Relationship between psychosocial elements and medical adherence in patients diagnosed with type II diabetes: Mediating role of illness perception

Context: Self-care plays a vital role in the management of diabetes. Commitment to medical adherence in diabetes care is linked with lower morbidity, mortality, and treatment cost. Aim: This study aimed on investigating the mediating role of illness perception concerning the relationship between psychosocial elements and medical adherence among patients with type II diabetes. Setting and Design: This is a correlational study that is conducted based on a well-framed equation modeling path analysis method. The study's statistical population consisted of all patients diagnosed with diabetes who referred to the International Iranian Diabetes Control and Prevention Foundation located in the Milad Clinic, in Mashhad during the first half of 2018 (n = 5600). Material ans Methods: Using the convenience sampling method, 392 eligible cases were selected among 5600 patients. Participants assessed with illness perception questionnaire, Lazarus and Folkman stress coping inventory, Tangney's self-Control scale, the multidimensional scale of perceived social support, patient-doctor relationship questionnaire-9, and the medication adherence rating scale-5. Statistical Analysis Used: SPSS20 and AMOS software were used to process and analyze the gathered data using structural equation modeling path analysis and the Sobel test. Results: Findings confirmed the mediating role of illness perception concerning the relationship between psychosocial factors and medical adherence in patients diagnosed with type II diabetes (P < 0.05). Social support can positively impact patients' illness perception (beta = 0.2). The emotion-focused coping style has a significant, negative, and direct effect on illness perception (beta = 0.13). It was found that self-control, problem-focused style, and the doctor-patient relationship had no significant effect on illness perception (P > 0.05). Conclusion: This study's findings suggest psychosocial factors including stress coping styles, social support, the patient-doctor relationship, and self-control associated with medical adherence. Moreover, the impact of psychological factors on medical adherence increases with higher illness perception.