Illness representations, emotional distress, coping strategies, and coping efficacy as predictors of patient outcomes in type 2 diabetes

Diabetes mellitus affects 20.8 million Americans in the United States and is the fifth leading cause of death in the United States. Acute and chronic disease-related complications can have a devastating effect on the life of individuals with Type 2 diabetes. Reduction in acute and chronic complications can be best achieved by individuals' adhering to appropriate lifestyle changes and maintaining tight glycemic control through a process of self-regulation.;The purpose of this study was to examine the relationship between illness representations, emotional distress, coping strategies, and coping efficacy as predictors of outcomes (self-care behavior and A1c levels) in individuals with type 2 diabetes.;A descriptive, correlational study with a convenience sample of 119 men and women between the ages of 22 and 93 were recruited from physician offices, medical clinics, and diabetes education centers. Inclusion criteria were that participants (a) had been diagnosed with type 2 diabetes for at least 1 year or more, (b) were able to read and write in English, (c) were 18 years of age or older, and (d) had an A1c level drawn within the past 30 days. The Illness Perceptions Questionnaire-Revised, Ways of Coping Questionnaire-Revised, Coping Efficacy Scale, and Summary of Diabetes Self-care Activities Questionnaire were used for data collection. Questionnaire booklets were mailed to participants. A1c levels were obtained from medical records.;Data were analyzed with descriptive and inferential statistics including frequencies, percentages, means, standard deviations, bivariate correlations, multiple linear regressions, and hierarchical multiple linear regressions. Participants perceived their diabetes to be a chronic, moderately cyclical condition with negative consequences and with moderate amounts of symptomatology that greatly influenced their emotional status. Hierarchical multiple linear regression analyses revealed that coping efficacy uniquely accounted for 9% of the variance in self-care behavior and illness representations, particularly timeline cyclical, uniquely accounted for 12% of the variance in A1c levels. Perceptions of higher coping efficacy were associated with higher beliefs of personal control and treatment control, a greater understanding of diabetes, engagement in higher levels of self-care behavior, and lower A1c levels. Perceptions of a more cyclical disease course were predicted of higher A1c levels.