title: Self-Efficacy, Depression, and Self-Care Activities in Adult Jordanians with Type 2 Diabetes: The Role of Illness Perception.
abstract: Diabetes mellitus is reaching epidemic levels worldwide. In a developing country like Jordan, type 2 diabetes mellitus (T2DM) has reached a prevalence rate of 17.1%. This cross-sectional study examined the relationship between self-care activities and: illness perception, depression, social support, religiosity and spiritual coping, and self-efficacy among patients with T2DM. A random sample of 220 patients with T2DM, who attended Jordan University Hospital in Jordan were enrolled. The data were collected through a structured interview and the medical files. The instruments consisted of a sociodemographic and clinical standardised questionnaires: Brief Illness Perception Questionnaire, Patients' Health Questionnaire-9; ENRICH Social Support Instrument; Religious and Spiritual Coping Subscale; Diabetes Management Self-Efficacy Scale; and Summary of Diabetes Self-Care Activities. Bivariate analysis investigated the relationship between variables. Structure Equation Modelling (SEM) was performed to test the proposed conceptual model. The study found that approximately 70% of the respondents suffered some form of depressive symptoms. The SEM showed a direct relationship between self-efficacy and self-care activities (β = 0.40; p < 0.001). Depression was indirectly related to self-care activities through self-efficacy (β = -0.20; p = 0.003); nevertheless, it was directly related to perception of: treatment control, consequences, and emotional representations. Overall, the sequence between illness perception and self-efficacy was mediated by depression. Strategies to promote self-efficacy and illness perception are vital in customising a diabetes health plan to meet Arabic cultural expectations.
authors.affiliation: a Western Sydney University , School of Nursing and Midwifery , Penrith , Australia.
authors.forename: Rasmieh
authors.initials: R
authors.lastname: Al-Amer
authors.affiliation: a Western Sydney University , School of Nursing and Midwifery , Penrith , Australia.|b Ingham Institute for Applied Medical Research, Centre for Applied Nursing Research (CANR) , Liverpool , Australia.
authors.forename: Lucie
authors.initials: L
authors.lastname: Ramjan
authors.affiliation: a Western Sydney University , School of Nursing and Midwifery , Penrith , Australia.|b Ingham Institute for Applied Medical Research, Centre for Applied Nursing Research (CANR) , Liverpool , Australia.
authors.forename: Paul
authors.initials: P
authors.lastname: Glew
authors.affiliation: c University of Sydney , School of Nursing and Midwifery , Camperdown , Australia.
authors.forename: Sue
authors.initials: S
authors.lastname: Randall
authors.affiliation: a Western Sydney University , School of Nursing and Midwifery , Penrith , Australia.|b Ingham Institute for Applied Medical Research, Centre for Applied Nursing Research (CANR) , Liverpool , Australia.
authors.forename: Yenna
authors.initials: Y
authors.lastname: Salamonson
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D003866:Depressive Disorder / Q000209:etiology* / Q000523:psychology; D003924:Diabetes Mellitus, Type 2 / Q000523:psychology* / Q000628:therapy; D005260:Female; D015438:Health Behavior; D006801:Humans; D007597:Jordan; D008297:Male; D008875:Middle Aged; D012648:Self Care; D020377:Self Efficacy; D012803:Sick Role; D012944:Social Support; D011795:Surveys and Questionnaires