Structural Relationships of Cognitive Illness Representations with Self-Management in Type 1 Diabetic Adolescents: The Mediating Role of Self-Regulation Strategies

Self-management is the basis of diabetes treatment and is based on psychological and social factors. The purpose of the present study was to evaluate the empirical fit of a model in which structural relationships of cognitive representations of disease with self-management of adolescents with type 1 diabetes were considered with regard to the mediating role of self-regulation strategies. This study was a correlation study (structural equation modeling) with a sample size of 250 adolescents with type 1 diabetes in Tabriz. Research tools were: IPQ Disease Perception Questionnaire, CISS Stressful Coping Scale, Standard Diabetes Self-Efficacy Questionnaire, DSMS Diabetes Self-Management Scale. Data were analyzed by SPSS and LISREL. Evaluation of the hypothetical model by using fitness indices showed that the hypothetical model fitted to the measurement model (CFI = 0.95, NFI = 0.97, RMSEA = 0.09). The results showed that cognitive representations with standard coefficient of -0.73 and -0.50 had significant effect on self-regulation and self-management at p> 0.05 level, respectively. Also, self-regulation had a significant effect on self-management with standard coefficient of 0.47. Cognitive perceptions of adolescents about the disease through self-regulation (self-efficacy and coping methods) influence self-management of diabetes in adolescents. Therefore, self-management of this disorder can be improved by identifying and modifying dysfunctional cognitive perceptions and improving self-regulation strategies in diabetic adolescents.