---
title: "Illness Perception, Resignation Coping, and Social Support Linked to Self‑Regulatory Fatigue in Ty"
id: "pubmed-42669206"
canonical_url: "https://medichelpline.com/clinical-feed/pubmed-42669206"
content_type: "clinical_feed_article"
specialty: "Pharmacology"
source_name: "PubMed / NCBI"
source_url: "https://pubmed.ncbi.nlm.nih.gov/42669206/"
doi: "10.1002/nop2.70781"
published_at: "2026-09-01T00:00:00.000Z"
evidence_level: "Journal Article"
license: "CC-BY-NC-4.0 / Informational Use"
---
# Illness Perception, Resignation Coping, and Social Support Linked to Self‑Regulatory Fatigue in Ty
## Provenance & Clinical Metadata
- **Canonical URL:** https://medichelpline.com/clinical-feed/pubmed-42669206
- **Specialty:** [Pharmacology](https://medichelpline.com/clinical-feed/pharmacology.md)
- **Primary Source:** PubMed / NCBI
- **Source URL:** [Original Journal Publication](https://pubmed.ncbi.nlm.nih.gov/42669206/)
- **DOI:** [10.1002/nop2.70781](https://doi.org/10.1002%2Fnop2.70781)
- **Published At:** 2026-09-01T00:00:00.000Z
- **Evidence Rating:** Journal Article
## Executive GIST (TL;DR)
- This cross-sectional study examined relationships among **illness perception**, **resignation coping**, **social support**, and **self‑regulatory fatigue (SRF)** in adults with Type 2 diabetes (T2DM). - A convenience sample of 302 T2DM patients was recruited from a tertiary general hospital in China between November 2024 and October 2025. - Validated measures used: Brief Illness Perception Questionnaire, Medical Coping Modes Questionnaire, Perceived Social Support Scale, and Self‑Regulatory Fatigue Scale. - Spearman correlations showed SRF positively correlated with negative illness perception (r = 0.579) and resignation coping (r = 0.612), and negatively correlated with social support (r = -0.598); all correlations p < 0.01. - Serial mediation analysis (PROCESS Model 6 with bias-corrected bootstrapping) found that illness perception was associated with SRF indirectly via resignation coping and social support, both individually and sequentially. - A serial mediation model adjusted for gender, age, education, diabetes duration, diabetes‑related complications, and other chronic comorbidities; model R2 values: Resignation coping = 0.467, Social support = 0.311, Self‑Regulatory Fatigue = 0.565. - Authors conclude negative illness perception is linked to higher SRF and that behavioural (resignation coping) and resource (social support) factors mediate this association. - Implication: integrated nursing assessment and interventions targeting illness beliefs, maladaptive coping, and social support may reduce SRF and support diabetes self‑management. - The study followed STROBE reporting for cross‑sectional studies; patients provided written informed consent and participated only as survey respondents. - Conflict of interest: authors declared none.
