Psychosocial Correlates of Diabetes Self-management Practices

  • Muhammad W. DARAWAD Dept. of Clinical Nursing, School of Nursing, University of Jordan, Amman, Jordan
  • Sawsan HAMMAD Dept. of Community Health Nursing, Faculty of Nursing, University of Jordan, Amman, Jordan
  • Sultan MOSLEH Dept. of Adult Health Nursing, Faculty of Nursing, University of Mutah, Karak, Jordan
  • Osama A. SAMARKANDI Basic Science Department, Prince Sultan bin Abdulaziz College for Emergency Medical Services, King Saud University, Riyadh, Saudi Arabia
  • Ayman HAMDAN-MANSOUR Dept. of Community Health Nursing, Faculty of Nursing, University of Jordan, Amman, Jordan
  • Amani A. KHALIL Dept. of Clinical Nursing, School of Nursing, University of Jordan, Amman, Jordan
  • Diana ARABIAT Dept. of Maternal & Child Health Nursing, School of Nursing, University of Jordan, Amman, Jordan Dept. of Innovative Research, School of Nursing and Midwifery, Edith Cowan University, Perth, WA, Australia
Keywords: Diabetes, Self-management, Depressive symptoms, Social support, Jordan


Background: Self-Management is a crucial regimen for patients with diabetes mellitus. Many factors have affected patients' self-management practice including psychosocial factors. Literature revealed contradictory results concerning the psychosocial correlates of patients' self-management practices. Therefore, this study assessed the psychosocial correlates of diabetes self-management practices among Jordanian diabetic patients.Methods: A descriptive, cross-sectional, correlational design was utilized to collect data (conducted in the middle region of Jordan in 2015) from 341 Jordanian outpatients with diabetes using self-reported questionnaires (Social Support Scale, CES-D, and Summary of Diabetes Self-Care Activities) and chart review.Results: Participants reported practice rate of 2.85/ 7 (SD=1.3), with diet practice the most (M=3.66, SD=1.5) and exercise the least (M=1.53, SD=2.1). Participants reported receiving social support (M=3.23, SD=1.3) less than needed (M=3.39, SD=1.3). High levels of depressive symptoms were reported (M=17.1, SD= 11.4). Diet practices had significant positive correlation with family support attitude (r= .266, P= .000) and negative correlation with depressive symptoms (r= - .114, P= .037). Testing blood sugar significantly correlated with both support needed (r= .144, P= .008) and support received (r= .166, P= .002).Conclusion: Jordanian DM patients were found to practice less than optimum DM self-management practices, and to consider diet practices than exercise practices. This study confirmed that the subcategories of DM self-care management should be considered rather than considering the general plan. 


International Diabetes Federation. IDF diabetes atlas, update 2012.

Shaw JE, Sicree RA, Zimmet PZ (2010). Global estimates of the prevalence of diabetes for 2010 and 2030. Diabetes Res Clin Pract, 87 (1): 4-14.

Abdallah S, Ahmad A, Bataieha A, Ajlouni K (2007). Diabetes mellitus: The leading cause of hemodialysis in Jordan. East Mediterr Health J, 13 (4): 803-9.

Zindah M, Belbeisi A, Walke H, Mokdad A (2008). Obesity and diabetes in Jordan: Findings from the behavioral risk factor surveillance system, 2004. Prev Chronic Dis, 5 (1):A17.

Abdel-Aal NM, Ahmad AT, Froelicher ES, et al (2008). Prevalence of dyslipidemia in patients with type 2 diabetes in Jordan. Saudi Med J, 29 (10): 1423-8.

Al-Amer RM, Sobeh MM, Zayed AA, Al-domi HA (2011). Depression among adults with diabetes in Jordan: risk factors and relationship to blood sugar control. J Diabetes Complications, 25(4): 247-252.

Abu Ali R, Al Hajeri R, Khader Y, Shegem N, Ajlouni K (2008). Sexual dysfunction in Jordanian diabetic women. Diabetes Care, 31 (8): 1580–81.

