A dyadic multiple mediation model of patient and spouse stressors predicting patient dietary and exercise adherence via depression symptoms and diabetes self-efficacy
Open accessAbstract
Using dyadic data from 117 married couples in which one partner was diagnosed with Type 2 diabetes, the purpose of this study was to determine whether a number of specific patient and spouse stressors (chronic life stress, diabetes-specific stress, and physical health stress in the form of the number of comorbidities) were associated with Type 2 diabetes patients' dietary and exercise adherence through two potentially modifiable patient and spouse factors-depression symptoms and diabetes self-efficacy. We found that patient and spouse stressors, particularly patient and spouse diabetes stress and the number of patient comorbidities, were related to patient dietary and exercise adherence through patient depression symptoms and both patient and spouse diabetes self-efficacy. These conclusions were strengthened by incorporating a number of relevant control variables in our models and by testing four alternative models which supported our proposed model. These results are important because they provide further evidence of the significant role spouses' play in managing diabetes and they provide diabetes educators and clinicians with specific targets for intervention programming.
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Low coping self-efficacy is associated with passive coping, avoidance, lower treatment adherence, substance use, and other maladaptive coping strategies that may increase risk or course of depression.
“In contrast, low coping self-efficacy is associated with passive coping51, avoidance, lower treatment adherence52,53, substance use54, and other maladaptive coping strategies55 that may serve to increase risk or course of depression.”
From Psychobiological factors of resilience and depression in late life (2019) · cites this paper as [52]
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- Authors
- Anderson, J. R., Novak, J. R., Johnson, M. D., Deitz, S. L., Walker, A., Wilcox, A., Lewis, V. L., & Robbins, D. C.
- Affiliations
- Kansas State University (US)
- University of Alberta (CA)
- University of Kansas Medical Center (US)
- Corresponding author
- Anderson, Jared R.
- Venue
- Journal of Behavioral Medicine
- Published
- 2016-09-30
- Volume
- 39
- Issue
- 6
- Pages
- 1020-1032
- ISSN
- 0160-7715 (ISSN-L)
- 1573-3521
- PMC
- PMC6545584
- OpenAlex
- W2525669342
- Cited by
- 25
- References
- 70
- Citations by year
- 2026: 2 · 2025: 1 · 2024: 1 · 2023: 2 · 2022: 8 · 2021: 1 · 2020: 1 · 2019: 2 · 2018: 3 · 2017: 3 · 2016: 1
- FWCI
- 3.01
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Journal of Behavioral Medicine (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- Georgia Clinical and Translational Science Alliance
- National Institutes of Health (UL1TR000001)
- Institute for Clinical and Translational Research, University of Wisconsin, Madison
- National Center for Research Resources
- National Center for Advancing Translational Sciences
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
- Health Sciences › Medicine › Family Practice › Medication Adherence and Compliance
- Social Sciences › Psychology › Social Psychology › Attachment and Relationship Dynamics
- Keywords
- type 2 diabetes, dietary adherence, exercise adherence, depressive symptoms, diabetes self-efficacy, marital stress, comorbidities, married couples, dyadic mediation
- MeSH terms
- Adult, Depression, Diabetes Mellitus, Type 2, Diet, Female, Humans, Male, Middle Aged, Models, Psychological, Patient Compliance, Stress, Psychological, Exercise, Spouses, Self Efficacy
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