## Clinical Analysis & Structured Key Points
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Affiliations Expand ### Affiliations * 1 School of Nursing, Guangdong Pharmaceutical University, Guangzhou, China. * 2 Science and Education Section, Dongguan Eighth People's Hospital (Dongguan Children's Hospital), Dongguan, China. * PMID: **42669206** * PMCID: [ PMC13526466 ](https://pmc.ncbi.nlm.nih.gov/articles/PMC13526466/) * DOI: [ 10.1002/nop2.70781 ](https://doi.org/10.1002/nop2.70781) Item in Clipboard # Associations of Illness Perception, Resignation Coping, and Social Support With Self-Regulatory Fatigue in Patients With Type 2 Diabetes: A Cross-Sectional Study Qian Liu et al. Nurs Open. 2026 Sep. Show details Display options Display options Format Abstract PubMed PMID Nurs Open Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Nurs+Open%22%5Bjour%5D&sort=date&sort_order=desc) * [ Search in NLM Catalog ](https://www.ncbi.nlm.nih.gov/nlmcatalog?term=%22Nurs+Open%22%5BTitle+Abbreviation%5D) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42669206/) . 2026 Sep;13(9):e70781. doi: 10.1002/nop2.70781. ### Authors [Qian Liu](https://pubmed.ncbi.nlm.nih.gov/?term=Liu+Q&cauthor_id=42669206)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42669206/#short-view-affiliation-1 "School of Nursing, Guangdong Pharmaceutical University, Guangzhou, China."), [Yijing Zhou](https://pubmed.ncbi.nlm.nih.gov/?term=Zhou+Y&cauthor_id=42669206)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42669206/#short-view-affiliation-1 "School of Nursing, Guangdong Pharmaceutical University, Guangzhou, China."), [Bing Li](https://pubmed.ncbi.nlm.nih.gov/?term=Li+B&cauthor_id=42669206)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42669206/#short-view-affiliation-1 "School of Nursing, Guangdong Pharmaceutical University, Guangzhou, China."), [Qiuru Zhuang](https://pubmed.ncbi.nlm.nih.gov/?term=Zhuang+Q&cauthor_id=42669206)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42669206/#short-view-affiliation-1 "School of Nursing, Guangdong Pharmaceutical University, Guangzhou, China."), [Zhier Lin](https://pubmed.ncbi.nlm.nih.gov/?term=Lin+Z&cauthor_id=42669206)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42669206/#short-view-affiliation-1 "School of Nursing, Guangdong Pharmaceutical University, Guangzhou, China."), [Zhenrong Zhang](https://pubmed.ncbi.nlm.nih.gov/?term=Zhang+Z&cauthor_id=42669206)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42669206/#short-view-affiliation-1 "School of Nursing, Guangdong Pharmaceutical University, Guangzhou, China."), [Xiaoying Yan](https://pubmed.ncbi.nlm.nih.gov/?term=Yan+X&cauthor_id=42669206)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42669206/#short-view-affiliation-1 "School of Nursing, Guangdong Pharmaceutical University, Guangzhou, China."), [Kun Zeng](https://pubmed.ncbi.nlm.nih.gov/?term=Zeng+K&cauthor_id=42669206)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42669206/#short-view-affiliation-1 "School of Nursing, Guangdong Pharmaceutical University, Guangzhou, China.")[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42669206/#short-view-affiliation-2 "Science and Education Section, Dongguan Eighth People's Hospital \(Dongguan Children's Hospital\), Dongguan, China."), [Weiyan Yuan](https://pubmed.ncbi.nlm.nih.gov/?term=Yuan+W&cauthor_id=42669206)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42669206/#short-view-affiliation-1 "School of Nursing, Guangdong Pharmaceutical University, Guangzhou, China.") ### Affiliations * 1 School of Nursing, Guangdong Pharmaceutical University, Guangzhou, China. * 2 Science and Education Section, Dongguan Eighth People's Hospital (Dongguan Children's Hospital), Dongguan, China. * PMID: **42669206** * PMCID: [ PMC13526466 ](https://pmc.ncbi.nlm.nih.gov/articles/PMC13526466/) * DOI: [ 10.1002/nop2.70781 ](https://doi.org/10.1002/nop2.70781) Item in Clipboard Full text links Cite Display options Display options Format Abstract PubMed PMID ## Abstract **Aims:** To examine the associations among illness perception, resignation coping, social support, and self-regulatory fatigue (SRF) in patients with Type 2 diabetes mellitus. The study specifically explores whether resignation coping and social support exhibit indirect associations with SRF in the context of illness perception. **Design:** A cross-sectional study. **Methods:** From November 2024 to October 2025, a convenience sample of 302 adult patients with T2DM was recruited from a tertiary general hospital in China. Participants completed validated instruments with established psychometric properties, namely