Self-Efficacy and the Self-as-Doer: New Perspectives in Diabetes Self-Care Behavior Management

Background: Diabetes is a significant health care concern with outcomes strongly related to self-care behaviors. Therefore, the present study examined factors contributing to the frequency of diabetes self-care behaviors. Previously documented factors, self-efficacy, social support, outcome expectancies, and self-care agency (Sigurdardottir,2005; Weijnam, et al.,2005), as well as a newer construct, the “self-as-doer” (Houser-Marko, & Sheldon, 2006) were investigated. “Self-as-doer” describes the degree to which individuals identify with doing a particular activity. In a diabetes context, individuals with stronger “self-as-doer” concepts may engage in requisite self-care behaviors more consistently. Therefore, it was hypothesized that “self-as-doer,” along with self-efficacy, outcome expectancies, social support, and self-care agency would contribute significantly to the frequency of self-care behaviors.

Methods: Ninety-seven individuals diagnosed with diabetes completed self-report measures examining the above constructs and diabetes self-care behaviors. Pearson correlations were calculated to investigate the relationships between “self-as-doer” and diabetes self-care behaviors. A forward-stepwise regression analysis was then conducted to determine significant predictors of self-care behaviors.

Results: Self-as-doer was positively correlated with diabetes self-care behaviors (p<.01). Self-efficacy (t(71)=6.27, p<.001) and self-as-doer (t(71)=2.37, p=.021) were included in the final stepwise model. Together, they accounted for 52% of the total variance in self-care behaviors.

Conclusions: Unlike previous assessments, the present study demonstrates that both self-efficacy and identification with doing a behavior are independently important to self-care behaviors. Findings suggest that developing an identity as the doer of behavior consistent with one's health care goals may be beneficial in motivating self-care behaviors. Further research related to the self-as-doer construct is warranted.