Psychological Predictors of Adherence to Self-Care Behaviour amongst Patients with Type 2 Diabetes Mellitus (T2DM) Visiting Public Hospital, North India

Background and aims: Patients with type 2 diabetes mellitus (T2DM) need a high degree of self-care behavior, treatment adherence, and good psychological health. Psychological health play a vital role in adherence to treatment regimen and self-management of diabetes. This study aims to identify the psychological predictors of self-care behaviors among patients with T2DM.

Methods: A descriptive cross-sectional survey was conducted at a diabetic clinic at a tertiary care hospital in North India. Structured pre-tested personal and clinical profile and self-efficacy, diabetes distress, depression and anxiety, and complications and fear of developing hypoglycaemia due to diabetes mellitus in the future are measured through standardized questionnaires.

Results: The mean age of the participants was 53.5 (±3.68) years, and 41.4% were in the overweight (BMI: 25.0-29.9) and obese (16.7%, BMI > 30) category. Self-care behaviours found significant association with self-efficacy (r = 0.34, P < 0.001), anxiety (r = -0.28, P < 0.001), depression (r = -0.28, P < 0.001) and diabetes-related distress (r = -0.30, P < 0.001). Further, self-efficacy (P = 0.001), diabetes distress (P < 0.001) and fear of developing hypoglycaemia (P < 0.001) were reported independent predictors of self-care behaviour in patients with T2DM.

Conclusions: The current study suggests that self-efficacy, fear of hypoglycaemia and emotional state played an important role in adherence to self-care behaviour in T2DM management. Patients with diabetes mellitus should be routinely screened for psychological factors at diabetes clinics. Thus, developing tailored interventions to raise belief and self-efficacy might be a useful way to increase the involvement of patients in treatment.