Studying Treatment Adherence in Relation to Perceived Self-Efficacy and Perceived Illness in Patients with Type 2 Diabetes

Document Type : Original Article

Authors

1 PhD Student, Department of Psychology, Roudehen Branch, Islamic Azad University, Roudehen, Tehran, Iran.

2 Associate Professor, Department of Psychology, Medical Sciences Branch, Islamic Azad University, Tehran, Iran.

Abstract

Introduction: Type 2 diabetes is a chronic, incurable disease, and adherence to treatment plays a crucial role in maintaining the health of affected patients. Therefore, the aim of the present study was to examine treatment adherence in relation to perceived self-efficacy and perceived recovery among patients with type 2 diabetes.
Method: The present study was applied and descriptive-correlational in design. The statistical population included all type 2 diabetic patients attending medical centers in District 4 of Tehran during 2022–2023. The study sample consisted of 270 patients with type 2 diabetes who met the inclusion criteria. These individuals were selected using a convenience sampling method. To assess the participants, the following questionnaires were used: Illness Perception Questionnaire (Broadbent et al., 2006), Treatment Adherence Questionnaire (Modanloo, 2013), and Cohen's Perceived Stress Scale (1983). After data collection, analysis was conducted using Pearson correlation and regression methods with SPSS version 22 software.
Results: There is a significant negative correlation between treatment adherence and the perceived self-efficacy component (r = -0.59), the perceived helplessness component (r = -0.66), and the total perceived stress score (r = -0.67). The perceived self-efficacy component accounted for 35%, the perceived helplessness component accounted for 44%, and the total perceived stress score accounted for 45% of the variance in treatment adherence, all in a statistically significant manner.
Discussion and Conclusion: It can be concluded that perceived self-efficacy and perceived helplessness are significantly related to treatment adherence in diabetic patients. Therefore, it is essential to consider patients' perceptions of their illness and their levels of perceived stress when developing treatment plans.

