Pathways of diabetes distress, decisional balance, self-efficacy and resilience to quality of life in insulin-treated patients with type 2 diabetes: A 9-month prospective study.

Nurses could provide educational programs focusing on enhancing decisional balance of injecting insulin to improve QoL in insulin-treated patients. Improving self-efficacy of injecting insulin and resilience could be promising strategies to improve the decisional balance of injecting insulin. More timely assessment of diabetes distress and intervention might be powerful strategies to improve subsequent QoL in these patients.