Type II Diabetic Patients’ Illness Perception and Self-care Behaviour: Does Comorbidity make any Difference?

Document Type: Original Article

Authors

Department of Psychology, School of Social and Behavioural Sciences, Central University of Karnataka, Kalaburagi, India-585367

Abstract

Abstract

Introduction: Earlier studies have shown that illness perception and self-care behaviour change based on the existence of comorbidity / no comorbidity conditions. The present study investigates the role of comorbidity in Type II diabetic patients' level of personal control, treatment control, illness coherence and self-care behaviour in the Indian context. 
Method: A cross-sectional survey was conducted among (N=303) type II diabetic patients in southern India, of whom 43.56% reported having one comorbidity condition or more comorbid conditions. Participants’ illness perception has been assessed using Illness Perception Questionnaire-Revised (IPQ-R) and self-care behaviour has been assessed through Diabetic Self-Care Management Questionnaire (DSMQ). 
Results: Patients with no comorbid conditions had higher beliefs of personal control, treatment controland illness coherence, and also showed better self-behaviour than their counterparts. Patients with comorbidity conditions perceived diabetes as a chronic disease and seemed to have more consequences in their lives. They also tend to be emotionally affected and to have a lower belief of personal control, treatment control and illness coherence. Besides this, self-care behaviour was also found to be significantly different based on the patients' level of personal control, treatment control and illness coherence beliefs between diabetics who had comorbidity and those with no comorbidity conditions.
Conclusion: Significant difference in self-care behaviour of patients with comorbidity indicates the necessity of interventions to enhance their self-care behaviour to manage their diabetes as well as their comorbid conditions.
Abstract

Introduction: Earlier studies have shown that illness perception and self-care behaviour change based on the existence of comorbidity / no comorbidity conditions. The present study investigates the role of comorbidity in Type II diabetic patients' level of personal control, treatment control, illness coherence and self-care behaviour in the Indian context. 
Method: A cross-sectional survey was conducted among (N=303) type II diabetic patients in southern India, of whom 43.56% reported having one comorbidity condition or more comorbid conditions. Participants’ illness perception has been assessed using Illness Perception Questionnaire-Revised (IPQ-R) and self-care behaviour has been assessed through Diabetic Self-Care Management Questionnaire (DSMQ). 
Results: Patients with no comorbid conditions had higher beliefs of personal control, treatment controland illness coherence, and also showed better self-behaviour than their counterparts. Patients with comorbidity conditions perceived diabetes as a chronic disease and seemed to have more consequences in their lives. They also tend to be emotionally affected and to have a lower belief of personal control, treatment control and illness coherence. Besides this, self-care behaviour was also found to be significantly different based on the patients' level of personal control, treatment control and illness coherence beliefs between diabetics who had comorbidity and those with no comorbidity conditions.
Conclusion: Significant difference in self-care behaviour of patients with comorbidity indicates the necessity of interventions to enhance their self-care behaviour to manage their diabetes as well as their comorbid conditions.

