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Feature Articles

Self-Efficacy and Diabetes Self-Management in Middle-Aged and Older Adults in the United States: A Systematic Review

  1. Weidi Qin1,
  2. Julia E. Blanchette2 and
  3. Miyoung Yoon1
  1. 1Jack, Joseph and Morton Mandel School of Applied Social Sciences, Case Western Reserve University, Cleveland, OH
  2. 2Department of Endocrinology and Metabolism, Cleveland Clinic, Cleveland, OH
  1. Corresponding author: Weidi Qin, wxq32{at}case.edu
Diabetes Spectrum 2020 Nov; 33(4): 315-323. https://doi.org/10.2337/ds19-0051
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Abstract

OBJECTIVE | This study aimed to systematically review the existing literature on the relationship between self-efficacy and diabetes self-management in middle-aged and older adults in the United States and to determine whether the relationship applies across race and ethnicity.

METHODS | Study selection followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses method. Studies published between 1990 to 2018 that investigated self-efficacy and diabetes self-management in middle-aged and older adults were searched using eight search engines: PsycINFO, CINAHL, SocIndex, AgeLine, MedLine, Social Science Citation Index, Cochrane Library, and Academic Search Complete. Only quantitative studies were included.

RESULTS | Eleven studies met the inclusion criteria. Ten studies found significant association between self-efficacy and at least one self-management behavior, which included exercise, healthy diet, adherence to medication, blood glucose testing, and foot care. Findings were mixed regarding the role of self-efficacy in exercise and medication adherence. Higher self-efficacy in Mexican Americans predicted better self-management behaviors, whereas no relationship between self-efficacy and diabetes self-management was found in a sample of Black and White participants. The methodological quality of the studies was assessed. In general, the included studies demonstrated moderate methodological quality. Their limitations included inconsistency in the self-efficacy measures, a lack of longitudinal studies, and confounding bias.

CONCLUSION | Self-efficacy has significant effects on self-management in middle-aged and older adults, but the effects may differ by race. Efforts to improve self-efficacy and deliver culturally appropriate services could potentially promote self-management behaviors in middle-aged and older adults with diabetes.

  • © 2020 by the American Diabetes Association
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Diabetes Spectrum: 33 (4)

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November 2020, 33(4)
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Self-Efficacy and Diabetes Self-Management in Middle-Aged and Older Adults in the United States: A Systematic Review
Weidi Qin, Julia E. Blanchette, Miyoung Yoon
Diabetes Spectrum Nov 2020, 33 (4) 315-323; DOI: 10.2337/ds19-0051

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Self-Efficacy and Diabetes Self-Management in Middle-Aged and Older Adults in the United States: A Systematic Review
Weidi Qin, Julia E. Blanchette, Miyoung Yoon
Diabetes Spectrum Nov 2020, 33 (4) 315-323; DOI: 10.2337/ds19-0051
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© 2021 by the American Diabetes Association. Diabetes Spectrum Print ISSN: 1040-9165, Online ISSN: 1944-7353.