Self-Efficacy and Adherence to Self-Care Among Patients With Type 2 Diabetes: A Systematic Review
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Abstract
Highly prevalent chronic illnesses such as type 2 diabetes can be effectively managed by adhering to certain health behaviors. As such, self-efficacy is a vital factor in this adherence process. This systematic review of cross-sectional studies aims to outline and evaluate the characteristics of the literature investigating self-efficacy and adherence to self-care in the type 2 diabetes population. Eleven eligible studies were identified based on the inclusion criteria after conducting a primary and secondary screening of three major databases (ProQuest, Scopus, and EBSCOhost) from inception to April 2022, along with manual searching from other sources. A narrative synthesis was used to analyze this review. The findings indicated that self-efficacy is significantly correlated with self-care adherence in persons with type 2 diabetes and that higher self-efficacy leads to better self-care behaviors. The selected studies failed to fulfill the quality criteria for identifying and measuring the confounding variables; therefore, future studies should focus on rigorous research design. A more sophisticated approach to elucidate phase-specific self-efficacy and its influence on health behavior among the type 2 diabetic population may be required in the future to design and test theoretical frameworks and intervention studies.
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References
• Al-Khawaldeh, O. A., Al-Hassan, M. A., & Froelicher, E. S. (2012). Self-efficacy, self-management, and glycemic control in adults with type 2 diabetes mellitus. Journal of Diabetes and its Complications, 26(1), 10–16. https://doi.org/10.1016/j.jdiacomp.2011.11.002
• Ali Morowatisharifabad, M., Abdolkarimi, M., Asadpour, M., Fathollahi, M. S., & Balaee, P. (2018). The predictive effects of protection motivation theory on intention and behaviour of physical activity in patients with type 2 diabetes. Open Access Macedonian Journal of Medical Sciences, 6(4), 709–714. https://doi.org/10.3889/oamjms.2018.119
• Amer, F. A., Mohamed, M. S., Elbur, A. I., Abdelaziz, S. I., & Elrayah, Z. A. (2018). Influence of self-efficacy management on adherence to self-care activities and treatment outcome among diabetes mellitus type 2. Pharmacy Practice (Granada), 16(4), Article 1274. https://doi.org/10.18549/pharmpract.2018.04.1274
• American Diabetes Association. (2010). Standards of medical care in diabetes–2010. Diabetes Care, 33(Supplement_1), S11–S61. https://doi.org/10.2337/dc10-S011
• American Diabetes Association. (2022). Introduction: Standards of medical care in diabetes—2022. Diabetes Care, 45(Supplement_1), S1–S2. https://doi.org/10.2337/dc22-Sint
• Anderson, R. M., Funnell, M. M., Aikens, J. E., Krein, S. L., Fitzgerald, J. T., Nwankwo, R., Tannas, C. L., & Tang, T. S. (2009). Evaluating the efficacy of an empowerment-based self-management consultant intervention: Results of a two-year randomized controlled trial. Education Thérapeutique du Patient-Therapeutic Patient Education, 1(1), 3–11. https://doi.org/10.1051/tpe/2009002
• Bandura, A. (1986). Social foundations of thought and action. Prentice-Hall.
• Bandura, A. (1997). Self-efficacy: The exercise of control. Freeman.
