Barriers to self-care for people with type 2 diabetes mellitus: a descriptive cross-sectional study

Abstract

Introduction
Due to its complexity, type 2 diabetes mellitus (T2DM) requires people to adopt different self-care behaviors. The domains of self-care: medication adherence, blood glucose testing, diet, physical activity, and self-monitoring are essential in its management. Identifying barriers to self-care is crucial to controlling T2DM2 ².

Objective
Identify the main barriers to self-care for people with T2DM.

Methods
A cross-sectional descriptive study was conducted between September 2022 and March 2023 in a primary healthcare setting, involving 365 people with T2DM. Data was collected using a questionnaire, categorized based on the COM-B model of behavior (B) change (capability (C), opportunity (O), and motivation (M)) ³, and analyzed using descriptive statistics.

Results
Of the sample, 66.9% (n=244) reported barriers in at least one of the self-care domains. Diet (58.5%) and physical activity (47.2%) were the most reported barriers. For diet, psychological capability (lack of knowledge) accounted for 12.3%, and automatic motivation (lack of will) for 22.7%. For physical activity, physical capability (pain, age) was the most frequently mentioned barrier (21.4%), followed by the category of automatic motivation (lack of will) with 14.5%. In medication management (6.9%), psychological capability (forgetfulness) was reported by 5.9%, and physical opportunity (access to the prescription) by 1.1%. In the self-monitoring domain, psychological capability (lack of knowledge) was the most common barrier (3.9%), and in blood glucose testing, automatic motivation (fear) was 6.3%.

Conclusion
Knowledge of the barriers to self-care in T2DM enables the development of targeted interventions by health professionals and informed health policies. This study provides a substantial, person-centered contribution to positively impacting the management and metabolic control of T2DM.