Structural Relationships Among Self-Regulation, Psychological Distress, and Medication Adherence in Adults With Type 2 Diabetes Mellitus
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Objective: This study examined the associations among self-regulation, psychological distress, and medication adherence in adults with type 2 diabetes mellitus (T2DM).
Methods and Materials: This cross-sectional correlational study was conducted on 471 adults with T2DM selected through convenience sampling from outpatient diabetes clinics. Data were collected using the Self-Regulation Questionnaire, Kessler Psychological Distress Scale, and General Medication Adherence Scale. Structural equation modeling was performed to evaluate direct and indirect associations among variables. Multi-group analyses examined invariance across gender and age groups.
Findings: Participants demonstrated moderate self-regulation (M = 3.12, SD = 0.41) and medication adherence (M = 2.84, SD = 0.49), while psychological distress was high (M = 4.03, SD = 0.58). Structural equation modeling revealed that self-regulation was negatively associated with psychological distress (β = −0.34, SE = 0.07, p < .001) and positively associated with medication adherence (β = 0.38, SE = 0.09, p < .001). Psychological distress was negatively associated with medication adherence (β = −0.42, SE = 0.09, p < .001). Psychological distress partially mediated the relationship between self-regulation and medication adherence (β = 0.14, SE = 0.05, p < .001). The model explained 12% of the variance in psychological distress and 31% of the variance in medication adherence. Multi-group analyses showed invariance across gender and age (ΔCFI = 0.00).
Conclusion: Higher self-regulation is associated with lower psychological distress and better medication adherence among adults with T2DM. Psychological distress partially mediates this relationship, suggesting that interventions targeting emotional regulation may improve adherence outcomes.
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