Belief-based Self-regulation Model to Improve Self-care in Type 2 Diabetes
DOI:
https://doi.org/10.21834/e-bpj.v10iSI35.7501Keywords:
self-regulation, belief, coping, self-care, type 2 diabetes mellitusAbstract
Background: Poor self-care among individuals with type 2 diabetes mellitus (T2DM) is often linked to inadequate self-regulation, leading to uncontrolled blood glucose and increased risk of complications. Significance: Addressing the psychological and behavioral dimensions of self-regulation is essential to improving outcomes in chronic disease management.
Objectives: The specific objectives are to: 1) examine the effects of individual, social, and health-service factors on problem interpretation and emotional responses; 2) determine the mediating roles of health beliefs and coping strategies in the self-regulation process; 3) assess the overall impact of the belief-based self-regulation model on self-care behavior in patients with T2DM.
Methods: A cross-sectional explanatory study was conducted on 150 T2DM patients with blood glucose levels >210 mg/dL, selected using multistage random sampling from health centers in South Sulawesi, Indonesia. Data were collected using structured and validated questionnaires. The structural relationships between variables were analyzed using Structural Equation Modeling–Partial Least Squares (SEM–PLS).
Limitations: The cross-sectional design limits the ability to infer causal relationships. Furthermore, the self-reported nature of the data may introduce response bias.
Findings: Individual characteristics, social support, and health service factors significantly influenced both the interpretation of illness and emotional responses. These, in turn, affected belief formation, coping mechanisms, and ultimately self-care behaviors. Coping was found to be the strongest direct predictor of self-care.
Implications: The study highlights the importance of integrating belief systems and emotional regulation into self-care interventions. The proposed model provides a comprehensive framework for health professionals to enhance self-care behaviors among T2DM patients through psychological, social, and health-system support.
References
Abebe, A., Wobie, Y., Kebede, B., Wale, A., Destaw, A., & Ambaye, A. S. (2022). Self-care practice and glycemic Control among type 2 diabetes patients on follow up in a developing country: a prospective observational study. Journal of Diabetes & Metabolic Disorders, 21(1), 455–461. https://doi.org/10.1007/s40200-022-00995-4
Ahmad, F., & Joshi, S. H. (2023). Self-Care Practices and Their Role in the Control of Diabetes: A Narrative Review. Cureus, 15(7), 1–7. https://doi.org/10.7759/cureus.41409
Bassi, G., Donadello, I., Gabrielli, S., Salcuni, S., Giuliano, C., & Forti, S. (2022). Early Development of a Virtual Coach for Healthy Coping Interventions in Type 2 Diabetes Mellitus: Validation Study. JMIR Formative Research, 6(2), e27500. https://doi.org/10.2196/27500
Bauer, W. S., Schiffman, R. F., Ellis, J. L., Erickson, J. M., Polfuss, M., Taani, M. H., & Sawin, K. J. (2025). An Integrative Review of the Use of the Individual and Family Self-Management Theory in Research. Advances in Nursing Science, 48(2), E41–E58. https://doi.org/10.1097/ANS.0000000000000512
Bretschneider, M. P., Klásek, J., Karbanová, M., Timpel, P., Herrmann, S., & Schwarz, P. E. H. (2022). Impact of a Digital Lifestyle Intervention on Diabetes Self-Management: A Pilot Study. Nutrients, 14(9). https://doi.org/10.3390/nu14091810
Castonguay, A., Miquelon, P., & Boudreau, F. (2018). Self-regulation resources and physical activity participation among adults with type 2 diabetes. Health Psychology Open, 5(1). https://doi.org/10.1177/2055102917750331
Chuman, N., & Hatamochi, C. (2021). Intervention Effect Based on Self-Regulation to Promote the Continuation of Self-Care Behavior of Patients with Type-2 Diabetes Mellitus. Health Journal, 13(4), 472–481. https://doi.org/10.4236/health.2021.134037
Fadli, F., Nursalam, Sjattar, E. L., Sumbara, Pangesti, D. N., & Pelawi, A. M. P. (2024). The Self-Management-Based care interventions on quality of life in type 2 Diabetes Mellitus patients: An integrative review. Multidisciplinary Reviews, 7(6), 2023086.
