title: Role of motivation in the relationship between depression, self-care, and glycemic control in adults with type 2 diabetes.
abstract: The mechanism by which depression influences health outcomes in persons with diabetes is uncertain. The purpose of this study was to test whether depression is related to self-care behavior via social motivation and indirectly related to glycemic control via self-care behavior.
  
  
  
  Patients with diabetes were recruited from an outpatient clinic. Information gathered pertained to demographics, depression, and diabetes knowledge (information); diabetes fatalism (personal motivation); social support (social motivation); and diabetes self-care (behavior). Hemoglobin A1C values were extracted from the patient medical record. Structural equation models tested the predicted pathways.
  
  
  
  Higher levels of depressive symptoms were significantly related to having less social support and decreased performance of diabetes self-care behavior. In addition, when depressive symptoms were included in the model, fatalistic attitudes were no longer associated with behavioral performance.
  
  
  
  Among adults with diabetes, depression impedes the adoption of effective self-management behaviors (including physical activity, appropriate dietary behavior, foot care, and appropriate self-monitoring of blood glucose behavior) through a decrease in social motivation.
authors.affiliation: The Department of Medicine and the Center for Health Disparities Research, Medical University of South Carolina, Charleston (Dr Egede)|Center for Disease Prevention and Health Interventions for Diverse Populations, Ralph H. Johnson VA Medical Center, Charleston, South Carolina (Dr Egede)
authors.forename: Leonard E
authors.initials: LE
authors.lastname: Egede
authors.affiliation: Department of Medicine and Vanderbilt Eskind Diabetes Center, Diabetes Research & Training Center, Vanderbilt University School of Medicine, Nashville, Tennessee (Dr Osborn)
authors.forename: Chandra Y
authors.initials: CY
authors.lastname: Osborn
mesh_terms: D000368:Aged; D001519:Behavior; D001521:Behavior Therapy; D044383:Black People; D001786:Blood Glucose / Q000378:metabolism*; D003863:Depression / Q000453:epidemiology*; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000523:psychology* / Q000534:rehabilitation; D004522:Educational Status; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D006304:Health Status; D006801:Humans; D007182:Income; D008297:Male; D008875:Middle Aged; D009042:Motivation; D012648:Self Care; D044465:White People
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin