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

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<0.001), diet (r = −0.26, p<0.001), exercise (r = −0.20, p<0.001) and blood sugar testing (r = −0.19, p<0.001). In the linear regression model, diabetes fatalism was significantly associated with medication adherence (β= 0.029, 95% 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.

Investigating the Mental Experience of Patients Suffering From Cancer

“…Walker et al showed that patients' fatalism was significantly correlated with medication adherence (r = 0.24), diet (r = -0.26), exercise (r = -0.20), and blood sugar testing (r = -0.19) (13). In Zamanzadeh et al study, participants thought their power was from God and by believing in God and getting closer to him they increased their power to deal with the disease and the fear of death (14).…”

Psychological aspects of diabetes care: Effecting behavioral change in patients

“…It is widely known that patients with diabetes mellitus (DM) are at high risk of decreased psychological wellbeing [1][2][3][4][5][6] which is already presence in about half of the patients at the time of diagnosis [7] . This is due to strained coping with changed life routine (such as relationships, work-related and financial issues) [6] right from the time of diagnosis of DM [7] .…”

“…This is due to strained coping with changed life routine (such as relationships, work-related and financial issues) [6] right from the time of diagnosis of DM [7] . An international survey, the Diabetes Attitudes, Wishes and Needs second study (DAWN2), included over 16000 individuals (comprising patients, family members and healthcare providers) in 17 countries across four continents, reported that the proportion of the people with DM who were likely to have depression and diabetes-related distress (DRD) was 13.8% and 44.6%, respectively, with overall poor quality of life at 12.2% [8] .…”

“…About 40% (18.6%-64.9%) of these patients reported their medication interfered with their ability to live a normal life [8] . Furthermore, these patients often use negative coping strategies and more frequently perceive that diabetes would negatively affect their future [4,7] . Untreated psychosocial disorders in DM, may lead to more physical symptoms [9] , cardiovascular complications [10] and depression [11,12] .…”

Evaluation of a Diabetes Management Program for Persons with Serious and Persistent Mental Illness

“…Patients who use negative coping strategies perceive diabetes will negatively impact their future and are not motivated to manage the disease (Walker et al, 2012).…”