Structural Model of the Relationship between Self-efficacy in Diabetes Management, Lifestyle and Disease Perception by Promoting Self-care behavior among Patients with Diabetes Mediated by Psychological Capital

Diabetes is a metabolic disorder that is associated with many serious medical, psychiatric, familial, occupational, legal and financial problems. The aim of this study was to determine the mediating role of psychological capital in the relationship between self-efficacy in diabetes management, lifestyle and disease perception with self-care behavior among patients with type 2 diabetes in Iran and Denmark.

This correlational study was conducted with the participation of patients with type 2 diabetes who are members of the Diabetes Association of Mazandaran Province in Iran and Aarhus city of Denmark. The sample size was 432 people who were selected using the available sampling method. Data were collected using the self-care behaviors, lifestyle, disease perception, psychological capital questionnaires, and diabetes management self-efficacy scale. Structural equation modeling using SPSS Statistics for Windows, version 22.0 (SPSS Inc., Chicago, Ill., USA) and SmartPLS 3.3.3 software was used to analyze the research data.

The mean (SD) age in the group of Iranian patients was 42.1 (7.8) and Danish patients was 40.6 (7.3). Self-efficacy in diabetes management (β = 0.467, t = 4.859), lifestyle (β = 0.355, t = 3.109), disease perception (β = 0.624, t = 9.974). =) and psychological capital (β = 0.506, t = 8.908) had a direct and positive relationship with self-care behaviors in Danish society. Self-efficacy in diabetes management (β = 0.475, t = 5,091), lifestyle (β = 0.423, t = 4.374), disease perception (β = 0.645, t = 9.992) and psychological capital (β = 0.501, t = 8.866) have a direct and positive relationship with self-care behaviors in Iranian society. Moreover, the mediating role of psychological capital in the relationship between self-efficacy, lifestyle, disease perception and self-care behaviors in Danish and Iranian society was confirmed.

The study showed that psychological capital had a mediating role in the relationship between self-efficacy, disease perception and lifestyle with self-care behavior, in such a way that the direct relationship of self-efficacy with psychological capital, disease perception and lifestyle, and self-care behavior increased.