• Bandura, A. (2004). Health promotion by social cognitive means. Health Education & Behavior, 31(2), 143–164. https://doi.org/10.1177/1090198104263660
• Bohanny, W., Wu, S. F. V., Liu, C. Y., Yeh, S. H., Tsay, S. L., & Wang, T. J. (2013). Health literacy, self-efficacy, and self-care behaviors in patients with type 2 diabetes mellitus. Journal of the American Association of Nurse Practitioners, 25(9), 495–502. https://doi.org/10.1111/1745-7599.12017
• Bonger, Z., Shiferaw, S., & Tariku, E. Z. (2018). Adherence to diabetic self-care practices and its associated factors among patients with type 2 diabetes in Addis Ababa, Ethiopia. Patient Preference and Adherence, 12, 963–970. https://doi.org/10.2147/PPA.S156043
• Brown, S. A., García, A. A., Brown, A., Becker, B. J., Conn, V. S., Ramírez, G., Winter, M.A., Sumlin, L.L., Garcia, T.J., & Cuevas, H. E. (2016). Biobehavioral determinants of glycemic control in type 2 diabetes: A systematic review and meta-analysis. Patient Education and Counseling, 99(10), 1558–1567. https://doi.org/10.1016/j.pec.2016.03.020
• Cai, C., & Hu, J. (2016). Effectiveness of a family-based diabetes self-management educational intervention for Chinese adults with type 2 diabetes in Wuhan, China. The Diabetes Educator, 42(6), 697–711. https://doi.org/10.1177/0145721716674325
• Centers for Disease Control and Prevention. (2022, March 2). Diabetes Quick Facts. https://www.cdc.gov/diabetes/basics/quick-facts.html
• Chan, C. K. Y., Cockshaw, W., Smith, K., Holmes-Truscott, E., Pouwer, F., & Speight, J. (2020). Social support and self-care outcomes in adults with diabetes: The mediating effects of self-efficacy and diabetes distress. Results of the second diabetes MILES – Australia (MILES-2) study. Diabetes Research and Clinical Practice, 166, Article 108314. https://doi.org/10.1016/j.diabres.2020.108314
• Chen, M., Yun, Q., Lin, H., Liu, S., Liu, Y., Shi, Y., Ji, Y., & Chang, C. (2022). Factors related to diabetes self-management among patients with type 2 diabetes: A Chinese cross-sectional survey based on self-determination theory and social support theory. Patient Preference and Adherence, 16, 925–936. https://doi.org/10.2147/PPA.S335363
• Dao-Tran, T. H., Anderson, D., Chang, A., Seib, C., & Hurst, C. (2018). Factors associated with self-management among Vietnamese adults with type 2 diabetes. Nursing Open, 5(4), 507–516. https://doi.org/10.1002/nop2.158
• Didarloo, A. R., Shojaeizadeh, D., Gharaaghaji ASL, R., Habibzadeh, H., Niknami, S., & Pourali, R. (2012). Prediction of self-management behavior among Iranian women with type 2 diabetes: Application of the Theory of Reasoned Action along with Self-Efficacy (ETRA). Iranian Red Crescent Medical Journal, 14(2), 86–95. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3372043/
• Fitzgerald, J. T., Davis, W. K., Connell, C. M., Hess, G. E., Funnell, M. M., & Hiss, R. G. (1996). Development and validation of the Diabetes Care Profile. Evaluation & the Health Professions, 19(2), 208–230. https://doi.org/10.1177/016327879601900205
• Francis, J., Eccles, M. P., Johnston, M., Walker, A. E., Grimshaw, J. M., Foy, R., Kaner, E. F. S., Smith, L., & Bonetti, D. (2004). Constructing questionnaires based on the theory of planned behaviour: A manual for health services researchers. Centre for Health Service Research. http://openaccess.city.ac.uk/id/eprint/1735
• Funnell, M. M., & Anderson, R. M. (2005). Patient empowerment. In F. J. Snoek & T. C. Skinner (Eds.), Psychology in diabetes care (2nd ed., pp. 95–108). John Wiley & Sons.
• Funnell, M. M., Tang, T. S., & Anderson, R. M. (2007). From DSME to DSMS: Developing empowerment-based diabetes self-management support. Diabetes Spectrum, 20(4), 221–226. https://doi.org/10.2337/diaspect.20.4.221
• Gurmu, Y., Gela, D., & Aga, F. (2018). Factors associated with self-care practice among adult diabetes patients in West Shoa Zone, Oromia Regional State, Ethiopia. BMC Health Services Research, 18(1), Article 732. https://doi.org/10.1186/s12913-018-3448-4
