A prospective examination of illness beliefs and coping in patients with type 2 diabetes

Objective. According to the common-sense model of illness behaviour, illness representations are directly related to coping and, via coping, to adaptive or maladaptive outcomes. However, it may be more appropriate to conceptualize coping by assessing what patients actually do - i.e., their coping behaviours - rather than what they say they do in coping scales - i.e., their coping cognitions. The aim of this study was to examine the relationships between illness representations and the relative importance of coping cognitions and coping behaviours in the context of the management of type 2 diabetes. Design. The relationship between illness representations and coping variables was explored within a prospective design. Methods. The illness representations of 134 patients were assessed with the IPQ-R (Moss-Morris et al., 2002) along with coping cognitions and coping behaviours (medication, physical activity, diet). Results. Illness representations predicted coping cognitions and coping behaviours but coping cognitions did not mediate the relationships between illness representations and coping behaviours. Conclusion. The results demonstrate that illness representations are direct predictors of both coping cognitions and coping behaviours in patients with type 2 diabetes. In addition, coping cognitions and coping behaviours appear to be distinct mechanisms that operate independently. The findings suggest that rather than manipulating patients' coping cognitions to improve patients' health behaviours it may be beneficial to focus on their beliefs about diabetes.