Mahnoush Reisi - Department of Health Education and Health Promotion, Faculty of Health, Bushehr University of Medical Sciences, Bushehr, Iran
Hamid Fazeli - Department of Health Education and Health Promotion, Faculty of Health, Bushehr University of Medical Sciences, Bushehr, Iran
Marzieh Mahmoodi - Department of Epidemiology and Bio-Statistics, Faculty of Health, Bushehr University of Medical Sciences, Bushehr, Iran
Homamodin Javadzadeh - Bushehr University of Medical SciencesDepartment of Health Education and Health Promotion, Faculty of Health, Bushehr University of Medical Sciences, Bushehr, Iran

Background and Objective: Although compliance with self-care behaviors is necessary for the successful management of diabetes, patients with diabetes often refuse favorable self-care. This study was conducted to determine the factors influencing self-care behaviors among type-۲ diabetic patients who had limited health literacy based on social cognitive theory (SCT). Materials and Methods: A cross-sectional study was conducted among ۲۹۳ diabetic patients with limited health literacy that was identified by S-TOFHLA. The data were collected using the summary of diabetes self-care activities, diabetes management self-efficacy scale, outcome expectancies questionnaire, and a researcher-made questionnaire for collecting data related to self-regulation and social support constructs. Data were analyzed by SPSS ver.۲۲ using multiple linear regression to determine the predictors of self-care behaviors.  Results: In the case of patient’s adherence to self-care tasks, they had the best adherence to medication regime and the worst adherence to physical activity. Employment status (p <۰.۰۳۲, β=۳.۵۷), supplementary insurance (p <۰.۰۱۸, β=۱.۷۴), and history of participating in diabetes education classes (p <۰.۰۴۴, β=۱.۶۳) were predictors of self-care behaviors in the studied patients. Among the SCT constructs, perceived self-efficacy (p <۰.۰۰۱, β=۰.۲۱) predicted self-care ability. The mean score of self-care increased around ۰.۲۱ by increasing one single unit of self-efficacy. Overall, these factors predicted ۶۷% (R۲ = ۰.۶۷) of self-care changes. Conclusions: The results of this study showed that self-efficacy and demographic variables are significant predictors to improve self-care ability among diabetic patients with limited health literacy.  

self-care behavior, Health Literacy, Diabetes, Social cognitive theory