• Haghayegh, A. S., Ghasemi, N., Neshatdoost, H. T., Kajbaf, M., & Khanbani, M. (2010). Psychometric properties of Diabetes Management Self-Efficacy Scale (DMSES). Iranian Journal of Endocrinology and Metabolism, 12(2), 111–115. https://www.sid.ir/paper/27483/en
• Hla, L. S. P., Pongthavornkamol, K., Wattanakitkrileart, D., & Orathai, P. (2018). Factors influencing adherence to therapeutic regimens among people with type 2 diabetes mellitus in Yangon, Myanmar. Journal of Population and Social Studies, 26(4), 262–280. https://doi.org/10.25133/JPSSv26n4.019
• International Diabetes Federation. (2015). IDF Diabetes Atlas 2015 (7th ed.). https://diabetesatlas.org/atlas/seventh-edition/
• International Diabetes Federation. (2021). IDF Diabetes Atlas 2021 (10th ed.). https://diabetesatlas.org/atlas/tenth-edition/
• Jiang, X., Wang, J., Lu, Y., Jiang, H., & Li, M. (2019). Self-efficacy-focused education in persons with diabetes: a systematic review and meta-analysis. Psychology Research and Behavior Management, 12, 67–79. https://doi.org/10.2147/PRBM.S192571
• Karimy, M., Koohestani, H. R., & Araban, M. (2018). The association between attitude, self-efficacy, and social support and adherence to diabetes self-care behavior. Diabetology & Metabolic Syndrome, 10(1), Article 86. https://doi.org/10.1186/s13098-018-0386-6
• Khan, M. A. B., Hashim, M. J., King, J. K., Govender, R. D., Mustafa, H., & Al Kaabi, J. (2020). Epidemiology of type 2 diabetes – Global burden of disease and forecasted trends. Journal of Epidemiology and Global Health, 10(1), 107–111. https://doi.org/10.2991/jegh.k.191028.001
• Kravitz, R. L., Hays, R. D., Sherbourne, C. D., DiMatteo, M. R., Rogers, W. H., Ordway, L., & Greenfield, S. (1993). Recall of recommendations and adherence to advice among patients with chronic medical conditions. Archives of Internal Medicine, 153(16), 1869–1878. https://doi.org/10.1001/archinte.153.16.1869
• Kurnia, A. D., Amatayakul, A., & Karuncharernpanit, S. (2017). Predictors of diabetes self-management among type 2 diabetics in Indonesia: Application theory of the health promotion model. International Journal of Nursing Sciences, 4(3), 260–265. https://doi.org/10.1016/j.ijnss.2017.06.010
• Lakerveld, J., Palmeira, A. L., van Duinkerken, E., Whitelock, V., Peyrot, M., & Nouwen, A. (2020). Motivation: Key to a healthy lifestyle in people with diabetes? Current and emerging knowledge and applications. Diabetic Medicine, 37(3), 464–472. https://doi.org/10.1111/dme.14228
• Lee, A. A., Piette, J. D., Heisler, M., Janevic, M. R., & Rosland, A. M. (2019). Diabetes self-management and glycemic control: The role of autonomy support from informal health supporters. Health Psychology, 38(2), 122–132. https://doi.org/10.1037/hea0000710
• Lee, Y. Y., & Lin, J. L. (2009). The effects of trust in physician on self-efficacy, adherence and diabetes outcomes. Social Science & Medicine, 68(6), 1060–1068. https://doi.org/10.1016/j.socscimed.2008.12.033
• Liang, D., Jia, R., Zhou, X., Lu, G., Wu, Z., Yu, J., Wang, Z., Huang, H., Guo, J & Chen, C. (2021). The effectiveness of peer support on self-efficacy and self-management in people with type 2 diabetes: A meta-analysis. Patient Education and Counseling, 104(4), 760–769. https://doi.org/10.1016/j.pec.2020.11.011
• Lin, C. C., Anderson, R. M., Chang, C. S., Hagerty, B. M., & Loveland-Cherry, C. J. (2008). Development and testing of the Diabetes Self-management Instrument: A confirmatory analysis. Research in Nursing & Health, 31(4), 370–380. https://doi.org/10.1002/nur.20258
• Luo, X., Liu, T., Yuan, X., Ge, S., Yang, J., Li, C., & Sun, W. (2015). Factors influencing self-management in Chinese adults with type 2 diabetes: A systematic review and meta-analysis. International Journal of Environmental Research and Public Health, 12(9), 11304–11327. https://doi.org/10.3390/ijerph120911304
