What are the combined effects of negative emotions and illness cognitions on self care in people with type 2 diabetes? A longitudinal structural equation model
Objective: To explore whether negative emotions mediate the effect of diabetes cognitions on diabetes self care and conversely whether diabetes cognitions mediate the effect of negative emotions on diabetes self care. Design: Longitudinal observational study in adults with type 2 diabetes. Main outcome measures: Self reported depression and anxiety (Diabetes Wellbeing Questionnaire) cognitions (Illness Perceptions Questionnaire Revised; Beliefs about Medicines Questionnaire) and diabetes self care (Summary of Diabetes Self Care Activities Scale) were completed at baseline and six months. Analyses used structural equation modelling. Results: Baseline medication concerns were associated with elevated symptoms of depression and anxiety at follow up, but emotions did not mediate medication concern's effect on diabetes self care. Baseline depression and anxiety symptoms were associated with specific diabetes cognitions over time, but these cognition domains did not mediate emotion's effect on diabetes self care. Personal control remained independent of emotions and was associated with diabetes self care over time. Conclusions: Negative emotions did not act directly or alongside cognitions to influence diabetes self care. The reciprocal relationship between diabetes cognitions and emotions suggests cognitive restructuring, in addition to other mood management intervention techniques would likely improve the emotional wellbeing of adults with type 2 diabetes. Likewise, personal control beliefs are likely important intervention targets for improving self care.
Psychology health