The Association Between Self-Management Barriers and Self-Efficacy in Chinese Patients with Type 2 Diabetes: The Mediating Role of Appraisal

L. Cheng, J.W. Sit, Yin Ping Leung, X. Li

Research output: Journal article publicationJournal articleAcademic researchpeer-review

8 Citations (Scopus)


© 2016 Sigma Theta Tau International.BACKGROUND: Patients with higher levels of self-management barriers are more likely to exhibit a lower level of self-efficacy. However, the theoretically meaningful mechanisms underlying the association between the two variables have not yet been established.AIMS: Informed by the Transactional Model of Stress and Coping, this study aimed to examine the potential role of diabetes appraisal on the association of self-management barriers and self-efficacy in patients with type 2 diabetes mellitus.METHODS: This article presents the secondary data analyses of a multicenter, cross-sectional study. A sample of 346 adults with type 2 diabetes was interviewed, using the Personal Diabetes Questionnaire, the Appraisal of Diabetes scale, the Diabetes Empowerment Scale-Short Form, and the Summary of Diabetes Self-Care Activities. Structure equation modeling was performed with 10,000 bootstrap samples using Mplus 7.RESULTS: The hypothesized model provided a good fit to the data (?2 = 22.975, df = 33; p = .1144; CFI = 0.989; SRMR = 0.036; RMSEA = 0.042). The mediating effect of diabetes appraisal on the association of self-management barriers and self-efficacy was significant (? = -0.521; 95% CI: -0.865, -0.283), explaining 44.82% of the total effect of barriers on self-efficacy. Significant associations were also detected between diet knowledge and diabetes appraisal (? = 0.148, p = .047).LINKING EVIDENCE TO ACTION: Diabetes appraisal plays a mediating role in the association between self-management barriers and self-efficacy in patients with type 2 diabetes. Reflecting on patients' appraisal of diabetes can help to develop evidence-based and patient-centered interventions. Interventions that enhance individuals' positive appraisal of diabetes have the potential to buffer the negative effects of self-management barriers on self-efficacy.
Original languageEnglish
Pages (from-to)356-362
Number of pages7
JournalWorldviews on Evidence-Based Nursing
Issue number5
Publication statusPublished - 1 Oct 2016
Externally publishedYes


  • appraisal
  • decision making
  • diabetes
  • knowledge
  • mediating effect
  • self-efficacy
  • self-management barriers

ASJC Scopus subject areas

  • Nursing(all)

Cite this