Predictors of self-care behaviour using health belief model among type 2 diabetes mellitus patients in a district of Penang, Malaysia

Background: The prevalence of diabetes mellitus among Malaysian aged ≥ 18 years increasing from 11.6% in 2006 to 17.5% in 2015. The diabetes prevalence in Penang state was 18.1% in 2015. Only 21% of audited type 2 diabetes mellitus (T2DM) patients in Penang achieved hemoglobin A1c < 6.5% in 2012. Positive self–care behaviour leads to good glycaemic control and reduce risk of diabetes complications. Objective: The objective of this study is to determine the diabetes self-care behaviour and its predictors using Health Belief Model (HBM) among T2DM patients in government health clinics at Seberang Perai Selatan district, Penang. Methodology: An analytical cross sectional study was conducted on 546 T2DM patients whose aged ≥18 years, they were recruited by simple random sampling method. Validated self-administered questionnaire was used, data were analysed using SPSS version 22.0. Results: The respondents practised 3.4 (SD = 1.11) days diabetes self-care behaviour for the past 1 week. The predictors of self-care behaviour were self-efficacy (standardized β = 0.257, p < 0.001), knowledge (standardized β = 0.112, p = 0.007), female gender (standardized β = 0.107, p = 0.010), combination oral hypoglycaemic agents (OHA) and insulin (standardized β = -0.182, p = 0.002), monthly income < RM1,000 (standardized β = -0.129, p = 0.002). The entire group of variables significantly predicted self-care behaviour [F (6, 539) = 15.79, p < 0.001, adjusted R2 = 0.140] with the total variance of 14.9%. Self-efficacy was identified as the strongest predictor in self-care behaviour. Conclusion: The findings enable us to identify the specific targeted groups with predicted lower self-care behaviour. This is useful in future planning and implementation of health intervention.

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