• McCollum, M., Hansen, L. B., Lu, L., & Sullivan, P. W. (2005). Gender differences in diabetes mellitus and effects on self-care activity. Gender Medicine, 2(4), 246–254. https://doi.org/10.1016/s1550-8579(05)80054-3
• Mende Sorato, M., Tesfahun, C., & Lamessa, D. (2016). Levels and predictors of adherence to self-care behaviour among adult type 2 diabetics at Arba Minch general hospital, Southern Ethiopia. Journal of Diabetes & Metabolism, 7(6), Article 11. https://doi.org/10.4172/2155-6156.1000684
• Miller, C. K., & Bauman, J. (2014). Goal setting: An integral component of effective diabetes care. Current Diabetes Reports, 14(8), Article 509. https://doi.org/10.1007/s11892-014-0509-x
• Mohebi, S., Azadbakht, L., Feizi, A., Sharifirad, G., & Kargar, M. (2013). Structural role of perceived benefits and barriers to self-care in patients with diabetes. Journal of Education and Health Promotion, 2, Article 37. https://doi.org/10.4103/2277-9531.115831
• Moher, D., Liberati, A., Tetzlaff, J., Altman, D. G., & the PRISMA Group. (2009). Preferred reporting items for systematic reviews and meta-analyses: The PRISMA statement. Annals of Internal Medicine, 151(4), 264–269. https://doi.org/10.7326/0003-4819-151-4-200908180-00135
• Moola, S., Munn, Z., Tufanaru, E., Aromataris, E., Sears, K., Sfetcu, R., Curie, M., Qureshi, R., Mattis, P., Lisy, K., & Mu, P-F. (2020). Systematic reviews of etiology and risk. In E. Aromataris & Z. Munn (Eds.), JBI Manual for Evidence Synthesis. Joanna Briggs Institute. https://synthesismanual.jbi.global
• Morisky, D. E., Green, L. W., & Levine, D. M. (1986). Concurrent and predictive validity of a self-reported measure of medication adherence. Medical Care, 24(1), 67–74. https://doi.org/10.1097/00005650-198601000-00007
• Page, M. J., McKenzie, J. E., Bossuyt, P. M., Boutron, I., Hoffmann, T. C., Mulrow, C. D., Shamseer, L., Tetzlaff, J. M., Akl, E. A., Brennan, S. E., Chou, R., Glanville, J., Grimshaw, J. M., Hróbjartsson, A., Lalu, M. M., Li, T., Loder, E. W., Mayo-Wilson, E., McDonald, S., . . . Moher, D. (2021). The PRISMA 2020 statement: An updated guideline for reporting systematic reviews. BMJ, 372, Article 71. https://doi.org/10.1136/bmj.n71
• Polonsky, W. (2009, June 5–9). Evaluation of the Confidence in Diabetes Scale (CIDS-2) for patients with poorly-controlled T2DM. 69th Scientific Sessions, New Orleans, Louisiana, United States. https://professional.diabetes.org/abstract/evaluation-confidence-diabetes-scale-cids-2-patients-poorly-controlled-t2dm
• Ranjbaran, S., Shojaeizadeh, D., Dehdari, T., Yaseri, M., & Shakibazadeh, E. (2020). Determinants of medication adherence among Iranian patients with type 2 diabetes: An application of health action process approach. Heliyon, 6(7), Article e04442. https://doi.org/10.1016/j.heliyon.2020.e04442
• Reisi, M., Mostafavi, F., Javadzade, H., Mahaki, B., Tavassoli, E., & Sharifirad, G. (2016). Impact of health literacy, self-efficacy, and outcome expectations on adherence to self-care behaviors in Iranians with type 2 diabetes. Oman Medical Journal, 31(1), 52–59. https://doi.org/10.5001/omj.2016.10
• Reisi, M., Fazeli, H., & Mahmoodi, M. (2021). Application of the social cognitive theory to predict self-care behavior among type 2 diabetes patients with limited health literacy. Journal of Health Literacy, 6(2), 21–32. https://doi.org/10.22038/JHL.2021.57503.1161
• Rodgers, W. M., & Sullivan, M. J. L. (2001). Task, coping, and scheduling self-efficacy in relation to frequency of physical activity. Journal of Applied Social Psychology, 31(4), 741–753. https://doi.org/10.1111/j.1559-1816.2001.tb01411.x
• Rollnick, S., Miller, W. R., Butler, C. C., & Aloia, M. S. (2008). Motivational interviewing in health care: Helping patients change behavior. COPD: Journal of Chronic Obstructive Pulmonary Disease, 5(3), 203. https://doi.org/10.1080/15412550802093108
