Risk Perception, Illness Representations And Self-Care Behaviors in Type 2 Diabetes

Abstract

Introduction: The study assessed relationships among perceived risk, illness representations and self-care behaviors in type 2 diabetes. The Common Sense Model (CSM) of self-regulation was the theoretical framework for understanding how illness representations inform risk perception to predict self-care behaviors.;Methods: The cross-sectional study examined a diverse sample of adults with type 2 diabetes. Measures included: Illness Perception Questionnaire-Revised, Risk Perception Survey-Diabetes Mellitus and Self-Care Inventory-Revised. Analyses included: correlations to assess the above relationships and regression models to evaluate the effect of risk perceptions and illness perceptions on treatment adherence.;Results: Results indicate significant correlations between knowledge of risk factors for diabetes-related complications and viewing diabetes symptoms in a cyclical manner. There were also significant associations between a holistic measure of risk for diabetes-related complications and the number of symptoms attributed to diabetes, viewing diabetes as more chronic, the perceived consequences of diabetes and negative emotions related to diabetes.. Regression models explained significantly more variance in predicting self-care behaviors when the illness representation component of consequences (R2 = .09, p = .006 for risk knowledge and consequences and R 2= .08, p = .012 for composite risk and consequences) was added into the models. A significant interaction between composite risk and perceived consequences (b = l .64, p = .030) indicated that the relationship between composite risk and better self-care was dependent on patient perceptions regarding the consequences of diabetes. When consequences were perceived to be relatively low (1SD below the mean), greater perceived risk was significantly associated with better self-care (b = -.47, p = .001). However, at higher levels of perceived consequences (1 SD above the mean), the magnitude of this relationship was near zero (b = -.02,p = .915, ns).;Conclusions: Implications of these results suggest that the delicate balance between the degree of the perceived negative consequences in enhancing or inhibiting self-care behaviors should be considered in patient-provider risk communication. Moderation analyses are an important contribution to the risk perception, illness representation and diabetes self-care literature, in terms of thinking about the relationship of perceived risk and illness representations as dependent upon each other in relation to self-care behaviors.