Purpose This study aimed to identify the effects of psychological insulin resistance, diabetes distress, and diabetes self-efficacy of patients and their spouses on insulin therapy adherence of patients with type 2 diabetes. Methods A path analysis based on the actor-partner interdependence model, a couple analysis method, was used to identify the actor and partner effects of psychological insulin resistance, diabetes distress, diabetes self-efficacy on the insulin therapy adherence of patients with type 2 diabetes. Data were collected between February 25 and May 1, 2019, from 200 patients with type 2 diabetes and their spouses. Results The psychological insulin resistance of the patient had an actor effect on the diabetes self-efficacy of the patient and a partner effect on the diabetes self-efficacy of the spouse, and the patient’s diabetes distress had a partner effect on the diabetes self-efficacy of the spouse. The psychological insulin resistance of the spouse had an actor effect on the diabetes self-efficacy of the spouse, and the diabetes self-efficacy of the patient and spouse were found to affect the insulin therapy adherence of the patient directly. Conclusion This study provided basic data for the development of programs that can enhance insulin therapy adherence in patients with type 2 diabetes, focusing on the perspectives of both the patient and spouse.
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