title: Depression, distress and self-efficacy: The impact on diabetes self-care practices.
abstract: The prevalence of type 2 diabetes is increasing in Malaysia, and people with diabetes have been reported to suffer from depression and diabetes distress which influences their self-efficacy in performing diabetes self-care practices. This interviewer administered, cross sectional study, conducted in the district of Hulu Selangor, Malaysia, involving 371 randomly selected patients with type 2 diabetes, recruited from 6 health clinics, aimed to examine a conceptual model regarding the association between depression, diabetes distress and self-efficacy with diabetes self-care practices using the partial least square approach of structural equation modeling. In this study, diabetes self-care practices were similar regardless of sex, age group, ethnicity, education level, diabetes complications or type of diabetes medication. This study found that self-efficacy had a direct effect on diabetes self-care practice (path coefficient = 0.438, p<0.001). Self-care was not directly affected by depression and diabetes distress, but indirectly by depression (path coefficient = -0.115, p<0.01) and diabetes distress (path coefficient = -0.122, p<0.001) via self-efficacy. In conclusion, to improve self-care practices, effort must be focused on enhancing self-efficacy levels, while not forgetting to deal with depression and diabetes distress, especially among those with poorer levels of self-efficacy.
authors.affiliation: Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Jalan Universiti, Wilayah Persekutuan, Kuala Lumpur, Malaysia.
authors.forename: Cassidy
authors.identifier: http://orcid.org/0000-0002-7601-6477
authors.initials: C
authors.lastname: Devarajooh
authors.affiliation: Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Jalan Universiti, Wilayah Persekutuan, Kuala Lumpur, Malaysia.
authors.forename: Karuthan
authors.initials: K
authors.lastname: Chinna
mesh_terms: D000368:Aged; D003430:Cross-Sectional Studies; D003863:Depression / Q000097:blood / Q000503:physiopathology* / Q000523:psychology*; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000503:physiopathology / Q000523:psychology; D015444:Exercise; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D008297:Male; D055118:Medication Adherence; D008875:Middle Aged; D012648:Self Care / Q000379:methods*; D020377:Self Efficacy
chemical_list: D006442:Glycated Hemoglobin