Social support and self-care outcomes in adults with diabetes: The mediating effects of self-efficacy and diabetes distress. Results of the second diabetes MILES - Australia (MILES-2) study

Carina K Y Chan; Wendell Cockshaw; Kimberley Smith; Elizabeth Holmes-Truscott; Frans Pouwer; Jane Speight

doi:10.1016/j.diabres.2020.108314

Social support and self-care outcomes in adults with diabetes: The mediating effects of self-efficacy and diabetes distress. Results of the second diabetes MILES - Australia (MILES-2) study

Diabetes Res Clin Pract. 2020 Aug:166:108314. doi: 10.1016/j.diabres.2020.108314. Epub 2020 Jul 10.

Authors

Carina K Y Chan¹, Wendell Cockshaw², Kimberley Smith³, Elizabeth Holmes-Truscott⁴, Frans Pouwer⁵, Jane Speight⁶

Affiliations

¹ School of Psychology and Public Health, La Trobe University, Australia. Electronic address: carina.chan@latrobe.edu.au.
² Psychology, School of Health and Biomedical Sciences, RMIT University, Australia. Electronic address: Wendell.cockshaw@rmit.edu.au.
³ School of Psychological Sciences, University of Surrey, United Kingdom. Electronic address: kimberley.j.smith@surrey.ac.uk.
⁴ School of Psychology, Deakin University, Geelong, Australia; The Australian Centre for Behavioural Research in Diabetes, Diabetes Victoria, Australia. Electronic address: etruscott@acbrd.org.au.
⁵ School of Psychology, Deakin University, Geelong, Australia; Department of Psychology, University of Southern Denmark, Odense, Denmark; STENO Diabetes Center Odense, Odense, Denmark. Electronic address: fpouwer@health.sdu.dk.
⁶ School of Psychology, Deakin University, Geelong, Australia; The Australian Centre for Behavioural Research in Diabetes, Diabetes Victoria, Australia. Electronic address: jspeight@acbrd.org.au.

PMID: 32653506
DOI: 10.1016/j.diabres.2020.108314

Abstract

Aims: Diabetes self-care outcomes are positively impacted by social support. Understanding the mechanisms involved can inform more effective interventions. This study tested potential cross-sectional mediation of social support through self-efficacy and diabetes distress for self-care and clinical outcomes (diet, physical activity, blood glucose monitoring, HbA_1c).

Method: We analysed a sub-sample of the Australian Diabetes MILES-2 cross-sectional online survey (N = 1727). Measures were: Diabetes Social Support Scale, Confidence in Diabetes Self-care Scale, Problem Areas In Diabetes scale, diet and physical activity subscales of the Summary of Diabetes Self-Care Activities, and self-reported HbA_1c. Separate mediation path models were tested for each of the four self-care/clinical outcomes in groups with type 1 and type 2 (insulin- and non-insulin-treated) diabetes.

Results: Social support was associated with more optimal self-care and self-reported HbA_1c outcomes. When diabetes-specific self-efficacy and distress were included as mediators, the direct path from social support became non-significant. Conversely, the indirect effects of social support through diabetes-specific self-efficacy and distress were significant across all diabetes groups and outcomes.

Conclusion: Diabetes-specific self-efficacy and distress may be important mechanisms linking social support with diabetes self-care and clinical outcomes. Social support interventions could explore whether improving diabetes self-efficacy and decreasing diabetes distress could help improve self-care.

Keywords: Diabetes; Diabetes distress; Health behaviour; Self-care; Self-efficacy; Social support.

MeSH terms

Adolescent
Adult
Aged
Australia
Cross-Sectional Studies
Diabetes Mellitus, Type 2 / psychology*
Female
Humans
Male
Middle Aged
Self Care / methods*
Self Efficacy*
Social Support*
Treatment Outcome
Young Adult