Self‑Management Barriers Perceived by Patients with Type 2 Diabetes: A Confirmatory Factor Analysis

Shohreh Jafari, Habibeh Ahmadipour


Background: Self‑management remains poor among most of the diabetic patients due to various individual and environmental barriers which affect it. These barriers should be identified and intervened promptly. The current study aimed to determine self‑management barriers perceived by patients with type 2 diabetes.

Methods: A cross‑sectional study carried out on 681 patients with type 2 diabetes who referred to the diabetes center which is affiliated to Kerman University of Medical Sciences, Kerman, Iran during 2018. Through a structured interview, demographic and disease‑related data were recorded and the Persian version of the modified Personal Diabetes Questionnaire (PDQ) was used to assess self‑management barriers. The tool has four subscales including diet, medication, monitoring, and exercise barriers. The higher score in each subscale indicates a higher level of barriers in that section. Data analyzed by SPSS 20 using T‑test, ANOVA, and multiple linear regressions.

Results: The majority of the patients (62.8%) were female, married (78.3%) with monthly income 10 to 20 million IRRLs (78.4%) and the mean age of 55.65 ± 14.65 years. Body Mass Index, marital status, monthly income, and HbA1C significantly predicted the barriers’ score. The instrument had excellent reliability (α = 0.95). In confirmatory factor analysis, the fit indices had approximately acceptable levels. Conclusions: The Persian version of modified PDQ had good psychometric properties and can be used as a valid and reliable instrument in the primary health care setting. The significant perceived barriers should be identified and intervened by health care providers through the comprehensive management of diabetic patients.


Barriers; diabetes mellitus; Iran; reproducibility; self-management

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