The roles of diabetes-specific self-compassion, affect balance, and self-care self-efficacy in psychological distress among Hong Kong patients with Type 2 diabetes.

Abstract

Patients with Type 2 diabetes (T2D) often blame themselves for their conditions and not reaching their self-management goals. Guided by the self-regulation resource model, self-compassion facilitates adjustments to chronic diseases through increasing affective and cognitive resources like positive affect and self-care self-efficacy. However, the contributions of positive and negative self-compassion (PSC and NSC) in psychological adjustment among patients with T2D have not been examined. Studies also suggest that patients with T2D experience positive changes from their illness journey (i.e., posttraumatic growth), but whether posttraumatic growth explains the link between self-compassion and psychological adjustment has not been understood. This study examined the associations between PSC / NSC and psychological distress among Hong Kong patients with T2D and explore whether affect balance (i.e., how positive affect outweighed negative affect), self-care self-efficacy, and posttraumatic growth mediated such associations. A sample of 416 patients with T2D recruited from public hospitals in Hong Kong completed a cross-sectional survey measuring the aforementioned variables. Multiple mediation analyses were conducted using SPSS Process Macro Model 4. From correlation analysis, NSC, but not PSC, was associated with psychological distress. Mediation model results indicated that the relationships between PSC / NSC and psychological distress were significantly mediated by affect balance and self-care self-efficacy. However, posttraumatic growth did not mediate the relationship between self-compassion and psychological distress. The direct effect from NSC, but not PSC, on psychological distress remained significant after accounting for the mediators. NSC contributed more than PSC to psychological distress among Hong Kong patients with T2D. Self-care self-efficacy and affect balance, but not posttraumatic growth, significantly mediated the associations between both aspects of self-compassion and psychological distress. Interventions guiding patients to reduce NSC, develop skills for self-care activities, and facilitate positive affect might improve psychological distress among Hong Kong patients with T2D.