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

Research output: Journal Publications and Reviews (RGC: 21, 22, 62)21_Publication in refereed journalpeer-review

10 Scopus Citations
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Author(s)

  • Zhenzhen Xie
  • Kaifeng Liu
  • Calvin Or
  • Jiayin Chen
  • Mian Yan
  • And 1 others
  • Hailiang Wang

Detail(s)

Original languageEnglish
Article number1227
Journal / PublicationBMC Public Health
Volume20
Online published12 Aug 2020
Publication statusPublished - 2020

Link(s)

Abstract

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, = 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,  = 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,  = 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.

Research Area(s)

  • Health attitudes, Health behavior, Hypertension, Self-efficacy, Self-management, Socio-demographic correlates, Type 2 diabetes mellitus

Citation Format(s)

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

In: BMC Public Health, Vol. 20, 1227, 2020.

Research output: Journal Publications and Reviews (RGC: 21, 22, 62)21_Publication in refereed journalpeer-review

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