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Effect of diabetes fatalism on medication adherence and self-care behaviors in adults with diabetes. Gen Hosp Psychiatry 2012 Nov-Dec;34(6):598-603

Date

08/18/2012

Pubmed ID

22898447

Pubmed Central ID

PMC3479321

DOI

10.1016/j.genhosppsych.2012.07.005

Scopus ID

2-s2.0-84867849414   62 Citations

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<.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.

Author List

Walker RJ, Smalls BL, Hernandez-Tejada MA, Campbell JA, Davis KS, Egede LE

Authors

Jennifer Annette Campbell PhD, MPH Assistant Professor in the Medicine department at Medical College of Wisconsin
Leonard E. Egede MD Center Director, Chief, Professor in the Medicine department at Medical College of Wisconsin
Rebekah Walker PhD Associate Professor in the Medicine department at Medical College of Wisconsin




MESH terms used to index this publication - Major topics in bold

Adult
Aged
Attitude to Health
Blood Glucose Self-Monitoring
Diabetes Mellitus, Type 2
Exercise
Female
Humans
Linear Models
Male
Medication Adherence
Middle Aged
Patient Compliance
Prognosis
Self Care
Southeastern United States