Keywords

References

  • Mustafiz, F., Hoogendoorn, C. J., Gonzalez, J. S. 43-LB: Diabetes Distress, Depression, Perceived Stress, and Medication Adherence in Type 2 Diabetes (T2D). Diabetes, 2022; 71(Supplement_1):1-10. https://doi.org/.2337/db22-43-LB [In Persian]
  • Khoddari, K., Nourimoghadam, S. The Role of the Self-Differentiation and Mindfulness in Predicting Disturbed Eating Behaviors in Adolescent’s Diabetic. Clinical Psychology and Personality, 2024; 22(2): 10.22070/CPAP.2023.17713.1368 [In Persian]
  • McKenzie, A. L., Athinarayanan, S. J., McCue, J. J., Adams, R. N., Keyes, M., McCarter, J. P., et al. Type 2 diabetes prevention focused on normalization of glycemia: a two-year pilot study. Nutrients, 2021; 13(3): 749. https://doi.org/10.3390/nu13030749.
  • Younossi, Z. M., Tampi, R. P., Racila, A., Qiu, Y., Burns, L., Younossi, I., et al. Economic and clinical burden of nonalcoholic steatohepatitis in patients with type 2 diabetes in the US. Diabetes care. 2020; 43(2): 283-9. https://doi.org/ 10.2337/dc19-1113. Epub 2019 Oct 28 [In Persian]
  • Simon, S. T., Kini, V., Levy, A. E., Ho, PM. Medication adherence in cardiovascular medicine. BMJ, 2021; 374. https://doi.org/ https://doi.org/10.1136/bmj.n1493
  • Nabolsi, M. M. Perception of diabetes management and cardiovascular disease risk among men with type 2 diabetes: A qualitative study. Nursing open, 2020; 7(3): 832-40. https://doi.org/ 10.1002/nop2.458. eCollection 2020 May.
  • Kengne, A. P., Brière, J-B, Zhu, L., Li, J., Bhatia, M. K., Atanasov, P., et al. Impact of poor medication adherence on clinical outcomes and health resource utilization in patients with hypertension and/or dyslipidemia: systematic review. Expert Review of Pharmacoeconomics & Outcomes Research, 2024; 24(1): 143-54. https://doi.org/10.1080/14737167.2023.2266135. Epub 2024
  • Shiloh, S., Peleg, S., Nudelman, G. Adherence to COVID-19 protective behaviors: A matter of cognition or emotion? Health Psychology, 2021‌; 40(7): 419. https://doi.org/10.1037/hea0001081.
  • Merabet, N., Lucassen, P. J., Crielaard, L., Stronks, K., Quax, R., Sloot, P. M., et al. How exposure to chronic stress contributes to the development of type 2 diabetes: A complexity science approach. Frontiers in Neuroendocrinology, 2022; 65: 100972. https://doi.org/10.1016/j.yfrne.2021
  • Ribeiro, G., Monge, J., Postolache, O., Pereira, J. M. D. A Novel AI Approach for Assessing Stress Levels in Patients with Type 2 Diabetes Mellitus Based on the Acquisition of Physiological Parameters Acquired during Daily Life. Sensors, 2024; 24(13): 4175. https://doi.org/10.3390/s24134175
  • Tan, F. C., Oka, P., Dambha-Miller, H., Tan, N. C. The association between self-efficacy and self-care in essential hypertension: a systematic review. BMC family practice, 2021 Dec; 22: 1-2.
  • Ruswadi, I. Asyari, H. Marsono, M. Akhmadi, A. & Purwanta, P. The Relationship Between Self Efficacy and Family Support With Hypertension Treatment Adherence of Elderly. Jurnal Pendidikan Keperawatan Indonesia, 2023; 9(1): 59-68. https://doi.org/10.35335/midwifery.v10i5.980
  • Xie, C., Li, L., Li, Y. Trajectories of learned helplessness in maintenance haemodialysis patients and their predictive effects on self-management: a latent growth mixture modeling approach. Psychology Research and Behavior Management, 2023 Dec 31:351-61.
  • Zhou, Y., Huo, Q., Du, S., Shi, X., Shi, Q., Cui‌, S., Feng, C., Du, X., Wang, Y. Social support and self-efficacy as mediating factors affecting the association between depression and medication adherence in older patients with coronary heart disease: a multiple mediator model with a cross-sectional study. Patient preference and adherence, 2022 Feb 4: 285-95.
  • Pan, Q., Zhang, C., Yao, L., Mai, C., Zhang, J., Zhang, Z., Hu, J. Factors influencing medication adherence in elderly patients with hypertension: a single center study in Western China. Patient preference and adherence, 2023 Dec 31: 1679-88.
  • Xie, C., Li, L., Li, Y. “Alive day is the day”: a qualitative study of experiences of learned helplessness in maintenance Haemodialysis patients. Risk Management and Healthcare Policy, 2023 Dec 31:231-45.
  • Hamama-Raz, Y., Frishberg, Y., Ben-Ezra, M., Levin, Y. The interrelations of family relationship, illness cognition of helplessness and perceived barriers to medication adherence: a study of adolescent and emerging adult kidney recipients and their parents. Adolescent Health, Medicine and Therapeutics, 2023 Dec 31:205-15.
  • Xie, C., Li, L., Zhou, L., Sun, C., Zhang, Y., Li, Y. Mediating role of learned helplessness’ components in the association between health literacy/social support and self-management among maintenance haemodialysis patients in Changsha, China: a cross-sectional study. BMJ open, 2023 Aug 1; 13(8): e068601..
  • Abu-Baker, N. N,, Al-Zyoud, NmH, Alshraifeen, A. Quality of life and self-care ability among individuals with spinal cord injury. Clinical Nursing Research, 2021; 30(6): 883-91. https://doi.org/10.1177/1054773820976623. Epub 2020 Nov 26.
  • Stevens JP. Intermediate statistics: A modern approach: Routledge; 2013. ISBN 9780805854664
  • Seyed Fatemi, N.,  Rafii, F.‌,  Hajizadeh, E.‌,  Modanloo, M. Psychometric properties of the adherence questionnaire in patients with chronic disease: A mix method study. Koomesh, 2018; 20 (2): 179 -191. com/p1805614.
  • Cohen, S., Janicki-Deverts, D., Miller, G. E. Psychological stress and disease. Jama, 2007; 298(14): 1685-7. https://doi.org/10.001/jama.298.14.

 Safaei, M., Shokri. O. Assessing Stress in Cancer Patients: Factoral Validity of the Perceived Dtress Scale in Iran. Iranian Journal of Psychiatric Nursing. 2014; 2(1): 13-22. http://ijpn.ir/article-1-283-fa.html

  • Fan, Y., Shen, B. J., Tay, H. Y. Depression, anxiety, perceived stress, and their changes predicted medical adherence over 9 months among patients with coronary heart disease. British Journal of Health Psychology, 2021; 26(3): 748-66. https://doi.org/10.1111/bjhp.12496. Epub 2020 Dec 31
  • Alvarez, C., Hines, A. L., Carson, K. A., Andrade, N., Ibe, C. A., Marsteller, J. A., Cooper, L. A., RICH LIFE Project Investigators. Association of perceived stress and discrimination on medication adherence among diverse patients with uncontrolled hypertension. Ethnicity & disease, 2021 Jan 21; 31(1): 97. https://doi.org/‌10.18865/ed.31.1.97. eCollection 2021 Winter. https://doi.org/10.18865/ed.31.1.97. eCollection 2021 Winter.

 

 

Clinical Psychology and Personality
Volume 23, Issue 2 - Serial Number 45
September 2025
Pages 79-86

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