Exploring the relationships between illness perceptions, self-efficacy, coping strategies, psychological distress and quality of life in a cohort of adults with diabetes mellitus

Psychol Health Med. 2020 Feb;25(2):214-228. doi: 10.1080/13548506.2019.1695865. Epub 2019 Dec 2.

Abstract

Diabetes has a significant negative impact on mental health and quality of life (QoL). Underpinned by the Common Sense Model (CSM) the mediating role of coping patterns, self-efficacy, anxiety and depression symptoms on the relationship between illness perceptions and QoL in patients diagnosed with diabetes was evaluated. A total of 115 participants with diabetes (56, Type 1; 59, Type 2), 51% female and an average age of 52.69 (SD = 15.89) in Australia completed self-report measures of illness perceptions and psychological wellbeing. Baseline measures included illness perceptions, coping styles, psychological distress (anxiety and depression symptoms), self-efficacy, and quality of life. Mediating relationships were measured using structural equation modelling. A model of good fit was identified explaining 51% of the variation in QoL. Illness perceptions directly influenced QoL, maladaptive coping, self-efficacy, and anxiety symptoms. The relationship between illness perceptions and QoL was partially mediated by anxiety; illness perceptions and depression was fully mediated by maladaptive coping and self-efficacy; and self-efficacy and QoL was partially mediated by depressive symptoms. Findings provide validation of the CSM in a diabetes cohort. Psychological interventions likely to have the most benefit on psychological distress and QoL are those targeting mediating psychological processes, including maladaptive coping and self-efficacy.

Keywords: Diabetes mellitus; anxiety; common sense model; coping; depression; illness perceptions; quality of life; self-efficacy.

MeSH terms

  • Adaptation, Psychological*
  • Adult
  • Aged
  • Anxiety / psychology*
  • Attitude to Health*
  • Australia
  • Cohort Studies
  • Depression / psychology*
  • Diabetes Mellitus / psychology*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Psychological Distress*
  • Quality of Life / psychology*
  • Self Efficacy*
  • Stress, Psychological / psychology*