Diabetes has a significant negative impact on mental health and quality of life (QoL). Underpinned by the Common Sense Model (CSM) the mediating role of coping patterns, self-efficacy, anxiety and depression symptoms on the relationship between illness perceptions and QoL in patients diagnosed with diabetes was evaluated. A total of 115 participants with diabetes (56, Type 1; 59, Type 2), 51% female and average age of 52.69 (SD=15.89) in Australia completed self-report measures of illness perceptions and psychological wellbeing. Baseline measures included illness perceptions, coping styles, psychological distress (anxiety and depression symptoms), self-efficacy, and quality of life.Mediating relationships were measured using structural equation modelling. A model of good fit was identified explaining 51% of variation in QoL. Illness perceptions directly influenced QoL, maladaptive coping, self-efficacy, and anxiety symptoms. The relationship between: illness perceptions and QoL was partially mediated by anxiety; illness perceptions and depression was fully mediated by maladaptive coping and self-efficacy; and self-efficacy and QoL was partially mediated by depressive symptoms. Findings provide validation of the CSM in a diabetes cohort. Psychological interventions likely to have most benefit on psychological distress and QoL are those targeting mediating psychological processes, including maladaptive coping and self-efficacy.

Level V, descriptive study.

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Background and Purpose: Stroke can have a devastating impact on the mental and physical health of stroke survivors and their carers. We aimed to evaluate the effectiveness of a novel psychosocial intervention designed to improve health outcomes in both groups. Methods:We conducted a randomized controlled trial of a personalized psychosocial intervention (8 one hour weekly sessions plus 1 booster) compared to usual care for adult stroke survivors and carers. Participants recruited from hospital services and community referrals completed questionnaires at baseline, 3, 6 and 12 months. Primary outcomes were quality of life and self-efficacy; secondary outcomes were depressive and anxiety symptoms, coping, illness perception, work and social adjustment, carer strain and carer satisfaction.Mixed-effect model repeated measures analysis between groups and across time was conducted.Results: Of the 173 participants recruited (89 stroke survivors; 84 carers), a total of 137 participants -73 stroke survivors (intervention n=42; usual care n=31) and 64 carers (intervention n=35; usual care n=29) -underwent analysis up to 12 months. No statistically significant differences were found in the primary outcomes between groups over time, though a significant improvement in carer satisfaction was found at 6 months in the intervention group compared to the usual care group. Conclusion:A personalized psychosocial intervention resulted in a significant improvement in carer satisfaction at 6 months but in no other outcomes. A lack of available services and barriers to social engagement may have impeded the effectiveness of this intervention.

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