Resilience, self‐efficacy and diabetes distress on self‐management behaviours in patients newly diagnosed with type 2 diabetes: A moderated mediation analysis

Abstract Aim To examine (1) the mediating role of self‐efficacy between resilience and self‐management behaviours and (2) the moderating role of diabetes distress on the relationship between self‐efficacy and self‐management behaviours in patients newly diagnosed with type 2 diabetes. Design Cross‐sectional design. Methods Totally, 195 patients newly diagnosed with type 2 diabetes for more than 5 months but less than 18 months were recruited from three endocrine clinics in Taiwan through convenience sampling. Self‐reported questionnaires including demographic and disease characteristics, resilience, self‐efficacy and self‐management behaviours were used to collect data from October 2020 to May 2021. Moderated mediation analysis was performed by Hayes's PROCESS macro. Result According to bootstrapping results, the indirect effect of resilience on self‐management was significant, although the direct effect of resilience on self‐management was not. Participants were categorized into with and without diabetes distress groups. The results of moderated mediation analysis indicated self‐efficacy significantly correlated with self‐management behaviours in participants without diabetes distress, although self‐efficacy did not significantly correlate with self‐management in participants with diabetes distress. Conclusion The association of resilience with self‐management behaviours was fully mediated through self‐efficacy with diabetes distress moderating the relationship between self‐efficacy and self‐management behaviours in patients newly diagnosed with type 2 diabetes. Impact Improving resilience could enhance self‐efficacy leading to possible improvement in self‐management behaviour, although improving self‐efficacy might not benefit self‐management behaviours for those with high levels of diabetes distress. Healthcare providers need to first assess and address the diabetes distress before intervening to improve self‐efficacy to enhance self‐management behaviours in patients newly diagnosed with type 2 diabetes. Patient or Public Contribution When designing this study, two patients newly diagnosed with diabetes were consulted about the importance of self‐management behaviours for them personally.