Health literacy, self-efficacy, and self-care behaviors in patients with type 2 diabetes mellitus

J Am Assoc Nurse Pract. 2013 Sep;25(9):495-502. doi: 10.1111/1745-7599.12017. Epub 2013 Mar 4.

Abstract

Purpose: The study purpose was to explore the relationships among health literacy, self-efficacy, and self-care behaviors of patients with type 2 diabetes.

Data sources: A cross-sectional study with a descriptive correlational design was conducted. Patients (N = 150) with type 2 diabetes were recruited from diabetes clinics in the Marshall Islands. Levels of health literacy, self-efficacy, and self-care behaviors were assessed by a questionnaire.

Conclusions: Health literacy, receiving diabetes education, and employment status together explained 11.8% of the variance in self-efficacy (F((3,147)) = 7.58, p < .001). Patients who had higher health literacy, received more diabetes-related education, were currently employed and had better self-efficacy. Self-efficacy and marital status together explained 16.7% of the variance in self-care behaviors (F((2,148)) = 15.96, p < .001). Patients who had higher self-efficacy and who were married had better self-care behaviors.

Implications for practice: Strategies are needed to incorporate the concept of self-efficacy in the design of diabetes education to promote patients' self-care behaviors, with an emphasis on dealing with hyper- or hypoglycemia, following the diet plan, and checking blood sugar levels as recommended. Diabetes education material that requires a lower literacy level may be needed for older or unemployed adult populations.

Keywords: Diabetes mellitus; health literacy; self-care behavior; self-efficacy; vulnerable populations.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Cross-Sectional Studies
  • Diabetes Mellitus, Type 2 / complications
  • Diabetes Mellitus, Type 2 / psychology*
  • Diabetes Mellitus, Type 2 / therapy*
  • Female
  • Health Behavior*
  • Health Knowledge, Attitudes, Practice
  • Health Literacy*
  • Humans
  • Male
  • Middle Aged
  • Self Care*
  • Self Efficacy*
  • Socioeconomic Factors
  • Surveys and Questionnaires