Keywords


eferences
1. A. L. van Puffelen, M. J. W. M. Heijmans, M. Rijken, G. E. H.
M. Rutten, G. Nijpels, and F. G. Schellevis, “Illness perceptions
and self-care behaviours in the first years of living with type 2
diabetes; does the presence of complications matter?,” Psychol.
Heal., vol. 30, no. 11, pp. 1274–1287, 2015.
2. A. Searle, M. A. Wetherell, R. Campbell, C. Dayan, J. Weinman,
and K. Vedhara, “Do patients’ beliefs about type 2 diabetes differ
in accordance with complications: An investigation into diabetic
foot ulceration and retinopathy,” Int. J. Behav. Med., vol. 15, no.
3, pp. 173–179, 2008.
3. S. E. Hampson, R. E. Glasgow, and L. S. Foster, “Personal
Models of Diabetes Among Older Adults: Relationship to Self-
Management and Other Variables,” Diabetes Educ., vol. 21, no.
4, pp. 300–307, 1995.
Comorbidity in Illness Perception and Self-care Behaviour of Type II Diabetes
Int J Behav Sci Vol.12, No.3, Autumn 2018 124
4. S. E. Hampson, R. E. Glasgow, and D. J. Toobert, “Personal
Models of Diabetes and their Relationships to Self-Care
Activities,” Heal. Psychol., vol. 9, no. 5, pp. 632–646, 1990.
5. R. Moss-Morris, J. Weinman, K. Petrie, R. Horne, L. Cameron,
and D. Buick, “The revised Illness Perception Questionnaire
(IPQ-R),” Psychol. Heal., vol. 17, no. 1, pp. 1–16, 2002.
6. T. Bodenheimer Lorig, K., Holman, H., Grumbach, K., “Patient
self-management of chronic disease in primary care,” J. Am.
Med. Assoc., vol. 288, no. 19, pp. 2469–2475, 2002.
7. A. Schmitt, “The Diabetes Self-Management Questionnaire (
DSMQ ): Development and evaluation of an instrument to assess
diabetes ... The Diabetes Self-Management Questionnaire (
DSMQ ): development and evaluation of an instrument to assess
diabetes self-care activities,” Health Qual. Life Outcomes, vol.
11, no. 1, p. 1, 2013.
8. J. Hwang and C. Shon, “Relationship between socioeconomic
status and type 2 diabetes: Results from Korea National Health
and Nutrition Examination Survey (KNHANES) 2010-2012,”
BMJ Open, vol. 4, no. 8, 2014.
9. M. Tang, Y. Chen, and D. Krewski, “Gender-related differences
in the association between socioeconomic status and selfreported
diabetes,” Int. J. Epidemiol., vol. 32, no. 3, pp. 381–385,
2003.
10. W. Boonsatean, I. D. Rosner, A. Carlsson, and M. Östman, “The
Influences of Income and Education on the Illness Perception of
Thai Adults with Type 2 ception and Self-Management
Diabetes,” J. Diabetes Metab. Disord., vol. 3, no. 3, p. 017, 2016.
11. J. F. Elgart et al., “Association between socioeconomic status,
type 2 diabetes and its chronic complications in Argentina,”
Diabetes Res. Clin. Pract., vol. 104, no. 2, pp. 241–247, 2014.
12. M. R. Km, A. Anandhasayanam, S. Kannan, and M. S. Noon,
“Prevalence of Co-morbidities in Type 2 Diabetes Mellitus
Patients, the Awareness Level and the Impact of Pharmacist’s
Patient Education Program,” Int. J. Pharma Res. Rev. IJPRR,
vol. 4, no. 45, pp. 11–20, 2015.
13. H. F. Jelinek et al., “Clinical profiles, comorbidities and
complications of type 2 diabetes mellitus in patients from United
Arab Emirates,” BMJ Open Diabetes Res. Care, vol. 5, no. 1, p.
e000427, 2017.
14. I. M. Stratton, “Association of glycaemia with macrovascular
and microvascular complications of type 2 diabetes (UKPDS
35): prospective observational study,” Bmj, vol. 321, no. 7258,
pp. 405–412, 2000.
15. R. E. Glasgow, S. E. Hampson, L. A. Strycker, and L. Ruggiero,
“Personal-model beliefs and social-environmental barriers
related to diabetes self-management,” Diabetes Care, vol. 20, no.
4, pp. 556–561, 1997.
16. H. Goodman, A. Firouzi, W. Banya, M. Lau-Walker, and M. R.
Cowie, “Illness perception, self-care behaviour and quality of
life of heart failure patients: A longitudinal questionnaire
survey,” Int. J. Nurs. Stud., vol. 50, no. 7, pp. 945–953, 2013.
17. R. M. Anjana, R. Pradeepa, D. Ph, M. Deepa, M. Datta, and V.
Sudha, “The Indian Council of Medical Research – India
Diabetes ( ICMR – INDIAB ) Study : Methodological Details,”
vol. 5, no. 4, pp. 906–914, 2015.