https://doi.org/10.31893/multirev.2024086
Fadli, F., Uly, N., Safruddin, S., Darmawan, S., & Batupadang, M. (2023). Analysis of self-regulation model to improvement of self-care capability in type 2 Diabetes Mellitus patients. Multidisciplinary Science Journal, 6(6), 2024082. https://doi.org/10.31893/multiscience.2024082
Goins, R. T., Jones, J., Schure, M., Winchester, B., & Bradley, V. (2020). Type 2 diabetes management among older American Indians: beliefs, attitudes, and practices. Ethnicity & Health, 25(8), 1055–1071. https://doi.org/10.1080/13557858.2018.1493092
Hariyono, H., & Romli, L. Y. (2020). Self Regulation Effect on Glycemic Control of Type 2 Diabetes Melitus Patients. Indian Journal of Public Health Research & Development, 11(6), 1257–1262. https://doi.org/10.37506/ijphrd.v11i6.9974
Hidayat, B., Ramadani, R. V., Rudijanto, A., Soewondo, P., Suastika, K., & Siu Ng, J. Y. (2022). Direct Medical Cost of Type 2 Diabetes Mellitus and Its Associated Complications in Indonesia. Value in Health Regional Issues, 28, 82–89. https://doi.org/10.1016/j.vhri.2021.04.006
Irwansyah, I., & Kasim, I. S. (2021). Indentifikasi Keterkaitan Lifestyle Dengan Risiko Diabetes Melitus. Jurnal Ilmiah Kesehatan Sandi Husada, 10(1), 62–69. https://doi.org/10.35816/jiskh.v10i1.511
Kiçaj, E., Saliaj, A., Çerçizaj, R., Prifti, V., Qirko, S., & Rogozea, L. (2025). Self-Care Behaviors, Health Indicators, and Quality of Life: A Comprehensive Study in Newly Diagnosed Type 2 Diabetes Patients. Nursing Reports, 15(6), 201. https://doi.org/10.3390/nursrep15060201
Mohamad, N., Mulud, Z. A., Chan, C. M., Rashmizal, H., Razak, A., & Esa, N. M. (2025). The impact of self-care behavior on quality of life among patients with heart failure in Malaysia : a cross-sectional study. Jurnal Ners, 20(3), 241–247.
Momenabadi, V., Kaveh, M. H., Nakhaee, N., Shirazi, K. K., Sedighi, B., & Tabatabaei, S. H. R. (2020). Health promoting self-care behaviors in patients with multiple sclerosis in the southeast of iran: Developing a model for practice. Basic and Clinical Neuroscience, 11(5), 687–700. https://doi.org/10.32598/BCN.11.5.1670.1
Papachristoforou, E., Lambadiari, V., Maratou, E., & Makrilakis, K. (2020). Association of Glycemic Indices (Hyperglycemia, Glucose Variability, and Hypoglycemia) with Oxidative Stress and Diabetic Complications. Journal of Diabetes Research, 2020, 1–17. https://doi.org/10.1155/2020/7489795
Park, S., & Park, J. H. (2024). Effects of digital self-care intervention for Korean older adults with type 2 diabetes: A randomized controlled trial over 12 weeks. Geriatric Nursing (New York, N.Y.), 58, 155–161. https://doi.org/10.1016/j.gerinurse.2024.05.019
Qi, X., Xu, J., Chen, G., Liu, H., Liu, J., Wang, J., Zhang, X., Hao, Y., Wu, Q., & Jiao, M. (2021). Self-management behavior and fasting plasma glucose control in patients with type 2 diabetes mellitus over 60 years old: multiple effects of social support on quality of life. Health and Quality of Life Outcomes, 19(1), 1–15. https://doi.org/10.1186/s12955-021-01881-y
Rahmatulloh, W., Ristiyorini, I., Kusumaningsih, W. S., Ainni, A. N., Siti, & Zakhroh, A. (2024). Patient adherence and diabetes distress on glycemic outcomes : a cross- sectional study. Mediasains Jurnal Ilmaih Ilmu-Ilmu Kesehatan, 23(1), 1–4.
Suleiman, N., Alkasem, M., Al Amer, Z., Salameh, O., Al-Thani, N., Hamad, M. K., Baagar, K., Abdalhakam, I., Othman, M., Dughmosh, R., Al-Mohanadi, D., Al Sanousi, A., Bashir, M., Chagoury, O., Taheri, S., & Abou-Samra, A.-B. (2022). Qatar Diabetes Mobile Application Trial (QDMAT): an open-label randomised controlled trial to examine the impact of using a mobile application to improve diabetes care in type 2 diabetes mellitus—a study protocol. Trials, 23(1). https://doi.org/10.1186/s13063-022-06334-5
Vohs, K. D., & Baumeister, R. F. (2011). Handbook of Self-Regulation: Research, Theory, and Applications (2nd Editio). The Guilford Press.
Yan, A. Z., Staab, E. M., Nuñez, D., Zhu, M., Wan, W., Schaefer, C. T., Campbell, A., Quinn, M. T., & Baig, A. A. (2024). Impact of a Text Messaging Intervention as an In-Between Support to Diabetes Group Visits in Federally Qualified Health Centers: Cluster Randomized Controlled Study. JMIR Diabetes, 9. https://doi.org/10.2196/55473
Zupa, M. F., Lee, A., Piette, J. D., Trivedi, R., Youk, A., Heisler, M., & Rosland, A.-M. (2022). Impact of a Dyadic Intervention on Family Supporter Involvement in Helping Adults Manage Type 2 Diabetes. Journal of General Internal Medicine, 37(4), 761–768. https://doi.org/10.1007/s11606-021-06946-8
Published
How to Cite
Issue
Section
License
Copyright (c) 2025 Nilawati Uly, Ratnasari Iskandar, Evawati Uly, Fadli, Dyah Tahir
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
