Studies of self-efficacy, or the beliefs one have that they can perform the skills required to manage a situation, are increasingly being presented. One recent study examined self-efficacy as shown by diabetic patients involved with the Department of Veteran Affairs. Surveys were mailed to patients with type 2 diabetes who attended a VA Medical Center. The surveys looked at the patient’s willingness to changes, their self-efficacy, the provider advice they received, and diabetes self-care practices. Responses were obtained by 717 (56%) of those sent the surveys.

Most respondents reported receiving advice from physicians regarding physical activity, nutrition, and glucose monitoring, but many were not ready to change self-management behaviors. Individuals with higher self-efficacy scores were more likely to adhere to medications, follow a diabetic meal plan, eat a lower fat diet, have higher levels of physical activity, and monitor their blood sugars.

Comment: The conclusions reached by the authors was that although veterans with poor diabetes control receive appropriate medical advice, many were not sufficiently confident or motivated to make and maintain self-management changes. We concur with the authors that patients should receive more training to emphasize increasing readiness to change and increasing self-efficacy.

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K.M.Nelson and colleagues. Factors influencing disease self-management among veterans with diabetes and poor glycemic control. Journal of General Internal Medicine, 2007;22:442-447.