Relationships among self-efficacy, social support, social problem-solving, and self-management behaviors of people living with Type 2 diabetes in rural Alabama
Self-management behaviors are the cornerstone for control of type 2 diabetes mellitus (T2DM). Patients living with T2DM manage their own care on a daily basis using a variety of self-care strategies. Rural people living with diabetes are diagnosed later and receive less than optimal care compared to people living with T2DM in urban areas. Research evidence supports a relationship between self-efficacy and self-management behaviors of people living with T2DM. Determining mediators of the relationship between self-efficacy and self-management can provide direction for development of interventions to improve participation in self-management behaviors, which can in turn improve diabetes outcomes.
The purpose of the current study was to examine whether social support and social problem-solving were mediators of the relationship between self-efficacy and diabetes self-management behaviors in rural Alabamians living with T2DM. Additionally, relationships among self-efficacy, social support, social problem-solving, and diabetes self-management behaviors in rural Alabamians living with T2DM were examined in this mediational study. A descriptive, correlational design was used to explore the relationships examined in the study, based on the theory of stress, appraisal, and coping by Lazarus and Folkman. A convenience sample of 152 rural Alabamians living with T2DM participated in the study. Participants ranged in age from 19 to over 81 with the majority (56.6%) being between 51 and 70. The majority of the sample was African American (58.6%), female (65.8%), and had at least a high school education (57.9%). Concerning marital status, 33.6% were single and 36.8% were married. Most (59.3%) of the participants had been diagnosed with T2DM for 10 years or less.
Self-efficacy was found to be a strong predictor of diabetes self-management. The effect of social support on diabetes self-management differed among men and women in the sample. Social support and social problem-solving were significantly associated with diabetes self-management in men in this sample. Multiple regression was used in four steps of mediation testing. Social support and social problem-solving were not mediators of the relationship between self-efficacy and diabetes self-management in this sample of people living with T2DM in rural Alabama.
The full abstract can be found here.