Network analysis of the relationship between self-management, self-efficacy, and quality of life among diabetes mellitus patients

Abstract

Diabetes mellitus (DM) requires constant self-management and self-efficiency, which affects the quality of life among patients. It is important to understand the complex interplay between these factors to improve the results of treatment. The aim of this study was to explore the relationship between self-management, self-efficacy, and quality of life among diabetes mellitus patients. A cross-sectional study of 363 diabetes patients from three public hospitals in Cao Lanh City, Vietnam, was conducted. Self-management, self-efficacy, and quality of life were assessed using the 35-item Diabetes Self-Management Instrument (DSMI), the 6-item Self-Efficacy for Managing Chronic Disease Scale (SECD6), and the 5-item European Quality of Life 5 Dimensions 5 Level Version (EQ-5D-5L), respectively. Network analysis was performed to visually describe the relationship between self-management (which includes five domains of self-integration, self-regulation, interaction with health professionals and other significant people, self-monitoring, and medication adherence), self-efficacy, and quality of life. The network analysis showed that self-monitoring had the highest centrality. Two subscales of self-management, adherence and self-integration, were directly and positively correlated with quality of life, while the interaction was directly and negatively correlated with quality of life. Self-efficacy was positively correlated with self-regulation and self-monitoring, while it was negatively correlated with adherence. A direct positive correlation was also found between self-efficacy and quality of life. In conclusion, these findings highlight the pivotal role of self-management and self-efficacy in enhancing quality of life. Future studies should focus on patient education interventions to enhance adherence and self-efficacy, ultimately improving the quality of life in people with diabetes.

Keywords: Adherence; Vietnam; quality of life; self-efficacy; self-management.

Figure 1.

Network visualization of functions of self-management, self-efficacy, and quality of life (QoL). The degree of correlation between two nodes is shown by the edge thickness. Partial correlation coefficients are represented by values on the edges. Positive correlations are indicated by blue borders, and negative correlations are indicated by red edges.

Figure 2.

Analysis of edge stability in terms of expected influence, strength, closeness, and betweenness using the network bootstrap procedure.

Figure 3.

Centrality of domains in the network. ADH: adherence; INT: interaction; QL: quality of life; SE: self-efficacy; SI: self-integration; SM: self-monitoring; SR: self-regulation.