Beyond Compliance: The Role of Self-Efficacy in Foot Care and Self-Management Among Patients With Type 1 Diabetes

Background: Effective self-management behaviors are crucial for diabetes management. This study examines the mediating role of self-efficacy in the relationship between compliance dimensions and self-management activities in patients with Type 1 diabetes. Methods: The current study explores a baseline analysis from a randomized controlled trial but the intervention's effectiveness is not reported here; the analysis focuses on elucidating potential mediating factors at baseline. The study investigated the relationships between seven compliance dimensions (treatment effort, intention, adaptability, integration, adherence, commitment, and indecisiveness) and six self-management activities (diet, exercise, smoking cessation, blood sugar monitoring, and foot care) through the potential mechanism of self-efficacy. Results: The analysis revealed an indirect association between three compliance dimensions (treatment effort, intention, and commitment) and foot care behavior, mediated by self-efficacy. Additionally, self-efficacy was identified as an indirect mechanism influencing the association between commitment and adaptability with dietary behaviors. Conclusions: This study highlights the importance of self-efficacy in promoting self-management behaviors in chronic conditions. By targeting specific compliance dimensions that influence self-efficacy, healthcare professionals can potentially improve patient self-management. Trial Registration: Iranian Registry of Clinical Trials number: IRCT20221029056335N1.