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

Citation

Hudson JL, Bundy C, Coventry P, Dickens C, Wood AM & Reeves D (2016) 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. Psychology and Health, 31 (7), pp. 873-890. https://doi.org/10.1080/08870446.2016.1156113

Abstract
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.

Keywords
depression; anxiety; illness cognitions; diabetes self-care; structural equation modelling; longitudinal

Journal
Psychology and Health: Volume 31, Issue 7

• 3. Statistical appendix.pdf