Journal Article

An examination of the socio-demographic correlates of patient adherence to self-management behaviors and the mediating roles of health attitudes and self-efficacy among patients with coexisting type 2 diabetes and hypertension

Or, Calvin, Wang, Hailiang, Chen, Jiayin, Liu, Kaifeng, Yan, Mian, Xie, Zhenzhen

2020

Overview

Background Patients with coexisting type 2 diabetes and hypertension generally exhibit poor adherence to self-management, which adversely affects their disease control. Therefore, identification of the factors related to patient adherence is warranted. In this study, we aimed to examine (i) the socio-demographic correlates of patient adherence to a set of self-management behaviors relevant to type 2 diabetes and hypertension, namely, medication therapy, diet therapy, exercise, tobacco and alcohol avoidance, stress reduction, and self-monitoring/self-care, and (ii) whether health attitudes and self-efficacy in performing self-management mediated the associations between socio-demographic characteristics and adherence. Methods We performed a secondary analysis of data collected in a randomized controlled trial. The sample comprised 148 patients with coexisting type 2 diabetes mellitus and hypertension. Data were collected by a questionnaire and analyzed using logistic regression. Results Female patients were found to be less likely to exercise regularly (odds ratio [OR] = 0.49, P  = 0.03) and more likely to avoid tobacco and alcohol (OR = 9.87, P  < 0.001) than male patients. Older patients were found to be more likely to adhere to diet therapy (OR = 2.21, P  = 0.01) and self-monitoring/self-care (OR = 2.17, P  = 0.02). Patients living with family or others (e.g., caregivers) were found to be more likely to exercise regularly (OR = 3.44, P  = 0.02) and less likely to avoid tobacco and alcohol (OR = 0.10, P  = 0.04) than those living alone. Patients with better perceived health status were found to be more likely to adhere to medication therapy (OR = 2.02, P  = 0.03). Patients with longer diabetes duration (OR = 2.33, P  = 0.01) were found to be more likely to adhere to self-monitoring/self-care. Self-efficacy was found to mediate the association between older age and better adherence to diet therapy, while no significant mediating effects were found for health attitudes. Conclusions Adherence to self-management was found to be associated with socio-demographic characteristics (sex, age, living status, perceived health status, and diabetes duration). Self-efficacy was an important mediator in some of these associations, suggesting that patient adherence may be improved by increasing patients’ self-management efficacy, such as by patient empowerment, collaborative care, or enhanced patient–physician interactions.

• Publisher: BioMed Central,BioMed Central Ltd,Springer Nature B.V,BMC
• Subject: Activities of daily living / Age / Attitudes / Biostatistics / Care and treatment / Chronic illnesses / Comorbidity / Data analysis / Demographic aspects / Demographics / Diabetes / Diabetes mellitus / Diabetes mellitus (non-insulin dependent) / Diet / Disease control / Drug therapy / Empowerment / Environmental Health / Epidemiology / Glucose monitoring / Health attitudes / Health behavior / health promotion and society / Hypertension / Management / Medicine / Medicine & Public Health / Nutrition therapy / Patient compliance / Patients / Public Health / Questionnaires / Regression analysis / Research Article / Secondary analysis / Self management (Psychology) / Self-efficacy / Self-management / Socio-demographic correlates / Sociodemographics / Studies / Telemedicine / Therapy / Tobacco / Type 2 diabetes / Type 2 diabetes mellitus / Vaccine / Variables