Self-Efficacy, Self-Care Activities Management and Treatment Outcome among Type 2 Diabetes Saudi Patients: Across-Sectional Study


Self-Care Activities
Treatment Outcome
Type 2 Diabetes

How to Cite

Abubaker Ibrahim Elbur, Abdullah Salem AlMalki, & Sultan Abdullah Alharthi. (2017). Self-Efficacy, Self-Care Activities Management and Treatment Outcome among Type 2 Diabetes Saudi Patients: Across-Sectional Study. Journal of Pharmacy and Nutrition Sciences, 7(2), 48–54.


The main aims of this study were to measure the level of diabetes management self-efficacy and adherence to self-care activities management and to identify the influence of self- efficacy on management of self-care activities and the outcome of treatment among type 2 diabetic patients. A cross-sectional study was conducted at the Diabetes Clinic; King Faisal Medical Complex during the period of June –August 2016. Patients aged >20 years and diagnosed with type 2 diabetes for at least one year. Data was collected through face-to-face interview method using a pretested and validated questionnaire. Data was processed by the software SPPS (21.0 SPSS Inc., Chicago IL, USA). P value <0.05 was considered statistically significant. A total of 300 patients were eligible. Slightly more than 50 % of them were females. Overall, 164 (54.7%) patients were classified as having high diabetes management self-efficacy. Living in the town (P = 0.006) and being married (P= 0.003) were found to be the significant predictors of high self-efficacy. There were significant associations between self-efficacy by domain and adherence to the specific self-care activity corresponding to that domain. Overall, 84 (28%) of the patients attained the target therapeutic goal for diabetes and the control was significantly more among females (33.6%) than males (22.3%), (P= 0.031).
The results of the study identified many gaps related to management self-efficacy of diabetes and adherence to self-care activities. Interventions targeting the patients and their families to improve this situation are urgently needed.


International Diabetes Federation Middle East and North Africa. IDF diabetes atlas Sixth edition 2014. Available at Accessed March 20, 2017.

International Diabetes Federation. [Online

Abuyassin B, Laher I. Diabetes epidemic sweeping the Arab world. World J Diabetes 2016; 7(8): 165-174.

Zimmet P, Alberti KG, Shaw J. Global and societal implications of the diabetes epidemic. Nature 2001; 414: 782-787.

Gerstein HC, Pogue J, Mann JF, Lonn E, Dagenais GR, McQueen M, et al. The relationship between dysglycaemia and cardiovascular and renal risk in diabetic and non-diabetic participants in the HOPE study: a prospective epidemiological analysis. Diabetologia 2005; 48: 1749-1755.

Sana lTS, Nair NS Adhikari P. Factors associated with poor control of type 2 diabetes mellitus: A systematic review and Meta-analysis. Journal of Diabetology 2011; 3: 1.

Quah JH, Liu YP, Luo N, How CH, Tay EG. Younger adult type 2 diabetic patients have poorer glycaemic control: a cross-sectional study in a primary care setting in Singapore. BMC Endocr Disord 2013; 13: 18.

Khattab M, Khader YS, Al-Khawaldeh A, Ajlouni K. Factors associated with poor glycemic control among patients with type 2 diabetes. J Diabetes Complications 2010; 24: 84-9.

Paterson B, Thorne S. Developmental evolution of expertise in diabetes self- management. Clin Nurs Res 2000; 9: 402- 419.

American Association of Diabetes Educators: AADE7 Self-Care Behaviors. Diabetes Educ 2008; 34: 445-449.

Bandura A. Self-Efficacy: The Exercise of Control. New York, Prentice-Hall 1994.

Al-Khawaldeh OA, Al-Hassan MA, Froelicher ES. Self-efficacy, self-management, and glycemic control in adults with type 2 diabetes mellitus. J Diabetes Complications 2012; 26(1): 10-6.

Venkataraman K, Kannan AT, Kalra OP, Gambhir JK, Sharma AK, Sundaram KR, Mohan V. Diabetes self-efficacy strongly influences actual control of diabetes in patients attending a tertiary hospital in India. J Community Health 2012; 37(3): 653-62.

Wynn Nyunt S, Howteerakul N, Suwannapong N, Rajatanun T. Self-efficacy, self-care behaviors and glycemic control among type-2 diabetes patients attending two private clinics in Yangon, Myanmar. Southeast Asian J Trop Med Public Health 2010; 41(4): 943-51.

