Sense of Coherence and Adherence to Self-Care in People with Diabetes: Systematic Review and Meta-Analysis

<b>Background/Objectives:</b> Self-care in people with diabetes requires constant physical and emotional effort, which can be a barrier to adhering to the care plan. The sense of coherence (SOC) might play a role in self-care. This study aimed to examine the relationship between sense of...

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Main Authors: María del Carmen Vega-Martínez, Catalina López-Martínez, Rafael Del-Pino-Casado
Format: Article
Language:English
Published: MDPI AG 2025-06-01
Series:Nursing Reports
Subjects:
Online Access:https://www.mdpi.com/2039-4403/15/7/230
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author María del Carmen Vega-Martínez
Catalina López-Martínez
Rafael Del-Pino-Casado
author_facet María del Carmen Vega-Martínez
Catalina López-Martínez
Rafael Del-Pino-Casado
author_sort María del Carmen Vega-Martínez
collection DOAJ
description <b>Background/Objectives:</b> Self-care in people with diabetes requires constant physical and emotional effort, which can be a barrier to adhering to the care plan. The sense of coherence (SOC) might play a role in self-care. This study aimed to examine the relationship between sense of coherence and self-care in people with Diabetes Mellitus. <b>Methods:</b> A systematic review with narrative synthesis (14 studies) and with meta-analysis (seven studies) was conducted. We searched PubMed, CINAHL, PsychInfo and Scopus up to June 2025. We included original studies that assessed the relationship between SOC and self-management in people with diabetes and reported the correlation coefficient or other compatible statistic. Selection bias (probabilistic vs. non-probabilistic), classification bias (validity and reliability of the instrument) and confounding (control of sex, age and type of diabetes) were evaluated. The meta-analysis used a random-effects model with sensitivity and subgroup analyses to assess robustness. <b>Results:</b> Fourteen studies with 9800 participants (type 1 or 2 diabetes) were included. Of the studies, eight used probability sampling, only one had classification bias risk, and three had low bias risk. A positive, moderate association was found between SOC and adherence to self-care (r = 0.32; 95% confidence interval (CI): 0.29, 0.35; N = 3985; average per study: 569.3). Limitations: a small number of studies; all were descriptive and cross-sectional. <b>Conclusions:</b> A sense of coherence may play a relevant role in improving adherence to the self-care plan in people with type 1 or 2 diabetes.
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spelling doaj-art-30f04b7a9fa741eba36e1b91044c84002025-08-20T03:07:55ZengMDPI AGNursing Reports2039-439X2039-44032025-06-0115723010.3390/nursrep15070230Sense of Coherence and Adherence to Self-Care in People with Diabetes: Systematic Review and Meta-AnalysisMaría del Carmen Vega-Martínez0Catalina López-Martínez1Rafael Del-Pino-Casado2Department of Nursing, University of the Balearic Islands, 07122 Palma de Mallorca, SpainDepartment of Nursing, Member of the CuiDsalud Research Group, Nursing and Innovation in Healthcare (CTS-464), University of Jaén, 23071 Andalusia, SpainDepartment of Nursing, Member of the CuiDsalud Research Group, Nursing and Innovation in Healthcare (CTS-464), University of Jaén, 23071 Andalusia, Spain<b>Background/Objectives:</b> Self-care in people with diabetes requires constant physical and emotional effort, which can be a barrier to adhering to the care plan. The sense of coherence (SOC) might play a role in self-care. This study aimed to examine the relationship between sense of coherence and self-care in people with Diabetes Mellitus. <b>Methods:</b> A systematic review with narrative synthesis (14 studies) and with meta-analysis (seven studies) was conducted. We searched PubMed, CINAHL, PsychInfo and Scopus up to June 2025. We included original studies that assessed the relationship between SOC and self-management in people with diabetes and reported the correlation coefficient or other compatible statistic. Selection bias (probabilistic vs. non-probabilistic), classification bias (validity and reliability of the instrument) and confounding (control of sex, age and type of diabetes) were evaluated. The meta-analysis used a random-effects model with sensitivity and subgroup analyses to assess robustness. <b>Results:</b> Fourteen studies with 9800 participants (type 1 or 2 diabetes) were included. Of the studies, eight used probability sampling, only one had classification bias risk, and three had low bias risk. A positive, moderate association was found between SOC and adherence to self-care (r = 0.32; 95% confidence interval (CI): 0.29, 0.35; N = 3985; average per study: 569.3). Limitations: a small number of studies; all were descriptive and cross-sectional. <b>Conclusions:</b> A sense of coherence may play a relevant role in improving adherence to the self-care plan in people with type 1 or 2 diabetes.https://www.mdpi.com/2039-4403/15/7/230diabetes mellitusself-caresense of coherencesystematic reviewmeta-analysisnursing
spellingShingle María del Carmen Vega-Martínez
Catalina López-Martínez
Rafael Del-Pino-Casado
Sense of Coherence and Adherence to Self-Care in People with Diabetes: Systematic Review and Meta-Analysis
Nursing Reports
diabetes mellitus
self-care
sense of coherence
systematic review
meta-analysis
nursing
title Sense of Coherence and Adherence to Self-Care in People with Diabetes: Systematic Review and Meta-Analysis
title_full Sense of Coherence and Adherence to Self-Care in People with Diabetes: Systematic Review and Meta-Analysis
title_fullStr Sense of Coherence and Adherence to Self-Care in People with Diabetes: Systematic Review and Meta-Analysis
title_full_unstemmed Sense of Coherence and Adherence to Self-Care in People with Diabetes: Systematic Review and Meta-Analysis
title_short Sense of Coherence and Adherence to Self-Care in People with Diabetes: Systematic Review and Meta-Analysis
title_sort sense of coherence and adherence to self care in people with diabetes systematic review and meta analysis
topic diabetes mellitus
self-care
sense of coherence
systematic review
meta-analysis
nursing
url https://www.mdpi.com/2039-4403/15/7/230
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