Factors Influencing Adherence to Self-Care in Patients with Type 2 Diabetes: A Systematic Literature Review

Background: Living with type 2 diabetes can be demanding from multiple perspectives. Many individuals with type 2 diabetes experience limited self-care ability and poor adherence to self-care recommendations. Objective: To describe factors that influence self-care adherence among adults with type 2 diabetes. Methods: A systematic review based on 19 studies using quantitative, qualitative, and mixed-method designs. The study design is a systematic literature review in accordance with the guidelines of the Swedish Agency for Health Technology Assessment and Assessment of Social Services (SBU) and PRISMA guidelines. The articles were retrieved from the research databases CINAHL, PubMed, and PsycInfo. Quality appraisal was conducted using the MMAT, and the studies were analyzed through meta-aggregation and subsequently compiled into a unified set of findings. Results: The findings showed that numerous factors influence adherence to self-care. These were presented in categories: sociodemographic factors; disease- and treatment-related factors; healthcare-related factors; and psychological factors. Psychological factors played a decisive role in adherence, particularly regarding motivation. Conclusions: Living with Type 2 diabetes demands considerable engagement and supporting them as a district nurse is a multidimensional task consisting of several components. Self-care adherence in type 2 diabetes cannot be understood as the result of isolated factors but rather as a complex interplay of psychological, social, economic circumstances. Understanding effective patient education enhances knowledge and understanding of the importance of adhering to treatment is the key to improving compliance in patients with type 2 diabetes.