Medical adherence in relationship with illness perception and self-control: Patients with type 2 diabetes

Document Type : Research Paper

Authors

1 Ph.D. student, Department of Psychology, Islamic Azad University, Roudehen Branch, Tehran, Iran.

2 Associate professor, Department of Psychology, Medical Sciences Branch, Islamic Azad University, Tehran, Iran.

10.22038/JFMH.2025.85568.3208

Abstract

Introduction: Effective management of type 2 diabetes largely depends on patients’ adherence to treatment recommendations, including medication use, dietary guidelines, physical activity, and blood glucose monitoring. However, adherence is not solely a behavioral matter; it is also significantly influenced by psychological factors, particularly patients’ perceptions of their illness and their capacity for self-regulation. This study aimed to examine the relationship between treatment adherence, illness perception, and self-control in patients with type 2 diabetes.
 
Materials and Methods: This descriptive-correlational study was conducted among 270 patients with type 2 diabetes who attended healthcare centers in District 4 of Tehran between 2022 and 2023. Participants were selected through the convenience sampling method. The research instruments included the Illness Perception Questionnaire, the Treatment Adherence Scale, and the Self-Control Scale. We analyzed the data using Pearson correlation coefficients, multiple regression analyses, and SPSS version 22.
 
Results: The findings showed that several dimensions of illness perception—such as timeline, treatment control, self-control, concern, and emotional representation—significantly predicted treatment adherence and collectively accounted for 51% of its variance. In addition, self-control was found to be a significant positive predictor, explaining 37% of the variance in treatment adherence, underscoring its essential role in maintaining consistent health-related behaviors.
 
Conclusion: These results highlight the critical influence of psychological factors in the management of type 2 diabetes. Interventions designed to improve treatment adherence should incorporate components that strengthen self-control and positively reshape patients’ perceptions of their illness to enhance health outcomes.

Keywords

References

  1. Joshi SR. RSSDI textbook of diabetes mellitus. India: Jaypee Brothers Medical Publishers; 2020.
  2. Bagherifard F, Kazemian Moghadam K, Safarzadeh S, Bahari F. [Comparison the effectiveness of unified transdiagnostic treatment and hope therapy on self-care activities and reducing cognitive-behavioral avoidance in patients with type 2 diabetes]. Journal of research in behavioural sciences 2023; 21(2): 200-14. (Persian)
  3. Dehghani Z, Mardani Z, Rezvanian H. [The effectiveness of compassion focused therapy on improving treatment adherence and blood lipids (cholesterol, triglycerides, LDL, and HDL) in patients with type 2 diabetes]. Quarterly journal of health psychology 2024; 13(2): 77-96. (Persian)
  4. Seyitoglu DC, Gunes G, Gokce A, Tekin Ç. Glycemic control and coping with stress in type 2 diabetes patients. International journal of community medicine and public health 2018; 5(2): 466.
  5. Hagger MS, Orbell S. The common sense model of illness self-regulation: A conceptual review and proposed extended model. Health Psychol Rev 2022; 16(3): 347-77.
  6. Gu X, Shen X, Zhou J-R, Chu J-H, Jiang L. The effects of common-sense model interventions on cancer patients: A systematic review. Medicine 2024; 103(17): e37777.
  7. Kim H, Sereika SM, Lingler JH, Albert SM, Bender CM. Illness perceptions, self-efficacy, and self-reported medication adherence in persons aged 50 and older with type 2 diabetes. J Cardiovasc Nurs 2021; 36(4): 312-28.
  8. Sawyer AT, Harris SL, Koenig HG. Illness perception and high readmission health outcomes. Health Psychol Open 2019; 6(1): 2055102919844504.
  9. Coventry PA, Young B, Balogun-Katang A, Taylor J, Brown JV, Kitchen C, et al. Determinants of physical health self-management behaviours in adults with serious mental illness: A systematic review. Front Psychiatry 2021; 12: 723962.
  10. Mortelmans L, Goossens E, Dilles T. Effect of an in-hospital medication self-management intervention (SelfMED) on medication adherence in polypharmacy patients postdischarge: protocol of a pre-post intervention study. BMJ Open 2024; 14(5): e083129.
  11. Zada A, Shafique F, Nadeem E. The impact of illness perception on self-care management and adherence to medication among patients: The moderating role of self-efficacy. Journal of health and rehabilitation research 2024; 4(2): 1821-8.
  12. Stevens JP. Intermediate statistics: A modern approach. New York: Routledge; 2013.
  13. Broadbent E, Petrie KJ, Main J, Weinman J. The brief illness perception questionnaire. J Psychosom Res 2006; 60(6): 631-7.
  14. Fatemi NS, Rafii F, Hajizadeh E, Modanloo M. Psychometric properties of the adherence questionnaire in patients with chronic disease: A mix method study. Koomesh 2018; 20(2): e152948.
  15. Tangney JP, Baumeister RF, Boone AL. High self- control predicts good adjustment, less pathology, better grades, and interpersonal success. J Pers 2004; 72: 271-324. 
  16. Asgarian FS, Namdari M, Soori H. Reliability and validity of Persian version of Brief Self-Control Scale (BSCS) in motorcyclists. Int J Psychiatry Clin Pract 2020; 24(2): 176-82.
  17. Alharbi S, Alhofaian A, Alaamri MM. Illness perception and medication adherence among adult patients with type 2 diabetes mellitus: a scoping review. Clin Pract 2023; 13(1): 71-83.
  18. Zhao M, Zhao J, Chen J, Li M, Zhang L, Luo X, et al. The relationship between medication adherence and illness perception in breast cancer patients with adjuvant endocrine therapy: Beliefs about medicines as mediators. Support Care Cancer 2022; 30(12): 10009-17.
  19. Alwatify S, Radhi M. Diabetes self-management and its association with medication adherence in diabetic patients. Iranian journal of war and public health 2025; 17(1): 17-22.
Fundamentals of Mental Health
Volume 27, Issue 6
November and December 2025
Pages 369-374

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