A path causal model in the association between self-efficacy and self-care with quality of life in patients with type 2 diabetes: An application of the structural equation model

Abstract

Background and Aims: The simultaneous role of self-care and self-efficacy in improving the quality of life (QoL) of diabetic patients has been less considered in previous studies. This study was aimed to investigate the path association between self-care and self-efficacy with QoL using the structural equation model (SEM). Methods: This cross-sectional study was conducted with 496 individuals of type 2 diabetic patients aged 35–75 years that were selected consequently from outpatients' clinic, in Babol, the north of Iran. The data collection instruments were demographic, self-care, self-efficacy, and QoL scales. The conceptual hypothesized model was designed based on previous evidence and tested by confirmatory factor analysis using SEM and path coefficients were estimated by the maximum likelihood method. Results: Self-care had a significant relationship with employment status, level of education, and body mass index. QoL was significantly associated with economic status and place of residence. Self-efficacy beliefs had a positive and a direct effect on both self-care and QoL. But self-care and self-efficacy tended to have a nonsignificant positive relationship with QoL. The postulated conceptual path model was acceptable through the SEM goodness of fit criteria. Conclusion: The findings show the fitness of the framework hypothesized structural model in the QoL of diabetic patients and this SEM makes this study unique from others. The results showed that the role of self-efficacy and self-care could be considered on the QoL. Therefore, nonpharmacological and supportive methods, such as strengthening self-efficacy and self-care, could be recommended as an effective method to enhance the QoL of diabetic patients.