Mediation by illness perceptions of the effect of personality and health threat communication on coping with the diagnosis of diabetes

Abstract

Objectives. (1) To examine the relationship of personality traits and diabetes health threat communication (DHTC) to the coping strategies of newly diagnosed diabetes patients; (2) to determine to what extent these postulated effects are mediated by illness representations (IRs). Design. A longitudinal prospective study based on the common sense model. Methods. Patients were assessed shortly after diagnosis and 2 years after the diagnosis of diabetes. Personality traits (Mini‐markers) were assessed at baseline. The DHTC Questionnaire was completed at baseline and 2 years. The Revised Illness Perception Questionnaire and the coping orientation to problems experienced were completed at 2 years. Mediation by IRs of the potential influence of personality and DHTC on coping behaviour was assessed by the method of Baron and Kenny. Results. Multiple regression analyses showed that educational level, agreeableness, openness/intellect, conscientiousness, and perceptions of a more reassuring health message since diagnosis were related to more adaptive coping (e.g., active coping, planning). The association of openness and perceived reassuring health message with active coping showed complete mediation by illness coherence and personal control. Openness led to seeking emotional support mediated by perceived personal control. Coherence associated with (partial mediation) the relation of openness to planning. Similarly, personal control and coherence mediated the relation of openness to positive reinterpretation and growth (PRG). Agreeableness had a direct relationship with active coping and PRG but led to planning and seeking instrumental support mediated by perceived treatment effectiveness. Perceptions of a threatening health message were associated with seeking instrumental and emotional support and this was mediated by symptom perception but threat had a direct relationship with planning. Conclusions. Both personality traits and health threat communication predict the way individuals cope with diabetes. The relationships of these factors are largely mediated through measurable IRs. The results suggest targets for intervention to achieve greater problem‐focused coping.

Mediation by illness perceptions of the association between the doctor–patient relationship and diabetes-related distress

“…This previous study found that a more reassuring health message was associated with better coping, and that Illness Coherence and Personal Control fully mediated these relationships (Lawson et al, 2010). Our findings partially support this previous work, in that we found that Personal Control fully mediated the association between the doctor-patient relationship and diabetes-related distress.…”

“…While type of diabetes was not associated with diabetesrelated distress, individuals with Type 1 diabetes had relatively higher scores on Timeline (Acute/Chronic), Consequences and Illness Coherence as well as lower scores on Treatment Control. These findings are in concordance with the notion that patients typically perceive Type 1 diabetes to be more severe than Type 2 (Lawson et al, 2010), but also suggest that Type 1 diabetes patients have a better perceived understanding of their condition.…”

“…and psychological health outcomes in diabetes is mediated by illness perceptions (Lawson et al, 2010). This previous study found that a more reassuring health message was associated with better coping, and that Illness Coherence and Personal Control fully mediated these relationships (Lawson et al, 2010).…”

Content validity of the illness perceptions questionnaire – revised among people with type 2 diabetes: A think-aloud study

“…The research generally demonstrates that illness perceptions explain a significant proportion of the variance in physical and psychological outcomes in a range of illnesses (Dempster et al, 2011a;Dorrian, Dempster & Adair, 2009;Glattacker, Opitz & Jäckel, 2010;Kaptein et al, 2010). The relationship between illness perceptions and both psychological and physical outcomes has been well established among adults with Type 2 diabetes Lawson, Bundy, Belcher & Harvey, 2010;Searle, Norman, Thompson & Vedhara, 2007a;Searle, Norman, Thompson & Vedhara, 2007b;Searle et al, 2008;Skinner et al, 2006;Skinner et al, 2011;Sultan, Attali, Gilberg, Zenasni & Hartemann, 2011), and the findings of this research have been posited as a basis for interventions to improve well-being among this population.…”

Effects of psychological distress and perceptions of illness on recovery from total knee replacement

“…Illness perceptions encompass the patient's own understanding and beliefs about their illness, its effects, causes and progression. Illness perceptions have been found to predict recovery from a range of conditions, such as myocardial infarction 11,12 or surgery 13,14 and also seem to influence how patients cope with chronic conditions, such as diabetes 15,16 , chronic lung disease 17 or arthritis [18][19][20] .…”