Improvement of self efficacy through bibliotherapy in diabetes patient

Atyanti Isworo


Background: Diabetes Mellitus is also known diabetes, as a chronic disease which will trigger various complications both microvascular and macrovascular. This is what leads diabetes patient to have high risk of low self-efficacy. Low of self-efficacy causes a decrease in self care. Therefore, to improve the patient’s self-efficacy is changing their mindset. Bibliotherapy is a treatment using written materials to guide and encourage the patients to challenge unhelpful thoughts. This research aims at discovering the influence of bibliotherapy on self-efficacy of diabetes patients.

Methods: This is a quantitative research using quasi-experimental with control group design. The number of samples in this research is 40 respondents, consisting of 20 intervention groups and 20 control group by simple random sampling method. The sample in this research is diabetes patients with such inclusion criteria as (1) 36-60 years of age, (2) having the ability to read well, (3) willing to be a research respondent. Meanwhile, the exclusion criteria are (1) diabetes patient with weak condition, (2) experiencing loss of consciousness, (3) having visual and audio problems, and (4) diabetes patient with mental disability. The intervention group undergoes bibliotherapy for 8 session, each session for 60 minutes. The Diabetes Management Self Efficacy Scale (DMSES) to determine the total score of self-efficacy.

Results: Most respondents are middle-aged adults (36-55 years) in both groups. Most respondents have suffered from diabetes for less than 5 years, unemployed and tend to have normal BMIs and also obese category 1. The mean score post test in intervention and control group is 37.00 and 25.65 respectively. The results show that there are differences in self-efficacy scores after treatment in control and intervention groups (p=0.000).

Conclusions: From our study we concluded that bibliotherapy could improve self-efficacy in diabetic patients.


Bibliotherapy, Diabetes, Self-efficacy

Full Text:



WHO. Diabetes cases could double in developing countries in next 30 years, 2003. Available at: Accessed 3 June 2018.

Basic Health Research. Jakarta: Ministry of Health Republic of Indonesia, 2013. Available at: Accessed 3 June 2018.

Anjali DD, Marcie HH, Mario S. Epidemiology of diabetes and diabetes-related complications. J Am Phys Ther Associa. 2008;88(11):1254-64.

Alder AI, Boyko EJ, Ahroni JH, Smith DG. Lower-extremity amputation in diabetes. The independent effects of peripheral vascular disease, sensory neuropathy, and foot ulcers. Diabetes Care. 1999;22(7):1029-35.

Isworo A. The relationship of depression and family support to blood glucose level in type 2 diabetes patients. Soedirman Nur J. 2009;5(2):37-46.

Anderson RJ, Freeland KE, Clouse RE, Lustman PJ. The prevalence of comorbid depression in adults with diabetes: a meta-analysis. Diabetes Care. 2001;24(1):1069-78.

Van der Bijl J, Van Poelgeest-eeltink A, Shortridge-baggett L. The psychometric properties of the diabetes management self-efficacy scale for patients with type 2 diabetes mellitus. J Adv Nurs. 1999;30:352-9.

Sigurdardottir AK. Self care in diabetes: Model of factors affecting self care. J Clin Nur. 2005;14(2):301-14.

Mc.Kenna G, Hevey D, Martin E. Patient’s and providers perspectives on bibliotherapy in Primary care. Clin Psychol Psychother. 2010;17(3):497-509.

Apodaca TR. Miller WR, Schermer, CR, Amrhein, PC. A pilot study of bibliotherapy to reduce alcohol problems among patients in a hospital trauma center. J Addictions Nursing. 2007;18(4):167-73.

Mohebi S, Azadbakht L, Feizi A, Sharifirad G, Kargar M. Review the key role of self-efficacy in diabetes care. J Education Health Promotion. 2013;36(2):33-9.

Hurlock EB. Developmental psychology: A approach in life time stage. Jakarta: Erlangga;2001.

Atak N, Gurkam T, Kose K. The effect of education on knowledge, self management behaviours and self effcacy of patients with type 2 diabetes. Aus J Adv Nursing. 2008;28(2):66-74.

LaPointe KA, Crandall CJ. Relationship of irrational beliefs to self-reprted depression. Cognitive Therapy Res.1980;4(1):247-50.

Trief PM, Teresi JA, Eimicke JP, Shea S, Weinstock RS. Improvement in diabetes self-efficacy and glycaemic control using telemedicine in a smaple of older, ethnically diverse individuals who have diabetes: the IDEATel project. Age Ageing. 2009;38(2):219-25.

Zareban I, Niknami S, Hidarnia A, Rakhshani F, Karimy M, Shamsi M. The effect of education program based on health belief model on decreasing blood sugar levels in diabetic type 2 patients in Zahedan. Health Scope. 2013;2(2):73-8.

Bandura A. Self-efficacy: toward a unifying theory of behavioral change. Psychol Rev. 1977;84(2):191.

Yuan S, Zhou X, Zhang Y, Zhang H, Pu J, Yang L, Liu L, Jiang X, Xie P. Comparative efficacy and acceptability of bibliotherapy for depression and anxiety disorders in children and adolescents: a meta-analysis of randomized clinical trials. Devo Med Press. 2017:14:353-65.

Melanie JVF. Cognitive therapy in treatment of low self-esteem. J Continuing Professional Deve. 1998;4(1):296-304.