Self-Care behaviors and their association with self-efficacy and health literacy among adolescents with type 1 diabetes mellitus in palestine: a cross-sectional study

Abstract

Abstract Purpose Type 1 diabetes mellitus (T1DM) is the most common endocrine disorder during adolescence. Self-care behaviors are the cornerstone of diabetes management. Effective self-care behaviors require individuals to perform a range of complex daily tasks, including monitoring blood glucose, adhering to dietary recommendations , administering insulin, and recognizing symptoms of hypo- or hyperglycemia. Two critical psychosocial and cognitive factors that influence the success of self-management are self-efficacy and health literacy. There are limited studies on the factors related to self-efficacy and health literacy associated with self-care behaviors among adolescents with T1DM in the Arab World, including Palestine. Therefore, this study investigated the associations between self-efficacy, health literacy, select demographic variables, and self-care behaviors among adolescents with T1DM in Palestine. Methods: A cross-sectional correlational design was used, and 156 adolescents aged 14–18 years were selected by a convenience sampling method from primary healthcare settings in Palestine between February and June 2024. A self reported questionnaire was used to collect data, which included demographic variables, the Diabetic Health Literacy Scale, the Self-Efficacy for Diabetes Scale, and the Self-Care Inventory. Descriptive statistics, Pearson’s and point biserial correlation tests, and multiple linear regression were used to examine the relationships between the study variables. Results Participants reported high levels of self-efficacy (M=108.80, SD=14.92), low levels of health literacy, (M=2.12, SD=0.78), and low engagement in self-care behaviors (M=33.82, SD=7.79). A positive correlation was found between self-efficacy and self-care behaviors (r=0.396, p<0.01). In contrast, age was negatively associated with self-care behaviors (r = -0.249, p<0.01). Furthermore, self-efficacy and age were significant predictors of self-care behaviors (β=0.196, p<0.001; β = -1.256, p<0.01, respectively). Conclusions This study helps policymakers, healthcare providers, and parents develop strategies to enhance self-care behaviors through targeted interventions and educational programs. The findings may guide any future educational program or training sessions to improve self-care behaviors among adolescents with T1DM. Keywords: Adolescents, Health literacy, Self-care behaviors, Self-efficacy, Type 1 diabetes mellitus