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Self-Care Adherence and Psychological Functioning of Older Patients with Type 2 Diabetes: Effects of Persuasion, Social Pressure, and Self-Efficacy

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Abstract

This cross-sectional study examined the role of family members’ use of persuasion versus pressure as distinct forms of social control by which family members attempt to encourage better diabetes management among older adults with type 2 diabetes mellitus (T2DM). The study also examined how self-efficacy might moderate the relationship between persuasion/pressure, psychological functioning, and self-care adherence. Participants were 96 men and 103 women with T2DM, with a mean age of 63.3 years. Regression results show that neither persuasion nor pressure was significantly related to self-care adherence, but persuasion and pressure were associated in complex ways with diabetes-related emotional distress and depressive symptoms for which significant interaction effects were found. Patients with lower self-efficacy benefited from persuasion, but were adversely affected by pressure. In contrast, patients with higher self-efficacy were adversely affected by persuasion, but were less negatively affected by pressure. Findings highlight the importance of reducing pressure-based social control, considering patients’ self-efficacy when family members seek to influence patients’ self-care behaviors, and targeting patient-family interactions in future interventions.

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Acknowledgments

Dr. Fang Yang’s work was supported by a grant from Shanghai Municipal Education Commission “Chenguang Scholar Program” (15CG46) and a grant from Mitsui Sumitomo Insurance Welfare Foundation (M4060918.100). The authors gratefully acknowledge their support. The authors also thank research assistants for their assistance with data collection, the Diabetic Society of Singapore and all the patients for their support in the data collection.

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Authors and Affiliations

  1. Department of Social Work, School of Sociology and Political Science, Shanghai University, A501, 99 Shangda Road, Baoshan District, Shanghai, 200444, China

    Fang Yang

  2. Division of Psychology, School of Humanities and Social Sciences, Nanyang Technological University, 14 Nanyang Drive, Singapore, 637332, Singapore

    Joyce S. Pang

  3. Psychological Services, INSEAD Asian Campus, 1 Ayer Rajah Avenue, Singapore, 138676, Singapore

    Wendy J. Y. Cheng

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Authors Fang Yang, Joyce Pang, and Wendy J.Y. Cheng declare that they have no conflict of interest.

Human and Animal Rights and Informed Consent

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation of the participating institutions (Nanyang Technological University, Diabetic Society of Singapore) and with the Helsinki Declaration of 1975, as revised in 2000. Informed consent was obtained from all subjects for being included in the study.

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Yang, F., Pang, J.S. & Cheng, W.J.Y. Self-Care Adherence and Psychological Functioning of Older Patients with Type 2 Diabetes: Effects of Persuasion, Social Pressure, and Self-Efficacy. J Clin Psychol Med Settings 23, 389–401 (2016). https://doi.org/10.1007/s10880-016-9470-y

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