Emotional distress counteracts the positive effects of health literacy on diabetes self-management

Abstract

BACKGROUND The best predictors of diabetes health outcomes are daily self-management activities. Because these are sources of concern and constraints, it is often difficult for new diagnosed type 2 diabetes patients to adopt them. As failure to take care of oneself is the first cause of diabetes worsening and complications, understanding predictors and moderators of self-care behaviors is of utmost importance. It has been previously shown that diabetes literacy and self-efficacy were strong predictors of self-care behaviors. However, moderators of their effect have not been studied. This study investigated whether sub-clinical or clinical distress moderates the relation between health literacy, self-efficacy and diabetes self-care behaviors. We hypothesized that emotional distress could prevent people for making use of their resources. METHODS 128 type 2 diabetes patients were recruited. They completed an 86-item questionnaire assessing health literacy, self-efficacy, emotional distress and self-care behaviors. Regression and moderation analyses were performed to test the moderating impact of emotional distress on the relation between health literacy, self-efficacy and diabetes self-care behaviors. FINDINGS As expected, higher levels of health literacy and self-efficacy increased self-care behaviors. However, this was not true for patients experiencing distress. Results therefore suggest that emotional distress, whether related to diabetes or not, prevents people from putting their knowledge into practice. DISCUSSION Results suggest that professionals involved in diabetes care should pay more attention to patients’ affects and their influence on self-care. Our findings support that psychological assistance should be integrated in the health care system for people suffering from type 2 diabetes.