Glasgow R, Funnell M, Bonomie A, Davis C, Beckham V (2002). Self-Management Aspects of the Improving Chronic Illness Care Breakthrough Series: Implementation with Diabetes and Heart Failure Teams. Ann Behav Med, 24(2): 80-7.

Audulv A, Asplund K, Norbergh K (2012). The integration of chronic illness self-management. Qual Health Res, 22 (3): 332–45.

Al-Khawaldeh OA, Al-Hassan MA, Froelicher ES (2012). Self-efficacy, self-management, and glycemic control in adults with type 2 diabetes mellitus. J Diabetes Complications, 26 (1): 10-6.

Al-Qazaz H, Sulaiman S, Hassali M, et al (2011). Diabetes knowledge, medication adherence and glycemic control among patients with type 2 diabetes. Int J Clin Pharm, 33(6):1028-35.

Arcury T, Grzvwacz J, Ip E, et al (2012). Social Integration and Diabetes Management among Rural Older Adults. J Aging Health, 24 (6): 899-922.

Daly J, Harts A, Xu Y, et al (2009). An assessment of attitude, behaviors, and outcomes of patients with type 2 diabetes. J Am Board Fam Med, 22 (3): 280-90.

Dixon J, Browne J, Mosely K, Rice T, Jones K, Speight J (2014). Severe obesity and diabetes self-care attitudes, behaviours and burden: Implications for weight management from a matched case-controlled study. Diabet Med, 31 (2): 232-240.

Mosha T, Rashidi H (2009). Evaluation of self-care practices and emotional distress among people with type 2 diabetes mellitus in Dar Es Salaam, Tanzania. Ecol Food Nutr, 48 (2): 89-111.

Yusuff K, Obe O, Joseph B (2008). Adherence to anti-diabetic drug therapy and self management practices among type-2 diabetics in Nigeria. Pharm World Sci, 30(6): 876-83.

Peyrot M, Rubin R, Lauritzen T, Snoek F, Matthews D, Skovlund E (2005). Psychosocial problems and barriers to improved diabetes management: Results of the cross-national diabetes attitudes, wishes and needs (DAWN) study. Diabet Med, 22 (10): 1379-1385.

Huang M, Courteny M, Edwards H, McDowell J (2010). Factors that affect health outcomes in adults with type 2 diabetes: A cross-sectional study. Int J Nurs Stud, 47 (5): 542-9.

Fortman A, Gallo L, Walker C (2010). Support for disease management, depression, self-care, and clinical indicators among Hispanics with type 2 diabetes in San Diego County, United States of America. Rev Panam Salud Publica, 28 (3): 230–4.

Schiotz M, Bogeland M, Almdal T, Jensen B, Willaing I (2012). Education and Psychological Aspects Social support and self-management behaviour among patients with Type 2 diabetes. Diabet Med, 29 (5): 654-61.

Watkins Y, Quinn L, Ruggiero L, Quinn M, Choi Y (2013). Spiritual and religious beliefs and practices and social support’s relationship to diabetes self-care activities in African Americans. Diabetes Educ, 39 (2): 231-9.

Shakibazadeh E, Larijani B, Shojaeezadeh D, et al(2011). Patients’ Perspectives on Factors that Influence Diabetes Self-Care. Iran J Pub Health, 40 (4): 146-158.

Wilkinson A, Whitehead L, Ritchie L (2014). Factors influencing the ability to self-manage diabetes for adults living with type 1 or 2 diabetes. Int J Nurs Stud, 51(1):111-22.

Osborn C, Egede L (2012). The relationship between depressive symptoms and medication nonadherence in type 2 diabetes: the role of social support. Gen Hosp Psychiatry, 34 (3): 249-253.

Hessler D, Fisher L, Naranjo D, Masharani U (2012). Young adult African American patients with type 2 diabetes: A high risk patient sub-group with few supports for good diabetes management. J Health Psychol, 17 (4): 535-544.

