Z, Naeem R, et al. Impact of health literacy on diabetes outcomes: a cross-sectional study from Lahore, Pakistan. Public Health. 2018; 156: 8–14.
  28. von Wagner C, Semmler C, Good A, et al. Health literacy and self-efficacy for participating in colorectal cancer screening: The role of information processing. Patient Educ Couns. 2009; 75(3): 352–357.
  29. Bohanny W, Wu SFV, Liu CY, et al. Health literacy, self-efficacy, and self-care behaviors in patients with type 2 diabetes mellitus. J Am Assoc Nurse Pract. 2013; 25(9): 495–502.
  30. Santos FR, Bernardo V, Gabbay MAL, et al. The impact of knowledge about diabetes, resilience and depression on glycemic control: a cross-sectional study among adolescents and young adults with type 1 diabetes. Diabetol Metab Syndr. 2013; 5(1): 55.
  31. Goodarzi M, Ebrahimzadeh I, Rabbi A, et al. Asghari jafarAbadi M. The relationship between knowledge, attitude and practice with self-efficacy in type 2 diabetic patients in Karaj. Iranian Journal of Diabetes and Lipid Disorders. 2012; 11(3): 269–81.
  32. Reisi M, Mostafavi F, Javadzade SH, et al. Assessment of Some Predicting Factors of Self-efficacy in Patients with Type 2 Diabetes. Iranian Journal of Endocrinology and Metabolism. 2015; 17(1): 44–52.
  33. Abolghasemi R, Sedaghat M. The Patient's Attitude Toward Type 2 Diabetes Mellitus, a Qualitative Study. J Relig Health. 2015; 54(4): 1191–1205.