| The rapidly rising prevalence of diagnosed and undiagnosed type 2 diabetes mellitus and those at risk of developing diabetes call for attention among healthcare professionals in addressing contributing factors to prevent and manage the illness. Type 2 diabetes affects and is affected by many other life-threatening chronic health conditions, as well as factors associated with one's psychosocial adjustment and environmental considerations. The dynamics and complexity of these factors interact with one another to bring significant impact on one's day-to-day living and overall quality of life, specifically subjective well-being. Thorough understanding of their structural interactions informs effective rehabilitation practice to improve health-related outcomes, community participation and subjective well-being. The purpose of this study was to investigate the World Health Organization's International Classification of Functioning, Disability, and Health (ICF) model as a way to better understand community participation and subjective well-being for adults with type 2 diabetes. Construct measurements specific to adults with type 2 diabetes corresponding to each ICF components were specified and their interactions were analyzed using structural equation modeling. Results from structural equation modeling revealed that the proposed model did not fit the sample data, and the modified model demonstrated mediocre goodness-of-fit, providing inconclusive results regarding the usefulness of the model. The correlations among variables varied from small to large. However, the final model demonstrated the significance of the contextual factors of diabetes management self-efficacy (personal factor) positively influencing adherence to diabetes self-management and diabetes condition; and perceived social support (environmental factor) positively influencing diabetes management self-efficacy and outcome variables of community participation and subjective well-being. As hypothesized, mediating variables were identified. The results of this study need to be interpreted with careful consideration to limitations such as research and sampling designs, sample size, sample representativeness, and measurement errors. Clinical interventions incorporating self-efficacy and social support in diabetes management are likely to facilitate active participation in the community, thus leading to subjective well-being for people with type 2 diabetes. Additional clinical and future research implication, and study limitations were discussed. |
