Effect of diabetes fatalism on medication adherence and self-care behaviors in adults with diabetes

Rebekah J. Walker, Brittany L. Smalls, Melba A. Hernandez-Tejada, Jennifer A. Campbell, Kimberly S. Davis, Leonard E. Egede

Research output: Contribution to journalArticlepeer-review

76 Scopus citations

Abstract

Objective: Diabetes fatalism is defined as "a complex psychological cycle characterized by perceptions of despair, hopelessness, and powerlessness" and associated with poor glycemic control. This study examined the association between diabetes fatalism and medication adherence and self-care behaviors in adults with diabetes. Methods: Data on 378 subjects with type 2 diabetes recruited from two primary care clinics in the Southeastern United States were examined. Previously validated scales were used to measure diabetes fatalism, medication adherence, diabetes knowledge and diabetes self-care behaviors (diet, physical activity, blood sugar testing and foot care). Multiple linear regression was used to assess the independent effect of diabetes fatalism on medication adherence and self-care behaviors controlling for relevant covariates. Results: Fatalism correlated significantly with medication adherence (r=0.24, P< .001), diet (r=-0.26, P< .001), exercise (r=-0.20, P< .001) and blood sugar testing (r=-0.19, P< .001). In the linear regression model, diabetes fatalism was significantly associated with medication adherence [β=0.029, 95% confidence interval (CI) 0.016, 0.043], diabetes knowledge (β=-0.042, 95% CI - 0.001, - 0.084), diet (β=-0.063, 95% CI - 0.039, - 0.087), exercise (β=-0.055, 95% CI - 0.028, - 0.083) and blood sugar testing (β=-0.055, 95% CI - 0.023, - 0.087). There was no significant association between diabetes fatalism and foot care (β=-0.018, 95% CI - 0.047, 0.011). The association between diabetes fatalism and medication adherence, diabetes knowledge and diabetes self-care behaviors did not change significantly when depression was added to the models, suggesting that the associations are independent of depression. Conclusion: Diabetes fatalism is associated with poor medication adherence and self-care and may be an important target for education and skills interventions in diabetes care. In addition, the effect of diabetes fatalism is independent of depression, suggesting that interventions that target depression may not be sufficient to deal with diabetes fatalism.

Original languageEnglish
Pages (from-to)598-603
Number of pages6
JournalGeneral Hospital Psychiatry
Volume34
Issue number6
DOIs
StatePublished - Nov 2012

Bibliographical note

Funding Information:
Supported by Grant #T35DK007431 from the National Institute for Diabetes, Digestive and Kidney Disease .

Keywords

  • Diabetes
  • Fatalism
  • Medication adherence
  • Self-care

ASJC Scopus subject areas

  • Psychiatry and Mental health

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