TY - JOUR
T1 - Effect of diabetes fatalism on medication adherence and self-care behaviors in adults with diabetes
AU - Walker, Rebekah J.
AU - Smalls, Brittany L.
AU - Hernandez-Tejada, Melba A.
AU - Campbell, Jennifer A.
AU - Davis, Kimberly S.
AU - Egede, Leonard E.
N1 - Funding Information:
Supported by Grant #T35DK007431 from the National Institute for Diabetes, Digestive and Kidney Disease .
PY - 2012/11
Y1 - 2012/11
N2 - 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.
AB - 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.
KW - Diabetes
KW - Fatalism
KW - Medication adherence
KW - Self-care
UR - http://www.scopus.com/inward/record.url?scp=84867849414&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84867849414&partnerID=8YFLogxK
U2 - 10.1016/j.genhosppsych.2012.07.005
DO - 10.1016/j.genhosppsych.2012.07.005
M3 - Article
C2 - 22898447
AN - SCOPUS:84867849414
SN - 0163-8343
VL - 34
SP - 598
EP - 603
JO - General Hospital Psychiatry
JF - General Hospital Psychiatry
IS - 6
ER -
