Objective: This study examined racial/ethnic differences in the relationship between diabetes self-efficacy and psychological distress among older adults with diabetes mellitus. Method: Adults aged 60 or older with a diagnosis of diabetes mellitus (N = 3,067) were drawn from the 2009 California Health Interview Survey (CHIS). Hierarchical multiple regression analyses were conducted. Results: After controlling for covariates, African Americans and those with higher levels of diabetes self-efficacy tended to have lower levels of psychological distress. Significant interactions were found in the Hispanic/Latino and Asian groups: The effect of diabetes self-efficacy on psychological distress was greater for Hispanics/Latinos and Asians than non-Hispanic Whites. Discussion: Findings suggest that diabetes self-efficacy is associated with psychological distress among older diabetic patients and that race/ethnicity moderates the relationship between diabetes self-efficacy and psychological distress. Increasing diabetes self-efficacy will help racial/ethnic minority older patients with diabetes to improve psychological well-being at a greater level.
Agency for Healthcare Research and Quality. (2011). National healthcare disparities report, United States, 2010 (DHHS Pub. No. [PHS] 11-0005). Rockville, MD: Author.
2.
BakerT. A.BuchananN. T.CorsonN. (2008). Factors influencing chronic pain intensity in older Black women: Examining depression, locus of control, and physical health. Journal of Women’s Health, 17, 869-878.
3.
BanduraA. (1977). Self-efficacy: Toward a unifying theory of behavioral change. Psychological Review, 84, 191-215.
4.
BarlowJ. H.WrightC. C.TurnerA. P.BancroftG. V. (2005). A 12-month follow-up study of self-management training for people with chronic disease: Are changes maintained over time?British Journal of Health Psychology, 10, 589-599.
5.
BeanD.CundyT.PetrieK. J. (2007). Ethnic differences in illness perceptions, self-efficacy and diabetes self-care. Psychology & Health, 22, 787-811.
6.
Centers for Disease Control and Prevention. (2011). National diabetes fact sheet: National estimates and general information on diabetes and prediabetes in the United States, 2011. U.S. Department of Health and Human Services. Retrieved from http://www.cdc.gov/diabetes/pubs/pdf/ndfs_2011.pdf
7.
Gleeson-KreigJ. M. (2006). Self-monitoring of physical activity: Effects on self-efficacy and behavior in people with type 2 diabetes. The Diabetes Educator, 32, 69-77.
8.
HeislerM.FaulJ. D.HaywardR. A.LangaK. M.BlaumC.WeirD. (2007). Mechanisms for racial and ethnic disparities in glycemic control in middle-aged and older Americans in the Health and Retirement Study. Archives of Internal Medicine, 167, 1853-1860.
9.
KesslerR. C.AndrewsG.ColpeL. J.HiripiE.MroczekD. K.NormandS. L. T.. . .ZaslavskyA. M. (2002). Short screening scales to monitor population prevalences and trends in non-specific psychological distress. Psychological Medicine, 32, 959-976.
10.
KimG.BryantA. N.GoinsR. T.WorleyC. B.ChiribogaD. A. (2012). Disparities in health status and health care access and use between older American Indians and Alaska Natives and non-Hispanic Whites in California. Journal of Aging and Health, 24, 799-811.
11.
KimG.ChiribogaD. A.JangY. (2009). Cultural equivalence in depressive symptoms in older White, Black, and Mexican American adults. Journal of the American Geriatrics Society, 57, 790-796.
12.
KimG.ChiribogaD. A.JangY.LeeS.HuangC.-H.ParmeleeP. (2010). Health status of older Asian Americans in California. Journal of the American Geriatrics Society, 58, 2003-2008.
13.
KimG.FordK. L.ChiribogaD.SorkinD. H. (2012). Racial and ethnic disparities in healthcare use, delayed care, and management of diabetes mellitus in older adults in California. Journal of the American Geriatrics Society, 60, 2319-2325.