Walker RJ, Gebregziabher M, Martin-Harris B, Egede LE. Independent effects of socioeconomic and psychological social determinants of health on self-care and outcomes in Type 2 diabetes. Gen Hosp Psychiatry 2014; 36(6): 662-8.

Van Der Bijl JJ, Van Poelgeest-Eeltink A, Shortridge-Baggett L. The psychometric properties of the diabetes management self-efficacy scale for patients with type 2 diabetes mellitus. Journal of Advanced Nursing 1999; 30: 352-359.

Toobert DJ, Hampson SE, Glasgow RE. The summary of diabetes self-care activities measure: results from 7 studies and a revised scale.Diabetes Care 2000; 23: 943-50.

WHO. Process of translation and adaptation of instruments [Online

Reisi M, Mostafavi F, Javadzade H, Mahaki B, Tavassoli E, Sharifirad G. Impact of Health Literacy, Self-efficacy, and Outcome Expectations on Adherence to Self-care Behaviors in Iranians with Type 2 Diabetes. Oman Med J 2016; 31: 52-9.

Chavan GM, Waghachavare VB, Gore AD, Chavan VM, Dhobale RV, Dhumale GB. Knowledge about diabetes and relationship between compliance to the management among the diabetic patients from Rural Area of Sangli District, Maharashtra, India. J Family Med Prim Care 2015; 4: 439-43.

Huang CH, Lin PC, Chang Yeh M, Lee PH. A Study on Self-Care Behaviors and Related Factors in Diabetes Patients. Hu Li Za Zhi 2017; 64: 61-69.

Naeem Z. Increasing trend of Junk food use in Saudi Arabia and health implications. Int J Health Sci (Qassim) 2012; 6: V-VI.

Luis-Emilio García-Pérez, María Álvarez, Tatiana Dilla, Vicente Gil-Guillén, and Domingo Orozco-Beltrán. Adherence to therapies in Patients with type 2 Diabetes. Diabetes Ther 2013; 4: 175-194.

Mumu SJ, Saleh F, Ara F, Ali L. Non-Adherence to Lifestyle Modification and its Determinants among Bangladeshi type 2 Diabetic Patients. Int J Epidemiol 2015; 44(Suppl_1): i148-i149.

Gao J, Wang J, Zheng P, Haardörfer R, Kegler MC, Zhu Y, Fu H. Effects of self-care, self-efficacy, social support on glycemic control in adults with type 2 diabetes. BMC Fam Pract 2013; 14: 66.

Al-Baghli NA, Al-Turki KA, Al-Ghamdi AJ, El-Zubaier AG, Al-Ameer MM, Al-Baghli FA. Control of diabetes mellitus in the Eastern Province of Saudi Arabia: results of screening campaign. East Mediterr Health J 2010; 16: 621-9.

Gucciardi E, Wang SC, DeMelo M, Amaral L, Stewart DE. Characteristics of men and women with diabetes: observations during patients' initial visit to a diabetes education centre. Can Fam Physician 2008; 54: 219-27.

Walker RJ, Smalls BL, Hernandez-Tejada MA, Campbell JA, Egede LE. Effect of diabetes self-efficacy on glycemic control, medication adherence, self-care behaviors, and quality of life in a predominantly low-income, minority population. Ethn Dis 2014; 24: 349-55.

Wichit N, Mnatzaganian G, Courtney M, Schulz P, Johnson M. Randomized controlled trial of a family-oriented self-management program to improve self-efficacy, glycemic control and quality of life among Thai individuals with Type 2 diabetes. Diabetes Res Clin Pract 2017; 123: 37-48.

Yang F, Pang JS, Cheng WJ. 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 2016; 23: 389-401.

Jerant A, Lichte M, Kravitz RL, Tancredi DJ, Magnan EM, Hudnut A, Franks P. Physician training in self-efficacy enhancing interviewing techniques (SEE IT): Effects on patient psychological health behavior change mediators. Patient Educ Couns 2016; (11): 1865-1872.

Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

Copyright (c) 2017 Abubaker Ibrahim Elbur, Abdullah Salem AlMalki , Sultan Abdullah Alharthi