The impact of barriers and self-efficacy on self-care behaviors in type 2 diabetes

Diabetes Educ. May-Jun 2001;27(3):393-404. doi: 10.1177/014572170102700309.


Purpose: This cross-sectional, correlational study examined the relationships of diabetes-specific treatment barriers and self-efficacy with self-care behaviors.

Methods: A total of 309 people with type 2 diabetes participated in this study. All of the factors were assessed by self-report questionnaires. Self-care behaviors included exercise, diet, skipping medication, testing blood for glucose, adjusting insulin to avoid or correct hyperglycemia, and adjusting diet to avoid or correct hypoglycemia.

Results: Perceived barriers to carrying out self-care behaviors were associated with worse diet and exercise behavior. Greater self-efficacy predicted more frequent blood glucose testing, less frequent skipping of medication and binge eating, and closer adherence to an ideal diet. Nontraditional dimensions of self-efficacy were associated with worse self-care. Self-efficacy explained 4% to 10% of the variance in diabetes self-care behaviors beyond that accounted for by patient characteristics and health beliefs about barriers.

Conclusions: The findings of this study provided support for Rosenstock's proposal that a person's self-perceived capability to carry out a behavior should be incorporated into an expanded health belief model.

MeSH terms

  • Adult
  • Aged
  • Attitude to Health
  • Blood Glucose Self-Monitoring
  • Demography
  • Diabetes Mellitus, Type 2 / physiopathology
  • Diabetes Mellitus, Type 2 / psychology*
  • Diabetes Mellitus, Type 2 / rehabilitation
  • Diet, Diabetic
  • Exercise
  • Feeding Behavior
  • Female
  • Humans
  • Male
  • Medical History Taking
  • Middle Aged
  • Self Care / psychology*
  • Self Efficacy*