Does Patients’ Perception Affect Self-Care Practices? The Perspective of Health Belief Model

Figures & data

Figure 1 Health belief model used to assess self-care practice and associated factors among diabetic patients in Gondar City.

Note: Data adapted from Glanz et al.²⁵

Table 1 Socio-Demographic and Economic Characteristics of Diabetic Patients University of Gondar Specialized Hospital, Northwest Ethiopia, 2019 (n=387)

Variables	Description	Frequency (%)
Age	18–29	61 (15.7)
	30–39	70 (18.1)
	40–49	52(13.4)
	50–59	86(22.2)
	≥60	118(30.5)
Sex	Male	205 (53)
	Female	182 (47)
Religion	Orthodox	330 (87.3)
	Muslim	50(12.9)
	Protestant	7(1.8)
Ethnicity	Amhara	339(87.6)
	Kimant	31 (8)
	Tigre	17(4.4)
Marital status	Married	222(57.6)
	Single	97(25.1)
	Widowed	44(11.4)
	Divorced	24(6.2)
Educational status	No formal education	121(31.3)
	Primary education	112(28.9)
	Secondary education	69(17.8)
	Diploma and above	85(21.9)
Employment status	Government employed	70 (18.1)
	Private employed	144 (37.2)
	Unemployed	173 (44.7)
Income	≤ 999	82(21.2)
	1000/1999	128(33.1)
	2000/2999	63(16.3)
	≥ 3000	114(29.5)

Table 2 Clinical Characteristics of Diabetic Patients in University of Gondar Specialized Hospital, Northwest Ethiopia, 2019 (n=387)

Variable	Description	Frequency (%)
Time since diagnosis	<5 years	184(47.5)
	5–10 years	119(30.8)
	≥ 10 years	84(21.7)
Type of diabetes	Type I	172(44.4)
	Type II	215(55.6)
Body mass index	Underweight	18(4.64)
	Normal weight	181(46.8)
	Overweight	147(37.9)
	Obese	41(10.6)
Comorbidities	Yes	96(24.8)
	No	291(75.2)
Family history of DM	Yes	61(15.7)
	No	326(84.3)
Social support	High social support	100(25.8)
	Medium social support	139(35.9)
	Low social support	148(38.2)
Knowledge about diabetes	Good knowledge	228(58.9%)
	Poor knowledge	159(41.1)

Table 3 Perceptions of Diabetic Patients in University of Gondar Specialized Hospital About DM and Self-Care Practice, Northwest Ethiopia, 2019 (n=387)

Variable	Description	Good Self-Care (%)	Poor Self-Care (%)	Total (%)
Perceived susceptibility	High	58(50)	58(50)	116(30)
	Medium	59(62.6)	35(37.2)	94(24.2)
	Low	98(55.4)	79(44.6)	177(45.8)
Perceived severity	High	85(70.8)	35(29.2)	120(31)
	Medium	48(64.9)	26(35.1)	74(19.1)
	Low	82(42.5)	111(57.5)	193(49.9)
Perceived benefit	High	50(62.5)	30(37.5)	80(20.7)
	Medium	109(54.2)	92(45.8)	201(51.9)
	Low	56(52.8)	50(47.2)	106(27.4)
Perceived barrier	High	28(27.4)	74(72.6)	102(26.4)
	Medium	63(50.4)	62(49.6)	125(32.3)
	Low	124(77.5)	36(22.5)	160(41.3)
Self-efficacy	High	45(66.2)	23(33.8)	68(17.5)
	Medium	162(63.5)	93(36.5)	255(65.9)
	Low	8(12.5)	56(87.5)	64(16.5)
Cues to action	High	92(66.2)	47(33.8)	139(35.9)
	Medium	55(67.1)	27(32.9)	82(21.1)
	Low	68(41)	98(59)	166(43)

Table 4 Correlation Between Health Belief Model Constructs (n=387)

Variable	1	2	3	4	5	6
1. Perceived susceptibility	1
2. Perceived severity	0.17**	1
3. Perceived benefit	−0.005	0.05	1
4. Perceived barrier	0.04	−0.13*	−0.28	1
5. Self-efficacy	−0.03	0.15**	0.36**	−0.29	1
6. Cues to action	0.06	0.86**	0.28**	−0.31**	0.33**	1

Note: significant level **<0.001, *<0.01.