Rosland A, Heisler M, Choi H, Silveria M, Piette, J (2010). Family influences on self-management among functionally independent adults with diabetes or heart failure: do family members hinder as much as they help? Chronic Illn, 6(1): 22-33.

Song Y, song H, Han H, Park S, Nam S, Kim M (2012). Unmet Needs for Social Support and Effects on Diabetes Self-care Activities in Korean Americans with Type 2 diabetes. Diabetes Educ, 38 (1): 77-85.

Gucciardi E, Wang S, DeMelo M, Amaral L, Stewart D (2008). Characteristics of men and women with diabetes observations during patients’ initial visit to a diabetes education centre. Can Fam Physician, 54 (2): 219-227.

Naranjo D, Hessler D, Deol R, Chesla C (2012). Health and psychosocial outcomes in U.S. adult patients with diabetes from diverse ethnicities. Curr Diab Rep, 12 (6): 729-38.

Snoek FJ, Kersch NY, Eldrup E, et al (2011). Monitoring of Individual Needs in Diabetes (MIND): baseline data from the cross-national Diabetes Attitudes, Wishes, and Needs (DAWN) MIND study. Diabetes Care, 34 (3): 601-3.

Zulman DM, Rosland AM, Choi H, et al (2012). The influence of diabetes psychosocial attributes and self-management practices on change in diabetes status. Patient Educ Couns, 87 (1): 74-80.

Rogvi S,Tapager I, Almdal T, Schiotz M, Willaing I (2012). Patient factors and glycaemic control – associations and explanatory power. Diabet Med, 29(10):e382-9.

Cohen J (1992). A power primer. Psychol Bull, 112 (1): 155-159.

Michigan Diabetes Research and Training Center. Diabetes Care Profile. Michigan Diabetes Research and Training Center (1998).

Radloff LS (1977). The CES-D scale: A self-report depression scale for research in the general population. Appl Psychol Meas, 1 (3): 385-401.

Toobert D, Hapson S, Glasgow R (2000). The summary of diabetes self-care activities measure. Diabetes Care, 23 (7): 943-50.

Johnson S (1992). Methodological issues in diabetes research. Diabetes Care, 15 (11): 1658-67.

Khalil A, Darawad M, El gammal E, et al (2013). Predictors of dietary and fluid nonadherence in Jordanian patients with end-stage renal disease receiving hemodialysis: A cross-sectional study. J Clin Nurs, 22(1-2): 127-36.

Mosleh S, Darawad M (2015). Patients' adherence to healthy behavior in coronary heart disease: Risk factor management among Jordanian patients. J Cardiovasc Nurs, 30 (6): 471-8.

Gatt S, Sammut R (2008). An exploratory study of predictors of self-care behavior in persons with type 2 diabetes. Int J Nurs Stud, 45 (10): 1525-33.

Alramly M, Khalil A, Darawad M (2013). Slowing the progression of chronic kidney disease: Comparison between predialysis and dialysis Jordanian patients. Ren Fail, 35 (10): 1348-52.

Karlsen B, Oftedal B, Bru E (2012). The relationship between clinical indicators, coping styles, perceived support and diabetes‐related distress among adults with type 2 diabetes. J Adv Nurs, 68 (2): 391-401.

Yacoub M, Demeh W, Darawad M, et al (2014). An assessment of diabetes-related knowledge among registered nurses working in hospitals in Jordan. Int Nurs Rev,61 (2): 255-62.

Yacoub M, Demeh W, Barr J, et al (2015). Outcomes of diabetes educational program for registered nurses caring for persons with diabetes. J Contin Educ Nurs, 46 (3): 129-33.

How to Cite
W. DARAWAD M, HAMMAD S, MOSLEH S, A. SAMARKANDI O, HAMDAN-MANSOUR A, A. KHALIL A, ARABIAT D. Psychosocial Correlates of Diabetes Self-management Practices. Iran J Public Health. 46(6):771-8.
Original Article(s)