Fereydouni Fatemeh, Hajian-Tilaki Karimollah, Meftah Neda, Chehrazi Mohamad
Student Research Committee Babol University of Medical Sciences Babol Mazandaran Iran.
Social Determinants of Health Research Center, Health Research Institute Babol University of Medical Sciences Babol Mazandaran Iran.
Health Sci Rep. 2022 Mar 9;5(2):e534. doi: 10.1002/hsr2.534. eCollection 2022 Mar.
The simultaneous role of self-care and self-efficacy in improving the quality of life (QoL) of diabetic patients has been less considered in previous studies. This study was aimed to investigate the path association between self-care and self-efficacy with QoL using the structural equation model (SEM).
This cross-sectional study was conducted with 496 individuals of type 2 diabetic patients aged 35-75 years that were selected consequently from outpatients' clinic, in Babol, the north of Iran. The data collection instruments were demographic, self-care, self-efficacy, and QoL scales. The conceptual hypothesized model was designed based on previous evidence and tested by confirmatory factor analysis using SEM and path coefficients were estimated by the maximum likelihood method.
Self-care had a significant relationship with employment status, level of education, and body mass index. QoL was significantly associated with economic status and place of residence. Self-efficacy beliefs had a positive and a direct effect on both self-care and QoL. But self-care and self-efficacy tended to have a nonsignificant positive relationship with QoL. The postulated conceptual path model was acceptable through the SEM goodness of fit criteria.
The findings show the fitness of the framework hypothesized structural model in the QoL of diabetic patients and this SEM makes this study unique from others. The results showed that the role of self-efficacy and self-care could be considered on the QoL. Therefore, nonpharmacological and supportive methods, such as strengthening self-efficacy and self-care, could be recommended as an effective method to enhance the QoL of diabetic patients.
以往研究较少考虑自我护理和自我效能感在改善糖尿病患者生活质量（QoL）方面的协同作用。本研究旨在使用结构方程模型（SEM）探讨自我护理和自我效能感与生活质量之间的路径关联。
本横断面研究选取了496名年龄在35 - 75岁之间的2型糖尿病患者，这些患者是从伊朗北部巴博勒的门诊患者中依次选取的。数据收集工具包括人口统计学、自我护理、自我效能感和生活质量量表。概念性假设模型是基于先前的证据设计的，并通过使用SEM的验证性因素分析进行检验，路径系数采用最大似然法估计。
自我护理与就业状况、教育水平和体重指数有显著关系。生活质量与经济状况和居住地点显著相关。自我效能感信念对自我护理和生活质量均有正向直接影响。但自我护理和自我效能感与生活质量之间的正向关系往往不显著。通过SEM拟合优度标准，假定的概念性路径模型是可以接受的。
研究结果表明所假设的结构模型框架适用于糖尿病患者的生活质量，并且这种SEM使本研究有别于其他研究。结果表明，可以考虑自我效能感和自我护理在生活质量方面的作用。因此，可推荐非药物和支持性方法，如增强自我效能感和自我护理，作为提高糖尿病患者生活质量的有效方法。
