Illness perception clusters are useful determinants of diabetes distress in adults with type 2 diabetes

Abstract

Background: Illness perceptions are important determinants of emotional adjustment among adults with Type 2 diabetes. This study aimed to explore whether clustering individuals with Type 2 diabetes according to shared illness perception schemas is a useful way of identifying those most susceptible to diabetes distress. A secondary aim was to explore any added value of relationship quality and coping behaviours in building cluster profiles. Methods: This study used a postal questionnaire design. Adults with type 2 Diabetes were recruited through the databases of General Practices in Northern Ireland. The questionnaire asked about demographics and incorporated 5 scales; Beck’s Depression Inventory, Diabetes Distress Scale, Revised Illness Perception Questionnaire, Dyadic Adjustment Scale and the Brief COPE. Dependent variables were diabetes distress and HbA1c, and depression was used as a control variable. Complete responses were received from 162 individuals with Type 2 diabetes. Hierarchical Cluster, K-Means, and Multiple Regression Analysis were performed. Findings: Three distinct illness perception clusters were identified in the analysis. Demographics, illness perception clusters, relationship quality and coping behaviour explained 45.7% of the variance in diabetes distress, with illness perception clusters contributing the most variance (18.6%). The emotional burden sub-scale produced the strongest model, with illness perception clusters contributing 32.5% to the total (51.9%) variance in emotional burden. Discussion: Clustering individuals with Type 2 diabetes according to shared illness perception schemas appears to be a useful way of identifying who is most at risk of diabetes distress, and who could benefit the most from an intervention supporting emotional adjustment.