Bridging illness uncertainty and self-care: The role of cognitive emotion regulation in type 2 diabetes management

Prim Care Diabetes. 2025 Apr 25:S1751-9918(25)00084-1. doi: 10.1016/j.pcd.2025.04.001. Online ahead of print.

ABSTRACT

AIMS: This study assessed the mediating role of cognitive emotion regulation strategies in the relationship between illness uncertainty and diabetes health-promoting self-care behaviours.

METHODS: A cross-sectional study was conducted with 433 T2DM outpatients using the Mishel Uncertainty in Illness Scale, the Diabetes Health Promotion Self-Care Scale, and the Cognitive Emotion Regulation Questionnaire (CERQ). Data were analysed using SPSS (v.29) for descriptive and Pearson correlation tests, and Process Macro for SPSS (Model 4, v.4.2) for mediation analysis.

RESULTS: There is a statistically significant, weak negative relationship between illness uncertainty and diabetes health promotion self-care scores (r = -0.105, p = 0.029). CERQ showed a weak negative correlation with illness uncertainty scores, whereas the questionnaire demonstrated a statistically significant, moderate positive correlation with diabetes health-promoting self-care (p < 0.05). The relationship between illness uncertainty and diabetes health- promoting self-care was mediated by CERQ such as self-blame (β= 0.083, 95 % CI= 0.019 – 0.155), acceptance (β= -0.031, 95 % CI= -0.061 – -0.007), rumination (β= -0.107, 95 % CI= -0.179 – -0.048), and positive reappraisal (β= -0.043, 95 % CI= -0.091 – -0.001).

CONCLUSIONS: Illness uncertainty negatively impacts self-care behaviours in T2DM patients. CERQ, including self-blame, acceptance, rumination, and positive reappraisal, play a mediating role, highlighting their potential in interventions to improve self-care.

PMID:40287346 | DOI:10.1016/j.pcd.2025.04.001