Predicting Self-Efficacy in Managing Type 2 Diabetes: Results From a Low-Income, Less Educated Community of Quetta City, Pakistan
Author(s)
Syireen Alwi, PhD1, MARYAM FAROOQUI, PhD2, Fahad Saleem, MBA, MPhil, PharmD, PhD1.
1Universiti Malaya, Kuala Lumpur, Malaysia, 2Universiti Sains Malaysia, Penang, Malaysia.
1Universiti Malaya, Kuala Lumpur, Malaysia, 2Universiti Sains Malaysia, Penang, Malaysia.
OBJECTIVES: Self-efficacy plays a significant role in developing health sensibility. Therefore, we conducted this study to establish a self-efficacy profile and identify the predictors of self-efficacy in patients with type 2 diabetes mellitus (T2DM) in Quetta city, Pakistan.
METHODS: A cross-sectional study was conducted at Sandeman Provincial Hospital, Quetta. In addition to the demographics, the validated Urdu version of the Diabetes Management Self-Efficacy Scale (DMSES) was used to assess diabetes patients’ self-efficacy in managing T2DM. Self-efficacy was measured as proposed by the developers. The chi-square test identified the relationships, and significant associations were interpreted through Cramér's phi where applicable. Binary logistic linear regression was used to highlight the predictors of self-efficacy. For all analyses, p<0.05 was considered significant.
RESULTS: In this study, 3087 (44.5%) patients were above 47 years of age, and males (58%) dominated the cohort. Among the 6951 enrolled patients, 5143 (74%) patients had uncontrolled blood glucose levels (> 199 mg/dl), while 81.5% had HbA1c values > 6.5%. Poor self-efficacy was reported for the entire scale and the five domains of the DMSES (≤ 10). Six out of the twelve (income, education, duration of disease, treatment module, fasting blood sugar, and HbA1c) independent variables were significantly associated with self-efficacy, with a φc of ≤ 0.495. The strongest predictor of self-efficacy reported by the regression model was education, with an odds ratio of 2.250, indicating an increase in self-efficacy to 2.250 times while controlling for all other factors in the model.
CONCLUSIONS: Our results underscore the importance of education as a predictor of self-efficacy among T2DM patients. Given the limitation of rapidly improving the educational status of patients, we propose upgrading health literacy, which should be tailored based on suggestions of the Health Belief Model (HBM) that will warrant the improvement of self-efficacy leading to improved selfcare and disease management in diabetic patients.
METHODS: A cross-sectional study was conducted at Sandeman Provincial Hospital, Quetta. In addition to the demographics, the validated Urdu version of the Diabetes Management Self-Efficacy Scale (DMSES) was used to assess diabetes patients’ self-efficacy in managing T2DM. Self-efficacy was measured as proposed by the developers. The chi-square test identified the relationships, and significant associations were interpreted through Cramér's phi where applicable. Binary logistic linear regression was used to highlight the predictors of self-efficacy. For all analyses, p<0.05 was considered significant.
RESULTS: In this study, 3087 (44.5%) patients were above 47 years of age, and males (58%) dominated the cohort. Among the 6951 enrolled patients, 5143 (74%) patients had uncontrolled blood glucose levels (> 199 mg/dl), while 81.5% had HbA1c values > 6.5%. Poor self-efficacy was reported for the entire scale and the five domains of the DMSES (≤ 10). Six out of the twelve (income, education, duration of disease, treatment module, fasting blood sugar, and HbA1c) independent variables were significantly associated with self-efficacy, with a φc of ≤ 0.495. The strongest predictor of self-efficacy reported by the regression model was education, with an odds ratio of 2.250, indicating an increase in self-efficacy to 2.250 times while controlling for all other factors in the model.
CONCLUSIONS: Our results underscore the importance of education as a predictor of self-efficacy among T2DM patients. Given the limitation of rapidly improving the educational status of patients, we propose upgrading health literacy, which should be tailored based on suggestions of the Health Belief Model (HBM) that will warrant the improvement of self-efficacy leading to improved selfcare and disease management in diabetic patients.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
PCR190
Topic
Patient-Centered Research
Topic Subcategory
Patient Engagement
Disease
Diabetes/Endocrine/Metabolic Disorders (including obesity)