Psychological, Social and Structural Determinants of Diabetes Self-Management

Self-management of diabetes, an important aspect of diabetes treatment, is strongly affected by psychological and sociostructural factors. The aim of this research was to investigate the psychological, social and structural determinants of diabetes self-management in patients with type 2 diabetes. In cross-sectional design study, 500 out patients (245 men and 255 women) with type II diabetes were selected by convenience sampling. Data collected by demographic questionnaires on the Scales of diabetes self-management, diabetes self- efficacy, belief to treatment effectiveness, belief to illness certainty, treatment motivation, patient- provider therapeutic communication, diabetic knowledge, satisfaction for therapeutic services, access to therapeutic services, familial social support, and on collaborative decision-making, were analyzed by correlation and stepwise multiple regressions. Diabetes self-management mean (standard deviation) was 45.77 (21.81). Self-efficacy, belief of treatment effectiveness, social support, >HbA1c%7 and Insulin therapy significantly predicted diabetes self-management variance (P<0.001). The variables explained 91% of diabetes self-management (R2 = 0.91). Self-efficacy has highest weight in prediction of diabetes self-management (β = 0.338, P<0.001). Self-efficacy, belief of treatment effectiveness, social support, mild HbA1c and treatment type are important factors for diabetes self-management and these variables explained the high rate of the diabetes self-management variance, emphasizing the importance of improvement of self-management behaviors in these patients.