Factors influencing self-management and health-related quality of life in low-income patients with diabetes: a predictive model

Background: While previous researchers have explored self-management in populations with diabetes, few have focused on the unique challenges faced by low income patients. Purpose: To address this gap in knowledge, we aimed to develop a predictive model based on the Information-Motivation-Behavioral skills model, identifying key factors influencing self-management and health-related quality of life among low-income patients with diabetes. While previous researchers have explored self-management in populations with diabetes, limited numbers have focused on the unique challenges faced by low-income patients. Methods: Structured questionnaires were used for the survey of adult patients in South Korea. A total of 354 participants were included in the analysis, and Partial Least Squares Structural Equation Modeling was employed to analyze the data. Key predictors included diabetes knowledge, fear of hypoglycemia, family support, and self-efficacy. Results: We found that self-efficacy and self-management had statistically significant direct effects on health-related quality of life, while diabetes knowledge indirectly influenced health-related quality of life through self-efficacy. Despite the hypothesized relationships, no significant effect was observed between any variables and glycated hemoglobin levels, suggesting that socio-economic barriers may impact glycemic control. Conclusion: We have underscored the importance of tailored educational interventions and continuous support systems to improve self-efficacy and diabetes self-management in low-income populations, contributing to enhanced health-related quality of life. Future research should explore interventions targeting these barriers to improve both glycemic control and quality of life in disadvantaged patients with diabetes.