• Rolnick, S. J., Pawloski, P. A., Hedblom, B. D., Asche, S. E., & Bruzek, R. J. (2013). Patient characteristics associated with medication adherence. Clinical Medicine & Research, 11(2), 54–65. https://doi.org/10.3121/cmr.2013.1113
• Saleh, A., Wirda, W., Irwan, A. M., & Latif, A. I. (2021). The relationships among self-efficacy, health literacy, self-care and glycemic control in older people with type 2 diabetes mellitus. Working with Older People, 25(2), 164–169. https://doi.org/10.1108/WWOP-08-2020-0044
• Sallay, V., Klinovszky, A., Csuka, S. I., Buzás, N., & Papp-Zipernovszky, O. (2021). Striving for autonomy in everyday diabetes self-management—qualitative exploration via grounded theory approach. BMJ Open, 11(12), Article e058885. https://doi.org/10.1136/bmjopen-2021-058885
• Scholz, U., Sniehotta, F. F., & Schwarzer, R. (2005). Predicting physical exercise in cardiac rehabilitation: The role of phase-specific self-efficacy beliefs. Journal of Sport and Exercise Psychology, 27(2), 135–151. https://doi.org/10.1123/jsep.27.2.135
• Schwarzer, R. (2008). Modeling health behavior change: How to predict and modify the adoption and maintenance of health behaviors. Applied Psychology, 57(1), 1–29. https://doi.org/10.1111/j.1464-0597.2007.00325.x
• Schwarzer, R., Lippke, S., & Luszczynska, A. (2011). Mechanisms of health behavior change in persons with chronic illness or disability: The Health Action Process Approach (HAPA). Rehabilitation Psychology, 56, 161–170. https://doi.org/10.1037/a0024509
• Schwarzer, R., & Renner, B. (2000). Social-cognitive predictors of health behavior: Action self-efficacy and coping self-efficacy. Health Psychology, 19(5), 487–495. https://psycnet.apa.org/doi/10.1037/0278-6133.19.5.487
• Selçuk‐Tosun, A., & Zincir, H. (2019). The effect of a transtheoretical model-based motivational interview on self‐efficacy, metabolic control, and health behaviour in adults with type 2 diabetes mellitus: A randomized controlled trial. International Journal of Nursing Practice, 25(4), Article e12742. https://doi.org/10.1111/ijn.12742
• Sharoni, S. K. A., & Wu, S. F. V. (2012). Self‐efficacy and self‐care behavior of Malaysian patients with type 2 diabetes: A cross sectional survey. Nursing & Health Sciences, 14(1), 38–45. https://doi.org/10.1111/j.1442-2018.2011.00658.x
• Shi, Q., Ostwald, S. K., & Wang, S. (2010). Improving glycaemic control self-efficacy and glycaemic control behaviour in Chinese patients with type 2 diabetes mellitus: Randomised controlled trial. Journal of clinical nursing, 19(3-4), 398–404. https://doi.org/10.1111/j.1365-2702.2009.03040.x
• Shrivastava, S. R., Shrivastava, P. S., & Ramasamy, J. (2013). Role of self-care in management of diabetes mellitus. Journal of Diabetes & Metabolic Disorders, 12(1), Article 14. https://doi.org/10.1186/2251-6581-12-14
• Stanford Patient Education Research Center. (2008). Diabetes Self-Efficacy scale.
• Stanford Patient Education Research Center. (2009). Self-Efficacy for Diabetes. https://acl.gov/sites/default/files/nutrition/Appendix%20L%20Stanford%20Self-Efficacy%20for%20Diabetes%20Survey_508.pdf
• Stanford Patient Education Research Center. (2016). Self-Efficacy for Diabetes scale. https://www.slu.edu/medicine/family-medicine/pdfs/diabetes-management-selfefficacy-scale.pdf
• Sturt, J., Hearnshaw, H., & Wakelin, M. (2010). Validity and reliability of the DMSES UK: A measure of self-efficacy for type 2 diabetes self-management. Primary Health Care Research & Development, 11(4), 374–381. https://doi.org/10.1017/S1463423610000101
• Świątoniowska-Lonc, N., Tański, W., Polański, J., Jankowska-Polańska, B., & Mazur, G. (2021). Psychosocial determinants of treatment adherence in patients with type 2 diabetes - A review. Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy, 14, 2701–2715. https://doi.org/10.2147/DMSO.S308322
