Application of the Social Cognitive Theory to Predict Self-Care Behavior among Type 2 Diabetes Patients with Limited Health Literacy

Background and Objective: Although compliance with selfcare behaviors is necessary for the successful management of diabetes, patients with diabetes often refuse favorable selfcare. This study was conducted to determine the factors influencing selfcare behaviors among type2 diabetic patients who had limited health literacy based on social cognitive theory (SCT). Materials and Methods: A cross sectional study was conducted among 293 diabetic patients with limited health literacy that was identified by STOFHLA. The data were collected using the summary of diabetes selfcare activities, diabetes management selfefficacy scale, outcome expectancies questionnaire, and a researchermade questionnaire for collecting data related to self regulation and social support constructs. Data were analyzed by SPSS ver.22 using multiple linear regression to determine the predictors of selfcare behaviors.  Results: In the case of patient’s adherence to selfcare tasks, they had the best adherence to medication regime and the worst adherence to physical activity. Employment status (p 0.032, β=3.57), supplementary insurance (p 0.018, β=1.74), and history of participating in diabetes education classes (p 0.044, β=1.63) were predictors of selfcare behaviors in the studied patients. Among the SCT constructs, perceived selfefficacy (p 0.001, β=0.21) predicted selfcare ability. The mean score of selfcare increased around 0.21 by increasing one single unit of selfefficacy. Overall, these factors predicted 67% (R2 = 0.67) of selfcare changes. Conclusions: The results of this study showed that self efficacy and demographic variables are significant predictors to improve selfcare ability among diabetic patients with limited health literacy.