The study also suggests that their "can do" beliefs achieve this effect by improving self-care practices, such as blood sugar testing and adherence to diet and exercise regimens.
Previous researchers have investigated the relationship between various psychosocial factors and diabetic control, or between self-care and diabetic control, among individuals with Type I (insulin-dependent) diabetes, notes lead author Catharine H. Johnston-Brooks, Ph.D. of the Denver Veterans Affairs Medical Center. This study, however, is the first to demonstrate the relationship between the belief in one's capabilities of adhering to a diet and exercise regimen -- what psychologists and sociologists call self-efficacy -- and blood sugar control.
In addition, the present study lends credence to the commonly accepted hypothesis that the belief in one's ability to adhere to a diabetes regimen improves self-care, which in turn is associated with better blood sugar control.
Johnston-Brooks and her colleagues followed 88 young adults at a diabetes treatment center in Denver for one year. All were 18 to 35 years old and under treatment for diabetes for at least one year. Self-efficacy and quality of self-care were measured at the study's beginning with self-administered questionnaires. Blood sugar control was assessed by measuring blood levels of HbA1c, an indicator of blood sugar levels over the previous three months, at the study's beginning and at three-month intervals during the following year.
The results reveal that young adults with high self-efficacy tend to have the best blood sugar control and the best adherence to their self-care regimens, both in the short and long term. Moreover, Johnston-Brooks notes, they are consistent with a growing body of evidence that "beliefs are strong predictors of behavior" and, therefore, clinical outcomes.
The researchers' findings, Johnston-Brooks observes, give health care practitioners tools and insights that can be used to help young adults with Type I diabetes. They suggest that an easily administered assessment of self-efficacy -- in conjunction with more traditional tools -- can be used to help predict how well blood sugar will be managed over time. In addition, they indicate that "teaching self-care behaviors will have a greater positive impact on [blood sugar control] when combined with interventions aimed at improving self-efficacy," Johnston-Brooks notes.
The study was funded by grants from the University of Colorado's Council on Research and Creative Works.
Psychosomatic Medicine is the official bimonthly peer-reviewed journal of the American Psychosomatic Society. For information about the journal, contact Joel E. Dimsdale, M.D., at (619) 543-5468.
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