TESTING A CONCEPTUAL FRAMEWORK FOR SELF- CARE IN PERSONS WITH DIABETES: THE EFFECT OF DEPRESSION

Abstract

Diabetes is a major source of morbidity, mortality, and economic expense. Not only do people with diabetes have a higher risk of developing depression, the rate of depression is much higher than in the general population (ADA, 2010). Depression is believed to influence Diabetes Self Care Management (DSCM), self efficacy, and self care agency. Therefore, the main study aim was to examine the relationships among these factors using a cross-sectional model testing design. The secondary aim was to examine item characteristics and reliability of the Diabetes Self Management Scale (DSMS). A convenience sample of 78 individuals with type 1 or type 2 diabetes mellitus who were taking insulin was recruited. Participants completed five psychometric questionnaires. Path analysis techniques were used to examine relationships among the variables. For the DSMS, item and reliability resulted in a reduced 40-item scale with an alpha of 0.947. The new scale had a strong correlation with self efficacy (r=0.80) which supports the validity of the scale. The results of the path analysis testing showed that depression negatively affected self efficacy (B=-1.43; p<.01; r2=.18) and self care agency (B=0.53; p<.01; r2=.23). The effect of depression on DSCM was completely mediated by self efficacy and self care agency. The findings may indicate that enhancing self efficacy and self-care agency might mitigate the negative impact of depression on DSCM.