14.
KingD. K.EstabrooksP. A.GlasgowR. E.OsunaD.ToobertD. J.FaberA. J.StryckerL. A. (2010). Self-efficacy, problem solving, and social-environmental support are associated with diabetes self-management behaviors. Diabetes Care, 33, 751-753.
15.
KirkmanM. S.BriscoeV. J.ClarkN.FlorezH.HaasL. B.HalterJ. B.. . .SwiftC. S. (2012). Diabetes in older adults: A consensus report. Journal of the American Geriatrics Society, 60, 2342-2356.
16.
KrichbaumK.AarestadV.BuetheM. (2003). Exploring the connection between self-efficacy and effective diabetes self-management. The Diabetes Educator, 29, 653-662.
17.
KutnerM.GreenbergE.JinY.PaulsenC. (2006). The health literacy of America’s adults: Results from the 2003 National Assessment of Adult Literacy. NCES 2006-483. Washington, DC: U.S. Department of Education, National Center for Education Statistics.
18.
LantingL. C.JoungI. M.VogelI.BootsmaA. H.LambertsS. W.MackenbachJ. P. (2008). Ethnic differences in outcomes of diabetes care and the role of self-management behavior. Patient Education and Counseling, 72, 146-154.
19.
MukhtarQ.JackL.Jr.MartinM.MurphyD.RiveraM. (2006). Evaluating progress toward Healthy People 2010 national diabetes objectives. Preventing Chronic Disease, 3(1), Article A11.
20.
OsbornC. Y.CavanaughK.WallstonK. A.KripalaniS.ElasyT. A.RothmanR. L.WhiteR. O. (2011). Health literacy explains racial disparities in diabetes medication adherence. Journal of Health Communication, 16(Suppl. 3), 268-278.
21.
RapleyP.PassmoreA.PhillipsM. (2003). Review of the psychometric properties of the Diabetes Self-Efficacy Scale: Australian longitudinal study. Nursing & Health Sciences, 5, 289-297.
22.
RichardP.AlexandreP. K.YounisM. Z.LaraA.AkamigboA. B. (2012). Racial and ethnic disparities in the quality of diabetes care for the elderly in a Nationally Representative Sample. Ageing International, 37, 155-164.
23.
RidnerS. H. (2004). Psychological distress: Concept analysis. Journal of Advanced Nursing, 45, 536-545.
24.
SaccoW. P.WellsK. J.VaughanC. A.FriedmanA.PerezS.MatthewR. (2005). Depression in adults with type 2 diabetes: The role of adherence, body mass index, and self-efficacy. Health Psychology, 24, 630-634.
25.
SarkarU.FisherL.SchillingerD. (2006). Is self-efficacy associated with diabetes self-management across race/ethnicity and health literacy?Diabetes Care, 29, 823-829.
26.
TraylorA. H.SubramanianU.UratsuC. S.MangioneC. M.SelbyJ. V.SchmittdielJ. A. (2010). Patient race/ethnicity and patient-physician race/ethnicity concordance in the management of cardiovascular disease risk factors for patients with diabetes. Diabetes Care, 33, 520-525.
27.
TriefP. M.TeresiJ. A.EimickeJ. P.SheaS.WeinstockR. S. (2009). Improvement in diabetes self-efficacy and glycaemic control using telemedicine in a sample of older, ethnically diverse individuals who have diabetes: The IDEATel project. Age and Aging, 38, 219-225.
WrightC. C.BarlowJ. H.TurnerA. P.BancroftG. V. (2003). Self-management training for people with chronic disease: An exploratory study. British Journal of Health Psychology, 8, 465-476.
30.
WuA. M. S.TangC. S. K.KwokT. C. Y. (2004). Self-efficacy, health locus of control, and psychological distress in elderly Chinese women with chronic illnesses. Aging & Mental Health, 8, 21-28.
