Sense of coherence and self-care in people with diabetes: systematic review
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Introduction
Diabetes mellitus is one of the diseases with the greatest social and health impact. Self-care in people with diabetes requires constant physical and emotional effort, which is one of the barriers to adherence to the care plan. Sense of coherence can play an important role in self-care.
Aims
To examine the relationship between sense of coherence and self-care in individuals with diabetes mellitus.
Method
A systematic review with narrative synthesis for all included studies and with meta-analysis in those with adequate statistical data. We searched PubMed, CINAHL, PsychInfo and Scopus up to July 2024. We included original studies that reported effect sizes on the association between sense of coherence and self-management of care plans in individuals with diabetes. Methodological quality of the studies was independently assessed by two researchers by evaluating the risk of selection bias, classification bias and confounding bias. Meta-analysis was performed using a random-effects model and various sensitivity and subgroup analyses were performed to assess the robustness of the meta-analysis result.
Results
Thirteen articles were included in the review (six were included in the meta-analysis), whose participants (9,800) were people with type 1 or 2 diabetes. In the studies analyzing the relationship between sense of coherence and adherence to self-care (diet, exercise, and medication), a positive association was observed between these variables. In addition, sense of coherence may have a protective effect against negative perceptions of self-care. In the meta-analysis, a positive and moderate association between sense of coherence and adherence to self-care was found, with no heterogeneity and possible publication bias that does not affect the results of the meta-analysis.
Limitations
Small number of studies; all were cross-sectional.
Conclusions
Sense of coherence may play a relevant role in improving adherence to the self-care plan in people with type 1 or 2 diabetes.
PROSPERO id
CRD42023390705
