Adherence and quality of life of patients II Diabets : Role of psychosocial Factors

Abstract

Diabetes is a daily personal challenge for those suffering from the condition, along with being a major public health burden for India. Treatment and management for diabetes is complex, demanding, and a lifelong continuous process which can be overwhelming for the patients and strains their quality of life. Adherence is a major factor in managing diabetes to achieve optimal glycemic control and delay or reduce the risk of any diabetes- related complications. The present study aimed to assess the difference in the level of social support, knowledge, self-efficacy, adherence, and quality of life among three groups of Type II diabetes patients categorized on the basis of duration of illness. It was also aimed to understand the role of social support, knowledge, and self-efficacy in adherence and quality of life of Type II diabetes patients. In phase I of the study, the pilot study was conducted to develop two new psychological instruments such as Diabetes Symptoms Checklist and Diabetes Knowledge Test for Indian Population and also to check the feasibility of the study. In phase II, the main study was conducted. In the main study, a correlational design was used to understand the relationship among the variables and the role of predictor variables on the criterion. Using purposive sampling method, 235 Type II diabetes patients both men and women, whose age range was from 25-75 years were included in this study. To assess the difference in the level of the variables under study, the sample was categorized into three groups based on the duration of illness, such as group I (one month to one year), group II (above one year to five years), and group III (above five years to 20 years). The instruments used to measure the variables under study were Clinical History Proforma, Diabetes Symptoms Checklist, The Diabetes Knowledge Test for Indian Population (DKT-I), Interpersonal SupportEvaluation List (ISEL), Stanford Self-efficacy Scale for Diabetes, Diabetes Adherence Scale (DAS), and Diabetes-39 Quality of Life Questionnaire. These instruments were administered in two sessions to the patients. Results showed that the three groups differed significantly, on few of the variables namely knowledge of diabetes, self-efficacy, adherence and quality of life. After ascertaining that there exists a relationship between the variables, subsequent analyses were conducted to assess the role of the predictor variables in the criterion variables. It was found that the only significant positive and independent predictor contributing to overall adherence was self-efficacy. And the significant independent predictors contributing to overall quality of life were overall diabetes knowledge, self-efficacy and adherence. A pathway was depicted to illustrate the influence of the identified predictor variables on the criterion variables, and it was noticed that self-efficacy played a major role in both adherence and quality of life of Type II diabetes patients. The implications, strengths and limitations of the study are also discussed.