Abstract
BACKGROUND: The burden of Type 2 Diabetes Mellitus (T2DM) has increased globally and a significant number of Malaysian women are being affected by this disease. Self-care plays a vital role in improving glycemic control and preventing complications. However, women with diabetes face barriers to practising good self-care. This study aimed to determine factors associated with self-care in women with T2DM: social role strain, psychological resources (problem-focused coping and social support) and perception of diabetes as a priority. METHODS: A cross-sectional study was conducted among women with T2DM between January and April 2023 in a public primary care clinic in Seremban, Malaysia. The study instrument consists of the Summary of Diabetes Self-care Activities (SDSCA), scale for Measuring Role Strain in Women with Diabetes, problem-focused coping from brief COPE, Multidimensional Scale of Perceived Social Support (MSPSS) and an item to assess the perception of diabetes as a priority. RESULTS: A total of 346 women participated in the study (mean age = 60.67, SD = 10.12). Most were elderly (60.4%), Indian (48.3%), had low education (80.6%) and from lower income (70.8%). The mean score for self-care was 2.81 (SD 0.80) days, indicating a suboptimal level. Multiple linear regression analysis revealed that higher income (β = 0.82, [95% CI 0.04, 1.59], p = 0.039), problem-focused coping (β = 0.47,[95% CI 0.03, 0.06],p < 0.001), and perceiving diabetes as a priority (β = 0.04, [95% CI 0.004, 0.09], p = 0.031) were positively associated with self-care. Meanwhile, older age (β= -0.02, [95% CI -0.03, -0.01], p < 0.001), low education (β = -0.25, [95% CI -0.03, -0.01], p = 0.007) and social role strain (β = -0.02, [95% CI -0.03, -0.01], p = 0.003) were negatively associated. CONCLUSIONS: Our findings highlighted that women with a higher social role strain, older age and low education have poor self-care. In contrast, those with higher income, utilising problem-focused coping and prioritising diabetes, exhibit better self-care. Interventions for women with T2DM should focus on assisting them to alleviate their social role strain and develop their coping skills. Additionally, involving family in the intervention would help women prioritise self-care.