Exploring the relationships between illness perceptions, self-efficacy, coping strategies, psychological distress and quality of life in a cohort of adults with diabetes mellitus

Simon R. Knowles, Pragalathan Apputhurai, Casey L. O'Brien, Chantal F. Ski, David, R. Thompson , David J. Castle

Research output: Contribution to journalArticle

2 Citations (Scopus)


Diabetes has a significant negative impact on mental health and quality of life (QoL). Underpinned by the Common Sense Model (CSM) the mediating role of coping patterns, self-efficacy, anxiety and depression symptoms on the relationship between illness perceptions and QoL in patients diagnosed with diabetes was evaluated. A total of 115 participants with diabetes (56, Type 1; 59, Type 2), 51% female and an average age of 52.69 (SD = 15.89) in Australia completed self-report measures of illness perceptions and psychological wellbeing. Baseline measures included illness perceptions, coping styles, psychological distress (anxiety and depression symptoms), self-efficacy, and quality of life. Mediating relationships were measured using structural equation modelling. A model of good fit was identified explaining 51% of the variation in QoL. Illness perceptions directly influenced QoL, maladaptive coping, self-efficacy, and anxiety symptoms. The relationship between illness perceptions and QoL was partially mediated by anxiety; illness perceptions and depression was fully mediated by maladaptive coping and self-efficacy; and self-efficacy and QoL was partially mediated by depressive symptoms. Findings provide validation of the CSM in a diabetes cohort. Psychological interventions likely to have the most benefit on psychological distress and QoL are those targeting mediating psychological processes, including maladaptive coping and self-efficacy.
Original languageEnglish
Pages (from-to)214-228
Number of pages15
JournalPsychology, Health and Medicine
Issue number2
Early online date02 Dec 2019
Publication statusPublished - 10 Jan 2020


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