The relationship among health literacy, self-efficacy, and self-management of individuals with diabetes
A serious patient safety issue exists in the United States; health care professionals lack a comprehensive idea of the factors that influence patients' ability to carry out appropriate self-management activities. Individuals diagnosed with chronic conditions must learn to live with rather than die from their life-altering states of health. The purpose of this study was to examine the relationship among health literacy, self-efficacy and self-management of individuals with diabetes and to determine if self-efficacy mediates the relationship between health literacy and self-management of diabetes. Research demonstrates an association among these variables, however the exact nature of the mechanism is not known. Bandura's Self-Efficacy Theory served as the theoretical framework and provided rationale for strategies that explain the potential for health-related behavior changes. Individuals may make changes when an increase in belief regarding one's ability occurs.
A cross sectional exploratory correlational design was appropriate for exploring these relationships and provided a proper foundation for testing the potential mediation effect of self-efficacy. Descriptive statistics and exploratory data analysis were employed to analyze data and to describe the sample of adult diabetics. Positive associations were demonstrated among the three variables and displayed statistically significant relationships between diabetes self-management and diabetic self-efficacy, as well as between diabetic self-efficacy and health literacy. Self-efficacy did not mediate the relationship between health literacy and self-management.
Self-efficacy emerged as the construct which was the strongest contributor in interfaces among the three variables. Demographic characteristics of insurance status, age groups, and annual income were significantly related to the three variables. The possession of insurance appeared to have the most significant effect on an individual's level of self-efficacy and ability to self-manage diabetes. Continued exploration of the true nature of the associations among these variables has far-reaching implications in the facilitation of effective self-care abilities for diverse patient populations. The nursing profession should continue the quest toward development of realistic strategies of health education for patients. As client advocates, the responsibility to positively contribute to patients' understanding of health care information and towards the development of individual competence in the performance of self-management of chronic conditions is of paramount importance.