An exploratory study of predictors of self-care behaviour in persons with type 2 diabetes

Type 2 diabetes constitutes a growing public health concern due to the risk of long-term complications. Control of blood glucose and other preventative measures are known to decrease this risk. Since prevention depends on the individual's behaviour, this study sought to identify factors related to self-care behaviour of persons with type 2 diabetes. The theory of planned behaviour provided the theoretical framework.

The objectives were to explore the relationship between attitudes towards self-care behaviour, subjective norms, behavioural control, behavioural intentions and actual self-care behaviour.

A two-stage, descriptive survey design was used; data was collected at two time points, 1 week apart.

Participants were recruited by telephone. Data collection was carried out in participants' homes and over the phone.

Participants were Maltese, over 50 years, diagnosed with type 2 diabetes at least 6 months beforehand. A random sample of 200 individuals was selected from a database of persons registered at a diabetes clinic in Malta.

In the first stage, data on factors which may predict self-care behaviour was collected by means of a structured interview. This included four subscales consisting of items rated on a seven point Likert Scale, constructed to measure the independent variables of attitudes to self-care behaviour, subjective norm, behavioural control and the independent variable of intent to perform the self-care behaviour. In the second stage, a structured telephone interview, including a revised version of the Summary of Diabetes Self-Care Activities, was used to measure the independent variable of self-care behaviour.

A 50% (n=100) response rate was achieved. All participants were on insulin and/or hypoglycaemic agents. Attitude to self-care behaviour, subjective norms and behavioural control all predicted behavioural intent. Of these, perceived behavioural control was the most predictive and was also predictive of actual self-care behaviour. Participants reported high perceived behavioural control in relation to medication taking, but low perceived control in relation to exercise and dietary behaviour.

Strategies to improve self-care behaviour in relation to type 2 diabetes should focus on improving the individual's perception of behavioural control, especially with regards to exercise and diet.