Structural Equation Modeling of Diabetes Type 2 Related Stress: The Role of Worthlessness and Illness Perception with the Mediating Effect of Self-Compassion

Abstract

This study aimed to explain the structural relationships among feelings of worthlessness, illness perception, and diabetes-related stress, emphasizing the mediating role of self-compassion. This applied, quantitative, descriptive–analytical study used a correlational design. The statistical population included patients with type 2 diabetes attending selected medical centers in Tehran in 2024, from whom 333 participants were selected using convenience sampling. Instruments included the Diabetes Distress Scale (Polonsky, 2005), Self-Worth Questionnaire (Schwartz, 2006), Illness Perception Questionnaire (Broadbent, 2006), and Self-Compassion Scale (Neff, 2011). Data were analyzed using Pearson correlation and structural equation modeling with SPSS-27 and SmartPLS-3. Results indicated that feelings of worthlessness had a significant direct effect on diabetes-related stress (β = −0.759, t = 25.517), and illness perception showed a significant direct effect on stress (β = −0.713, t = 17.731). Self-compassion significantly mediated the relationships between worthlessness and stress (total effect = −1.365) and between illness perception and stress (total effect = −1.331). The structural model demonstrated satisfactory goodness of fit. Self-compassion substantially buffers the negative effects of worthlessness and negative illness perception on diabetes-related stress and represents a valuable psychological intervention target for improving mental health in patients with type 2 diabetes.