title: The role of social support on the relationship of depressive symptoms to medication adherence and self-care activities in adults with type 2 diabetes.
abstract: OBJECTIVE
  To examine the mediating role of social support on the relationship of depressive symptoms to medication adherence and self-care activities in Korean adults.
  
  
  BACKGROUND
  Recent evidence suggests that higher levels of social support are associated with improved medication adherence and self-care activities; however, the role of social support on the relationship of depressive symptoms to medication adherence and self-care activities is less well understood.
  
  
  METHODS
  A cross-sectional survey.
  
  
  METHODS
  The data were collected from 311 Korean adults with type 2 diabetes who were taking hypoglycaemic agents in the period 2012-2013. Depressive symptoms, social support, medication adherence and self-care activities were assessed using structured questionnaires. Multiple regression analysis with adjustment for covariates and the Sobel test were used to examine the mediating effect of social support on the relationship of depressive symptoms to medication adherence and self-care activities.
  
  
  RESULTS
  There were statistically significant differences by subgroups with and without depressive symptoms in social support, medication adherence and self-care activities of diet, physical activity and stress management. The Sobel test confirmed that social support mediated the effect of depressive symptoms on medication adherence and self-care activities of diet, physical activity and stress management.
  
  
  CONCLUSIONS
  The evidence from this study suggests that social support-enhancing interventions that also manage depressive symptoms may be more timely and effective than interventions that target depressive symptoms alone in promoting adherence to medication adherence and self-care activities in this population.
authors.affiliation: Department of Adult Health Nursing, Ajou University College of Nursing, Suwon, Korea.
authors.forename: Chun-Ja
authors.initials: CJ
authors.lastname: Kim
authors.affiliation: University of Pittsburgh School of Nursing, Pittsburgh, Pennsylvania, USA.
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Schlenk
authors.affiliation: Department of Endocrinology and Metabolism, Ajou University School of Medicine, Suwon, Korea.
authors.forename: Dae Jung
authors.initials: DJ
authors.lastname: Kim
authors.affiliation: Ajou University College of Nursing, Suwon, Korea.
authors.forename: Moonsun
authors.initials: M
authors.lastname: Kim
authors.affiliation: University of Pittsburgh School of Nursing, Pittsburgh, Pennsylvania, USA.
authors.forename: Judith A
authors.initials: JA
authors.lastname: Erlen
authors.affiliation: Department of Nursing, Koje College, Geoje, Korea.
authors.forename: Se-Eun
authors.initials: SE
authors.lastname: Kim
mesh_terms: D000328:Adult; D000368:Aged; D003863:Depression / Q000150:complications* / Q000503:physiopathology / Q000523:psychology; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy* / Q000503:physiopathology / Q000523:psychology; D036262:Empirical Research; D005260:Female; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D056910:Republic of Korea; D012648:Self Care; D012944:Social Support
chemical_list: D007004:Hypoglycemic Agents
keywords: depression; medication adherence; nursing; self care; social support; type 2 diabetes mellitus