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Nam S, Nam S, Song Y. Role of Self-Efficacy in the Relationship Between Patient-Provider Relationships and Psychological Insulin Resistance Among Patients with Type 2 Diabetes. J Contemp Diabetes Res. 2014;1(1):1-15
Nam, S., Nam, S., & Song, Y. (2014). Role of Self-Efficacy in the Relationship Between Patient-Provider Relationships and Psychological Insulin Resistance Among Patients with Type 2 Diabetes. Journal of contemporary diabetes research, 1(1), 1-15.
Nam, Soohyun, et al. "Role of Self-Efficacy in the Relationship Between Patient-Provider Relationships and Psychological Insulin Resistance Among Patients with Type 2 Diabetes." Journal of contemporary diabetes research vol. 1,1 (2014): 1-15.
Nam S, Nam S, Song Y. Role of Self-Efficacy in the Relationship Between Patient-Provider Relationships and Psychological Insulin Resistance Among Patients with Type 2 Diabetes. J Contemp Diabetes Res. 2014;1(1):1-15. PMID: 25584361; PMCID: PMC4288822.
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J Contemp Diabetes Res. 2014;1(1):1-15.

Role of Self-Efficacy in the Relationship Between Patient-Provider Relationships and Psychological Insulin Resistance Among Patients with Type 2 Diabetes.

Journal of contemporary diabetes research

Soohyun Nam, Soohyun Nam, Youngshin Song

Affiliations

  1. Yale University, School of Nursing, West Haven, CT, USA.
  2. Chungnam National University, College of Nursing, Daejeon, South Korea.

PMID: 25584361 PMCID: PMC4288822

Abstract

Psychological insulin resistance (PIR) affects patients' self-care behaviors and quality of life due to the delay of insulin treatment for optimal glycemic control. Although effective patient-provider communication and relationships have been shown to improve patients' overall treatment adherence and attitude toward treatment, little is known about the potential mechanisms by which effective patient-provider communication and relationships decrease PIR and whether these relationships are mediated by diabetes self-efficacy. The purpose of this study is to examine whether diabetes self-efficacy among patients with type 2 diabetes (T2D) mediates the relationships between PIR and perceived patient-provider relationships. A total of 178 patients with T2D participated in a cross-sectional study. Data were obtained by patient interview using validated measures of diabetes attitude, diabetes knowledge, self-efficacy, and patient-provider communication. PIR was measured by using a validated measure, Barriers to Insulin Treatment. A structural equation model was developed to estimate direct and indirect effects of patient-provider relationship on PIR when self-efficacy was controlled as a mediator. Diabetes knowledge and attitude were not significantly associated with PIR. Better patient-provider relationship was directly associated with lower PIR (β = -.40, p = 0.008). When diabetes self-efficacy was included as a mediator, the direct effect between patient-provider relationship and PIR changed (β = -.27, p = 0.034), indicating that better patient-provider relationship that reduces PIR is due to greater diabetes self-efficacy. The findings suggest that development of intervention programs aimed at improving diabetes self-efficacy-which may be positively correlated with better patient-provider relationship-is needed to reduce PIR.

Keywords: mediator; patient-provider relationship; psychological insulin resistance; self-efficacy

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