Table 5 Bivariable and Multivariable Logistic Regression of Self-Care Practice of Diabetic Patients in University of Gondar Specialized Hospital, Northwest Ethiopia, 2019 (n=387)

Variables	Description	COR (95% CI)	AOR (95% CI)	P value
Age (mean ± SD)^♦	48 (±16)	0.99 (0.97, 1.01)	1.00 (0.97, 1.03)	0.98
Marital status	Single	1	1
	Married	1.29 (0.79, 2.09)	3.12 (1.27, 7.69)	0.013*
	Widowed	0.63 (0.31, 1.29)	3.44 (0.89, 13.36)	0.074
	Divorced	0.42 (0.16, 1.06)	0.52 (0.13, 2.08)	0.353
Religion	Orthodox	1	1
	Muslim	1.54 (0.83–2.84)	2.19 (0.79, 6.07)	0.134
	Protestant	5.18 (0.62–43.5)	1.43 (0.10, 30.3)	0.817
Educational status	No formal education	1	1
	Primary education	3.67 (2.12–6.34)	5.00 (2.17, 11.57)	0.000**
	Secondary education	5.46(2.87–10.39)	6.89 (2.40, 19.72)	0.000**
	Diploma and above	10.23 (5.27–19.86)	7.68 (2.19, 26.96)	0.001**
Employment status	Government employ	1	1
	Private employ	0.37 (0.20, 0.69)	1.66 (0.50, 5.49)	0.403
	Unemployed	0.42 (0.23, 0.78)	3.50 (1.06, 11.51)	0.039*
Duration of diabetes	< 5 years	1	1
	5–10 years	1.96 (1.23, 3.13)	2.23 (1.10, 4.51)	0.026*
	≥10 years	7.10 (3.73, 13.53)	7.88 (3.02, 20.53)	0.000**
Comorbidities	No	1	1
	Yes	0.29 (0.18–0.48)	0.34 (0.16, 0.76)	0.008**
Family history	No	1	1
	Yes	1.64 (0.93–2.90)	0.85 (0.32, 2.27)	0.744
Knowledge about DM	Poor knowledge	1	1
	Good knowledge	6.01 (3.85, 9.38)	3.31 (1.66, 6.60)	0.001**
Social support	Low	1	1
	Medium	1.77 (1.10–2.82)	1.60 (0.80, 3.23)	0.186
	High	5.51 (3.08–9.87)	4.88 (2.00, 11.90)	0.000**
Perceived susceptibility	Low	1	1
	Medium	1.36 (0.81, 2.27)	1.42 (0.62, 3.24)	0.403
	High	0.81 (0.50, 1.29)	0.98 (0.45, 2.12)	0.952
Perceived severity	Low	1	1
	Medium	2.49 (1.43–4.35)	2.46 (1.06, 5.73)	0.037*
	High	3.28 (2.02–5.34)	4.57 (2.11, 9.93)	0.000**
Perceived benefit	Low	1	1
	Medium	1.06 (0.66, 1.70)	0.32 (0.14, 0.72)	0.006**
	High	1.49 (0.82, 2.69)	0.26 (0.09, 0.73)	0.011*
Perceived barrier	Low	1	1
	Medium	0.29 (0.17, 0.49)	0.49 (0.23, 1.06)	0.069
	High	0.11 (0.06, 0.19)	0.21 (0.08, 0.50)	0.001**
Self-efficacy	Low	1	1
	Medium	12.19 (5.57, 26.69)	9.43 (2.86, 31.10)	0.000**
	High	13.69 (5.59, 33.52)	9.12 (2.28, 36.48)	0.002 **
Cues to action	Low	1	1
	Medium	2.93 (1.68, 5.11)	1.34 (0.55, 3.27)	0.525
	High	2.82 (1.76, 4.50)	1.52 (0.71, 3.26)	0.279

Note: ^♦Continuous variable; **Significant at p-value ≤ 0.01; *significant at p-value ≤ 0.05.

Abbreviations: AOR, adjusted odds ratio; COR, crude odds ratio.

Glanz K , Rimer BK , Viswanath K , editors. Health Behavior and Health Education: Theory, Research, and Practice . John Wiley & Sons; 2008.

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