Association of Fatalism and Diabetes-Related Stigma With Self-Care in Individuals With Type 2 Diabetes: A...

To examine the association between fatalism, diabetes-related stigma and self-care in individuals with type 2 diabetes.

A descriptive, cross-sectional study.

The study was conducted in the internal medicine outpatient clinic of a training and research hospital in Northern Türkiye (April-December 2024). The study sample consisted of 150 individuals with type 2 diabetes aged 18 years and over, who were literate, had no psychiatric or communication problems and voluntarily agreed to participate in the study. Data were collected using the Diabetes Introduction Form, Diabetes Fatalism Scale, Type 2 Diabetes Stigma Assessment Scale and Diabetes Self-Care Scale. Descriptive statistics, correlation analysis and multiple linear regression were performed using SPSS 26.

Participants had a mean fatalism score of 51.50 ± 9.45 (possible range: 12-72), a stigma score of 39.61 ± 15.80 (possible range: 19-90) and a self-care score of 84.39 ± 14.96 (possible range: 35-140), with higher scores indicating higher levels of fatalism, stigma and self-care, respectively. Diabetes fatalism and stigma were moderately and negatively correlated with self-care (p < 0.001). Regression analysis showed that fatalism (B = -0.466, p = 0.001) and stigma (B = -0.174, p = 0.030) significantly predicted lower self-care levels, explaining 15.7% of the variance in self-care behaviours.

Fatalistic beliefs and diabetes-related stigma have a detrimental impact on self-care behaviours among adults with type 2 diabetes. Interventions targeting psychosocial determinants should be prioritized to improve diabetes self-management.

Nurses are in a key position to assess and address fatalistic beliefs and stigma during routine diabetes care. Incorporating psychosocial screening into clinical practice and providing tailored education and counselling may reduce stigma, improve patients' sense of control and ultimately enhance self-care behaviours.

Although adults with type 2 diabetes participated in the study as respondents, they were not involved in the design, conduct, analysis or interpretation of the research. The study used validated self-report instruments, and therefore patients or members of the public did not have an active role in shaping the research process beyond providing data.