Association between self-efficacy, depression and self-care in type 2 diabetes mellitus

Abstract

Introduction: Type 2 diabetes care mostly depends on self-care. However, a large proportion of patients suffer from depression, which has a negative effect on adherence. Treating depression is important for the effective therapy of diabetes. In the last years, examination of self-efficacy has become an important topic in adherence research. It has arisen that an appropriate self-efficacy may minimalize the negative effect of depression on self-care. Objective: We aimed to determine the prevalence of depression in a Hungarian sample, to examine the correlation between depressive symptoms and self-care, and the possible mediating effect of self-efficacy between depression and self-care. Method: In the cross-sectional questionnaire study, we analyzed data of 262 patients. Median age was 63 years, average BMI was 32.5 (SD = 6.18). Measures: socio-demographic data, DSMQ (Diabetes Self-Management Questionnaire), PHQ-9 (Patient Health Questionnaire), Self-Efficacy for Diabetes Scale. Results: Frequency of depressive symptoms is 18% in our sample. Depressive symptoms (PHQ-9 score) and self-care (DSMQ score) were in inverse correlation (r = –0.275, p<0.001). In the model, we examined the impact of self-efficacy; beside controlling for age and gender, BMI (ß = 0.135, t = –2.367) and self-efficacy (ß = 0.585, t = 9.591, p<0.001) were independent impacts, while depressive symptoms lost their significance (ß = –0.033, t = –0.547). Discussion: Prevalence of depression was identical to literature. Depressive mood had a negative effect on self-care, while self-efficacy may play a mediating role in the connection between depression and self-care. Conclusion: Reinforcing the theory on the mediating role of self-efficacy may open new perspectives for the treatment of depression as a comorbidity of type 2 diabetes.