Self Management Mastery and perceived autonomy support are correlates of Dutch diabetes patients’ self-management and quality of life Lieke G.M. Raaijmakers a, *, Marloes K. Martens b , Arlette E. Hesselink b , Inge de Weerdt c , Nanne K. de Vries d , Stef P.J. Kremers a a Department of Health Promotion, NUTRIM School for Nutrition, Toxicology and Metabolism, Maastricht University Medical Centre+, Maastricht, The Netherlands b ResCon, Research & Consultancy, Haarlem, The Netherlands c Netherlands Diabetes Federation, Amersfoort, The Netherlands d Caphri, School for Primary Care and Public Health, Maastricht University Medical Centre+, Maastricht, The Netherlands 1. Introduction Diabetes mellitus is a rapidly growing health problem, which affects approximately 382 million people worldwide [1]. The prevalence of diabetes in the Netherlands in 2011 was 801.000 and this number has been increasing by 87,000 a year [2]. Diabetes is a complex chronic illness, since it affects various organs and systems and is often accompanied by other (chronic) diseases. In the Netherlands, the life expectancy of people with diabetes at the age of 45 is 9 years less for men and 11 years less for women, compared to people without diabetes, and the corresponding numbers for diabetes patients at the age of 65 are four and six years less, respectively [3]. People with diabetes have a better quality of life than people with most other serious chronic diseases [4]. Moreover, diabetes patients without complications rate their quality of life only slightly below that of persons of similar age in the general population, but when complications appear, quality of life decreases considerably [4,5]. It is estimated that chronic complications occur in 40–56% of all people with type 2 diabetes [3]. The overall goal for the treatment of diabetes is to prevent acute and chronic complications, while preserving a good quality of life. Knowledge about the occurrence of physical and psychological complications and its association with patients’ self-management and health-related quality of life (HRQOL) is therefore of great importance. Patient Education and Counseling 97 (2014) 75–81 A R T I C L E I N F O Article history: Received 23 January 2014 Received in revised form 2 May 2014 Accepted 25 June 2014 Keywords: Diabetes Mastery Perceived autonomy support Self-management Health-related quality of life A B S T R A C T Objective: The aim of this study was to assess the associations between type 2 diabetes patients’ mastery and perceived autonomy support and their self-management skills and health-related quality of life (HRQOL). Methods: A cross-sectional questionnaire survey was conducted among 3352 patients with type 2 diabetes. Key variables were assessed with validated questionnaires. Results: Patients’ mastery and perceived autonomy support correlated positively with their self- management skills (r = 0.34, p < 0.001; r = 0.37, p < 0.001) and HRQOL (r = 0.37, p < 0.001; r = 0.15, p < 0.001). In the linear regression analysis, mastery and perceived autonomy support were positive correlates of self-management (b = 0.23; p < 0.001; b = 0.25; p < 0.001). Patients with more physical or psychological complications had significantly lower scores on mastery, perceived autonomy support, self-management and HRQOL. Conclusion: Our results indicate the importance of mastery in relation to diabetes patients’ perceived autonomy support, self-management skills and HRQOL. Practice implications: Since a greater sense of mastery is likely to increase patients’ autonomous motivation to cope with their disease, interventions can aim to influence patients’ motivational regulation. In addition, we confirmed the need for autonomy support to improve patients’ self- management skills. Professionals can be trained to be autonomy-supportive, which relates to person- centered approaches such as motivational interviewing (MI). ß 2014 Elsevier Ireland Ltd. All rights reserved. * Corresponding author at: Department of Health Promotion, Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands. Tel.: +31 43 3882401; fax: +31 43 671032. E-mail address: lieke.raaijmakers@maastrichtuniversity.nl (Lieke G.M. Raaijmakers). Contents lists available at ScienceDirect Patient Education and Counseling jo ur n al h o mep ag e: w ww .elsevier .co m /loc ate/p ated u co u http://dx.doi.org/10.1016/j.pec.2014.06.016 0738-3991/ß 2014 Elsevier Ireland Ltd. All rights reserved.