Effects of a Behavioral Intervention on Self-Efficacy, Self-Care Behavior and HbA1c Values among Patients with Type 2 Diabetes Mellitus

Diabetes is a chronic disease with severe complications and high mortality rate. Much of the complications are related to poor glycemic control. Making their own decisions for improving blood sugar levels and performing related self chosen actions and maintaining its long term performance is the key element in diabetes self care management. However, sustenance of these activities seldom happens. Addressing this issue, several behavioral support programmes have been tried and tested.

To evaluate the effectiveness of a behavioural intervention on self efficacy, self care behavior and HbA1c values among patients with type 2 diabetes mellitus.

A True experimental study with pretest-posttest control group design was done on a sample of 300 patients attending diabetes clinic of a tertiary care centre in Kerala, South India. Subjects were randomly allotted to intervention and control group after obtaining ethical clearance and consent. Self efficacy was measured by Diabetes Self Efficacy Scale and self care behaviour was assessed by Summary of Diabetes Self Care Activities (Revised version). The assessments were carried out at baseline, at 3 months and at 6 months. Subjects in experimental group received both routine hospital treatment and behavioral intervention. Control group received routine hospital treatment which included drug therapy and nutritional counseling. Data collected were analyzed using SPSS version 16 by means of appropriate descriptive and inferential statistics.

It was found that the mean difference in overall self efficacy and self care behaviour between third month and baseline, sixth month and baseline, between sixth month and third month were significantly higher (p<0.001) in experimental group than in control group. HbA1c values were also significantly reduced. It was concluded that adding a behavioural intervention along with routine diabetic care enhances patients’ confidence in self management of the disease which in turn improves their self care behavior.