A Structural Equation Model of Self care Activities in Diabetic Elderly Patients

Mousa Alavi, Razieh Molavi, Parvin Eslami


Background: Self‑care is a valuable strategy to improve health and reduce events of hospitalization  and the duration of hospital stay in elderly diabetic patients. This study aimed to examine the model  of self‑care behaviors in elderly diabetic patients.

Materials and Methods: A survey was conducted  among 209 diabetic elderly patients who were admitted in three hospitals affiliated with the Isfahan  University of Medical Sciences, Iran. Convenience sampling method was used to recruit the  participants. Depression, anxiety, stress, and perceived social support were considered as predicting  exogenous variables and elderly patients’ self‑care activities were treated as endogenous variables.  The data were collected by a four‑part questionnaire consisting of demographic and health‑related  characteristics; 21‑item depression anxiety stress scale, multidimensional scale of perceived social  support, and Diabetes Self‑care Activities scale. Structural equation modelling by Statistical Package  for the Social Sciences (SPSS) version 16 and Analysis of Moment Structures‑7 (AMOS) software  was applied for data analysis.

Results: Mean (standard deviation) of depression, anxiety, stress,  perceived social support, and self‑care activities of participants were 14.29 (4.3), 13.62 (3.74),  16.83 (4.23), 57.33 (14.19), and 44.56 (13.77), respectively. The results showed that the overall model  fitted the data (÷2/df = 3.8, goodness‑of‑fit index (GFI) = 0.52, incremental fit index (IFI) = 0.48, and  root mean square error of approximation (RMSEA) = 0.14). Three out of four variables (i.e., perceived  social support, anxiety, and depression) significantly predicted adherence to self‑care behaviors among  diabetic elderly patients (p < 0.05).

Conclusions: The perceived social support, anxiety, and depression  were identified as key constructs which need to be taken into account and well managed by health care  professionals to enhance adherence to self‑care activities in diabetic elderly patients. 


Aged, diabetes, self care

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