This study aims to examine the relationships between socio-ecological determinants, health literacy, and self-management agency among patients with diabetes mellitus. Using a path analysis framework, the study investigates how multi-level socio-ecological factors and different dimensions of health literacy influence patients' capacity for diabetes self-management. Understanding these pathways will support the development of comprehensive, context-sensitive interventions to improve diabetes outcomes.
- Adults aged 18 years and older.
Diagnosed with type 1 or type 2 diabetes mellitus.
Receiving follow-up care in outpatient or primary healthcare settings.
Able to communicate verbally and provide informed consent.
- Patients with severe cognitive impairment.
Patients with acute medical conditions preventing participation.
Pregnant women diagnosed with gestational diabetes.
Adult patients diagnosed with type 1 or type 2 diabetes mellitus and attending outpatient clinics or primary healthcare centers.
Other
Cross-sectional
Questionnaire-based assessment
Other interventionNo clinical or behavioral intervention is applied. This observational study involves a questionnaire-based assessment to collect data on socio-ecological determinants, health literacy, and self-management agency among adult patients with diabetes mellitus.
Self-management agency
The level of self-management agency among adult patients with diabetes mellitus, measured using the adapted Appraisal of Self-Care Agency Scale-Revised (ASAS-R).
Health literacy
Health literacy levels measured using the adapted All Aspects of Health Literacy Scale (AAHLS), including functional, communicative, and critical domains.
Socio-ecological determinants of diabetes self-management
Socio-ecological determinants measured across individual, interpersonal, organizational, community, and policy levels using a researcher-developed assessment tool.
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