title: Effects of self-care, self-efficacy, social support on glycemic control in adults with type 2 diabetes.
abstract: BACKGROUND
  A number of studies have examined the influence of self-efficacy, social support and patient-provider communication (PPC) on self-care and glycemic control. Relatively few studies have tested the pathways through which these constructs operate to improve glycemic control, however. We used structural equation modeling to examine a conceptual model that hypothesizes how self-efficacy, social support and patient-provider communication influence glycemic control through self-care behaviors in Chinese adults with type 2 diabetes.
  
  
  METHODS
  We conducted a cross-sectional study of 222 Chinese adults with type 2 diabetes in one primary care center. We collected information on demographics, self-efficacy, social support, patient-provider communication (PPC) and diabetes self-care. Hemoglobin A1c (HbA1c) values were also obtained. Measured variable path analyses were used to determine the predicted pathways linking self-efficacy, social support and PPC to diabetes self-care and glycemic control.
  
  
  RESULTS
  Diabetes self-care had a direct effect on glycemic control (β = -0.21, p = .007), No direct effect was observed for self-efficacy, social support or PPC on glycemic control. There were significant positive direct paths from self-efficacy (β = 0.32, p < .001), social support (β = 0.17, p = .009) and PPC (β = 0.14, p = .029) to diabetes self-care. All of them had an indirect effect on HbA1c (β =-0.06, β =-0.04, β =-0.03 respectively). Additionally, PPC was positively associated with social support (γ = 0.32, p < .001).
  
  
  CONCLUSIONS
  Having better provider-patient communication, having social support, and having higher self-efficacy was associated with performing diabetes self-care behaviors; and these behaviors were directly linked to glycemic control. So longitudinal studies are needed to explore the effect of self-efficacy, social support and PPC on changes in diabetes self-care behaviors and glycemic control.
authors.affiliation: School of Public Health, Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, PO Box 248 138 Yixueyuan Road, Shanghai 200032, People's Republic of China.
authors.forename: Junling
authors.initials: J
authors.lastname: Gao
authors.forename: Jingli
authors.initials: J
authors.lastname: Wang
authors.forename: Pinpin
authors.initials: P
authors.lastname: Zheng
authors.forename: Regine
authors.initials: R
authors.lastname: Haardörfer
authors.forename: Michelle C
authors.initials: MC
authors.lastname: Kegler
authors.forename: Yaocheng
authors.initials: Y
authors.lastname: Zhu
authors.forename: Hua
authors.initials: H
authors.lastname: Fu
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002681:China; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000523:psychology*; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D008297:Male; D008875:Middle Aged; D010817:Physician-Patient Relations; D012648:Self Care; D020377:Self Efficacy; D012944:Social Support
chemical_list: D006442:Glycated Hemoglobin