Using the common-sense model to explicate the role of illness representation in self-care behaviours and anxiety symptoms among patients with Type 2 diabetes

• Published in: Patient education and counseling 2023-02, Vol.107, p.107581-107581, Article 107581
• Main Authors: Xin, Meiqi, Chan, Virginia W.Y., Kong, Alice P.S., Lau, Joseph T.F., Cameron, Linda D., Mak, Winnie W.S., Mo, Phoenix K.H.
• Format: Article
• Language: English
• Subjects: Adaptation, Psychological; Anxiety; Common-sense model; Diabetes Mellitus, Type 2 - therapy; Humans; Illness representation; Illness self-regulation; Self Care; Self Efficacy; Self-care behaviours; Surveys and Questionnaires; Type 2 diabetes
• ISSN: 0738-3991; 1873-5134
• DOI: 10.1016/j.pec.2022.107581

Based on the common-sense model of self-regulation, this study aimed to explicate the mechanism underlying the effect of illness representations on self-care behaviours and anxiety symptoms among patients with type 2 diabetes. A telephone survey was administered to 473 patients in Hong Kong. Structural equation modelling was used to test if threat and control perceptions regarding diabetes would be associated with self-reported self-care behaviours and anxiety symptoms through adoption of adaptive/maladaptive coping strategies and diabetes-related self-efficacy. Control perceptions but not threat perceptions were positively associated with self-care behaviours. Control perceptions had a positive indirect association with self-care behaviours through more problem-focused coping and diabetes-related self-efficacy. Threat perceptions simultaneously had a positive indirect association through more problem-focused coping and a negative indirect association through more avoidant coping and lower diabetes-related self-efficacy. In contrast, threat and control perceptions were positively and negatively, respectively, associated with anxiety symptoms. Problem-focused and avoidant coping consistently mediated the indirect association between threat perceptions and anxiety symptoms. Threat and control perceptions were associated with diabetes self-care behaviours and anxiety symptoms through different self-regulation pathways. Our findings inform possible targets for self-management interventions to simultaneously enhance self-care behaviours and alleviate diabetes-associated anxiety. •Control and threat perceptions of diabetes exhibited different associations with self-care behaviours and anxiety symptoms.•Different self-regulation pathways through adoption of coping strategies and self-care self-efficacy were observed.•The findings might help inform effective psychological interventions for diabetes self-management.