Depression, motivation, and self-care behaviors with type 2 diabetes

Abstract

Depression occurs approximately twice more often in type 2 diabetes patients than in the general population, affecting diabetes treatment adherence and outcomes negatively. Components of motivation such as self-efficacy, social support, and patient-provider communication were found to have effects on diabetes self-care behavior. Based on self-determination theory (SDT), motivation constructs refer to autonomous motivation (personal motivation), perceived competence, and perceived autonomy support (perceived support from healthcare providers). In this research study, the relationship among depression, motivation, and diabetic self-care behavior in patients with type 2 diabetes was explored. It was hypothesized that severity of depression would be associated with self-care behavior in type 2 diabetes patients, and this association would be mediated by perceived competence and perceived autonomy support. Data were obtained from 248 participants who were clinically diagnosed with type 2 diabetes. They were recruited at The University of Hong Kong and non-profit organizations for diabetes patients. Online survey was employed to obtain data. Structural equation model (SEM) was used to test the mediation models. The model demonstrated good data fit, χ2(24, N = 151) = 34.70, p = .073, CFI = 0.99, RMSEA = 0.05 (90% CI: 0.00–0.10). Significant paths were found from depression to perceived competence (β = –.409, p < .001) and from perceived competence to diabetes self-care behavior (β = .492, p < .001). The indirect effect of depression on diabetes self-care behavior was significant (β = –.201, p < .001. 95%, CI [–0.58, – 0.17]). The association between depression and diabetes self-care behavior was full mediated by perceived competence. The other Components of motivation did not mediate the association between depression and diabetes self-care behavior. Implications and limitations of the study were discussed.