• Talbot, F., Nouwen, A., Gingras, J., Gosselin, M., & Audet, J. (1997). The assessment of diabetes-related cognitive and social factors: The multidimensional diabetes questionnaire. Journal of Behavioral Medicine, 20(3), 291–312. https://doi.org/10.1023/a:1025508928696
• Tang, T. S., Gillard, M. L., Funnell, M. M., Nwankwo, R., Parker, E., Spurlock, D., & Anderson, R. M. (2005). Developing a new generation of ongoing diabetes self-management support interventions. The Diabetes Educator, 31(1), 91–97. https://doi.org/10.1177/0145721704273231
• Tharek, Z., Ramli, A. S., Whitford, D. L., Ismail, Z., Mohd Zulkifli, M., Ahmad Sharoni, S. K., Shafie, A. A., & Jayaraman, T. (2018). Relationship between self-efficacy, self-care behaviour and glycaemic control among patients with type 2 diabetes mellitus in the Malaysian primary care setting. BMC Family Practice, 19(1), Article 39. https://doi.org/10.1186/s12875-018-0725-6
• Toobert, D. J., Hampson, S. E., & Glasgow, R. E. (2000). The summary of diabetes self-care activities measure: Results from 7 studies and a revised scale. Diabetes Care, 23(7), 943–950. https://doi.org/10.2337/diacare.23.7.943
• van der Bijl, J., van Poelgeest‐Eeltink, A., & Shortridge‐Baggett, L. (1999). The psychometric properties of the diabetes management self‐efficacy scale for patients with type 2 diabetes mellitus. Journal of Advanced Nursing, 30(2), 352–359. https://doi.org/10.1046/j.1365-2648.1999.01077.x
• van der Ven, N. C. W., Weinger, K., Yi, J., Pouwer, F., Adèr, H., van der Ploeg, H. M., & Snoek, F. J. (2003). The confidence in diabetes self-care scale: Psychometric properties of a new measure of diabetes-specific self-efficacy in Dutch and U.S. patients with type 1 diabetes. Diabetes care, 26(3), 713–718. https://doi.org/10.2337/diacare.26.3.713
• Wahyuni, A., & Ramayani, D. (2020). The relationship between self-efficacy and self-care in type 2 diabetes mellitus patients. The Malaysian Journal of Nursing, 11(3), 68–75. https://doi.org/10.31674/MJN.2020.V11I03.011
• Wainwright, K., Romanowich, P., & Crabtree, M. A. (2022). Associations between impulsivity and self-care adherence in individuals diagnosed with type 2 or prediabetes. PLOS ONE, 17(3), Article e0263961. https://doi.org/10.1371/journal.pone.0263961
• Walker, R. J., Smalls, B. L., Hernandez-Tejada, M. A., Campbell, J. A., & Egede, L. E. (2014). Effect of diabetes self-efficacy on glycemic control, medication adherence, self-care behaviors, and quality of life in a predominantly low-income, minority population. Ethnicity & Disease, 24(3), 349–355. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7394238/
• Wallston, K. A., Rothman, R. L., & Cherrington, A. (2007). Psychometric properties of the perceived Diabetes Self-Management Scale (PDSMS). Journal of Behavioral Medicine, 30(5), 395–401. https://doi.org/10.1007/s10865-007-9110-y
• Wang, J. Q., & Shiu, A. T. Y. (2004). Diabetes self-efficacy and self-care behaviour of Chinese patients living in Shanghai. Journal of Clinical Nursing, 13(6), 771–772. https://doi.org/10.1111/j.1365-2702.2004.00918.x
• Wichit, N., Mnatzaganian, G., Courtney, M., Schulz, P., & Johnson, M. (2017). Randomized controlled trial of a family-oriented self-management program to improve self-efficacy, glycemic control and quality of life among Thai individuals with type 2 diabetes. Diabetes Research and Clinical Practice, 123, 37–48. https://doi.org/10.1016/j.diabres.2016.11.013
• World Health Organization. (2003). Adherence to long-term therapies: Evidence for action. https://apps.who.int/iris/handle/10665/42682
• Yao, J., Wang, H., Yin, X., Yin, J., Guo, X., & Sun, Q. (2019). The association between self-efficacy and self-management behaviors among Chinese patients with type 2 diabetes. PLOS ONE, 14(11), Article e0224869. https://doi.org/10.1371/journal.pone.0224869
• Zhou, Y., Liao, L., Sun, M., & He, G. (2013). Self-care practices of Chinese individuals with diabetes. Experimental and Therapeutic Medicine, 5(4), 1137–1142. https://doi.org/10.3892/etm.2013.945