August 16, 2017
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Self-compassion improves psychological well-being, self-management in diabetes

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In adults with type 1 and type 2 diabetes, a high level of self-compassion predicts a higher psychological well-being and is a predicter for several diabetes self-management behaviors, according to findings from a cross-sectional study in Australia.

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“The demands of managing diabetes emphasize the need for self-compassion,” Madeleine Ferrari, DClinPsy, MPhil, a lecturer in the School of Psychology at Australian Catholic University in Strathfield, New South Wales, and colleagues wrote. “High internal locus of control and knowledge may promote persistence at self-management behavior, yet in the event of inevitable hypoglycemia or a health complication, such personal responsibility may turn into self-criticism and self-blame. Clinical psychology research argues these responses weaken a person’s emotional resilience, which in the context of diabetes is likely to weaken one’s ability to recover and persist at their self-management plan in times of crisis.”

Ferrari and colleagues analyzed data from 310 adults with type 1 and type 2 diabetes who completed a series of online questionnaires between May and December 2015 (mean age, 37 years; 81.3% women; 69.7% Australian; 65.5% with type 1 diabetes). Most participants used insulin therapy (44.8%) and diet and exercise (31.6%) for disease management; mean HbA1c for the cohort was 7.7%. Participants completed the 12-item Self-Compassion Scale-Short Form, the 16-item Diabetes Self-Management Questionnaire, the 22-item Well-Being Questionnaire, the Diabetes Family Behavior Checklist and the 18-item Diabetes Locus of Control Scale. Researchers measured three primary outcomes: self-reported HbA1c, self-management behavior and psychological well-being, and used multiple regression models with a backward elimination procedure to identify the predictive value of each variable on diabetes self-care behavior.

Researchers found that self-compassion was positively correlated with higher well-being (r = 0.74), lower HbA1c (r = –0.23) and higher engagement with all self-management behaviors including dietary care (r = 0.36) and physical activity (r = 0.31).

In linear multiple regression analyses with backward elimination, researchers found that self-compassion, high school education, technical and further education and undergraduate education predicted 12.1% of the variance in self-management behavior scores, whereas self-compassion, social support and education predicted 16.1% of the variance in physical activity engagement. Sex, internal locus of control, powerful others locus of control, chance locus of control, self-compassion and technical and further education predicted 60% of the variance in well-being.

In individual regression analyses with only self-compassion as a predictor, researchers found that self-compassion predicted a high proportion of the variance for well-being (r² = 55.1%; P < .001), but a lower proportion for the self-management total score (10.5%) and physical activity engagement (9.2%). Self-compassion also predicted a smaller proportion of the variance for HbA1c (5.1%), health care use (4.1%) and glucose management (1.9%), according to researchers.

The researchers noted that HbA1c was self-reported by participants and 23% did not report HbA1c values.

“Taken together, the present results indicate that self-compassion is a psychological construct that relates to a range of general positive mental and physical outcomes for adults with diabetes,” the researchers wrote. “An internal locus of control was also related to beneficial outcomes; however, these relationships were generally weaker and not present for overall self-management behavior, healthcare use and glucose management. Thus, although developing a high internal locus of control and perceived ability to manage one’s health condition remains relevant and of importance, self-compassion seems to be a more globally relevant construct.” – by Regina Schaffer

Disclosures: The authors report no relevant financial disclosures.