Psychosocial variables affecting diabetes self-management and the impact on quality of life

The diabetes population in Malaysia has grown and exceeded the prediction by WHO and potentially exhausts the country’s healthcare systems. Such rapid growth has directly challenged the effectiveness of existing diabetes self-management education, urging researchers to explore any overlooked elements to be included in the healthcare services, especially from psychological health aspects. Rooting itself in Social Cognitive Theory and Self-Determination Theory, this research explored psychosocial aspects in personal disease management and quality of life. Thirteen scales relevant to personal attributions, emotion management, interpersonal relationship, health literacy, perceived care, self-care activities, and quality of life were compiled and conducted along with an engagement interview. The data of 181 Malaysian Type 2 diabetics were used for analyses including multiple regression, independent-samples T-test, ANOVA, Kruskal-Wallis, and Mann-Whitney U test. Results revealed significant associations between psychosocial variables and self-management. Factors including self-efficacy, problem-solving skill, optimism, depression, anxiety, and distress were powerful determinants for self-management, which in turns predicts the quality of life amongst diabetics. Among self-management factors, self-perception of care was identified as the most powerful predictor for quality of life. Further, between-groups comparisons revealed that West Coast group and Chinese ethnic group reported better glycaemic control. Additional information related to diagnosis, motivation, adaptation, self-evaluation, and acknowledgement was obtained via engagement interviews. The overall findings have placed personality, emotion regulations, availability of quality health services, education levels, cultural differences in health belief and lifestyle, under the speculation for the explanations. Lastly, limitation of study, practical implications, recommendations, and future directions of study were identified and discussed.