Cognitive Representations of Diabetes and their Role in Metabolic Control and Health: When a Positive View of Illness Protects

Abstract

A positive cognitive illness representation (CIR) of diabetes is associated with better metabolic control and health. The aims of this research were to assess CIR with a newly developed Spanish scale – the ERCE – and to predict metabolic control, health outcomes, and psychological distress. One hundred and fifty-two Type 1 diabetic patients were all administered the ERCE, the MOS SF-36, the PANAS, and the HADS scales. Data on glycated hemoglobin (HbA1c) were also collected. Scores on the ERCE led to the creation of two profiles (+/- CIR) by clustering the scores. After patients were grouped, multiple hierarchical regressions were performed. A negative view of diabetes (negative CIR) was associated with poor health outcomes. The ERCE scale demonstrated acceptable psychometric guarantees and validity evidences for being used in clinical contexts. This new instrument allows educators to adjust treatment to each individual, which leads to a more efficient and better support for people with diabetes in Spain.

Una representación cognitiva de la enfermedad (RCE) positiva se asocia con mejor control metabólico y mayor salud en diabetes. Los objetivos fueron evaluar la RCE con una nueva escala –la ERCE– y predecir el control metabólico, los indicadores de salud y el malestar psicológico en 152 pacientes diabéticos tipo 1. Se administraron la escala ERCE, la MOS SF-36, la PANAS y la HADS. Se recogió también la hemoglobina glicosilada (HbA1c). Mediante un análisis de clusters con las puntuaciones de la ERCE, se crearon dos perfiles (+/-RCE). El análisis de regresión jerárquico mostró que una visión negativa de la diabetes (RCE negativa) se asoció con peor estado de salud. La ERCE demostró garantías psicométricas y evidencias de validez aceptables, que justifican su uso en contextos clínicos. Este instrumento permite a los educadores evaluar la RCE y ajustar el tratamiento, lo que conduce a una asistencia más eficiente para las personas con diabetes en España.