Self-efficacy, stress levels and daily style of living among older patients with type 2 diabetes in a rural primary care setting: a cross-sectional study

Abstract

Aims. To identify to what extent stress and self-efficacy may be associated with specific features in the elderly with type 2 diabetes, such as lifestyle habits, multi morbidity, sleep quality and duration, and treatment regimen. Methods. A cross-sectional study of 92 out of 103 recruited patients ≥65 year old with a diagnosis of type 2 diabetes was conducted at a rural primary care unit in Northern Greece. The General Self-Efficacy Scale (GSES), the Short Anxiety Screening Test (SAST) and an original questionnaire to assess health habits and disease monitoring information were completed after structured personal interviews.

Results. In the multiple linear regression analysis, patients with higher education, with more night sleeping hours and physical exercise weekly had a higher GSES score than their counterparts (p<0.05). Stress levels assessed with SAST were shown mostly associated with poor sleep quality, fewer days of meat and legumes
consumption, increased body mass index and multi-morbidity (p<0.05), as emerged from the multiple linear regression analysis. Glycemic control in the elderly does not have a significant correlation with stress levels or general self-efficacy.

Conclusions. Self-efficacy and stress levels are not predictors for glycemic control, but can indirectly be seen as co-determinants, contributing to the overall daily life quality among patients with diabetes. Mental health well-being, expressed by higher self-efficacy and less stress scale rating, showed positive interferences with eating, sleep and daily life attitudes among elderly with diabetes.