the Brief Illness Perception Questionnaire, the Medical Coping Modes Questionnaire, the Perceived Social Support Scale, and the Self-Regulatory Fatigue Scale. Statistical analyses included Spearman correlation and serial mediation analysis using the PROCESS Macro (Model 6) with bias-corrected bootstrapping. **Results:** SRF was positively correlated with negative illness perception (r = 0.579, p < 0.01) and resignation coping (r = 0.612, p < 0.01), and negatively correlated with social support (r = -0.598, p < 0.01). Serial mediation analysis revealed that illness perception was associated with SRF through indirect pathways involving resignation coping and social support. Resignation coping and social support mediated the association between illness perception and self-regulatory fatigue, both individually and sequentially. **Conclusions:** Negative illness perception correlates with higher SRF. This observed correlation is additionally linked to indirect pathways involving resignation coping and lower social support. Collectively, these findings highlight a pattern of interrelated cognitive (illness perception), behavioural (resignation coping), and resource (social support) factors that are associated with self-regulatory fatigue in this cross-sectional study. **Implications for the profession:** The findings offer a clear, evidence-based framework for nursing practice. They highlight the potential value of integrated assessment and intervention that simultaneously addresses patients' illness beliefs, maladaptive coping strategies, and social support systems, which are associated with lower SRF and better diabetes self-management. **Reporting method:** This study adheres to the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines for cross-sectional studies. **Patient or public contribution:** Patients participated solely as research participants by providing survey data. They were not involved in the study design, implementation, data analysis, interpretation, or manuscript preparation. All patients provided written informed consent prior to questionnaire completion. **Keywords:** Type 2 diabetes; coping style; illness perception; self‐regulatory fatigue; social support. © 2026 The Author(s). Nursing Open published by John Wiley & Sons Ltd. [PubMed Disclaimer](https://pubmed.ncbi.nlm.nih.gov/disclaimer/) ## Conflict of interest statement The authors declare no conflicts of interest. ## Figures [ ![FIGURE 1](https://cdn.ncbi.nlm.nih.gov/pmc/blobs/017e/13526466/d9750bbd0ce9/NOP2-13-e70781-g001.gif) ](https://cdn.ncbi.nlm.nih.gov/pmc/blobs/017e/13526466/72c3b702b15e/NOP2-13-e70781-g001.webp) ** FIGURE 1 ** Serial mediation model for illness… ** FIGURE 1 ** Serial mediation model for illness perception, social support, resignation coping and self‐regulatory fatigue.… **FIGURE 1** Serial mediation model for illness perception, social support, resignation coping and self‐regulatory fatigue. Path coefficients were shown in standardized regression coefficients. ***_p_ < 0.001, *_p_ < 0.05. All paths were adjusted for gender, age, educational level, diabetes duration, diabetes‐related complications, and other chronic comorbidities. _R_ 2: Resignation coping = 0.467, Social Support = 0.311, Self‐Regulatory Fatigue = 0.565. [See this image and copyright information in PMC](https://pubmed.ncbi.nlm.nih.gov/42669206/) ## Similar articles * [ Effect of illness perception on self-regulatory fatigue in older adult patients with hypertension: chain-mediating role of self-efficacy and coping style. ](https://pubmed.ncbi.nlm.nih.gov/41480063/) Lu T, Shi L, Zhang H, Zhang J, Shen Y.Lu T, et al.Front Public Health. 2025 Dec 17;13:1728453. doi: 10.3389/fpubh.2025.1728453. eCollection 2025.Front Public Health. 2025.PMID: 41480063Free PMC article. * [ The mediating roles of personal mastery and health-promoting behaviors in the relationship between self-regulatory fatigue and quality of life among patients with type 2 diabetes mellitus. ](https://pubmed.ncbi.nlm.nih.gov/42139324/) Fang G, Gong W, Xia L, Li L, Sun P, Song J, Cui Y, Tang X, Wu Y, Li P, Zhang X, Ni X, Lu F, Ru J, Yin J, Li Y, Wang Z.Fang G, et al.PLoS One. 2026 May 15;21(5):e0349561. doi: 10.1371/journal.pone.0349561. eCollection 2026.PLoS One. 2026.PMID: 42139324Free PMC article. * [ Stress and Health-Related Quality of Life in Adults With Type 1 Diabetes: The Mediating Role of Perceived Support and Treatment Adherence. ](https://pubmed.ncbi.nlm.nih.gov/40970574/) Salas-Muriel R, De Santiago-Herrero FJ, García-Mateos MM, Del Sol Fortea Sevilla M, Jenaro C, Igartua JJ.Salas-Muriel R, et al.J Clin Nurs. 2026 Mar;35(3):1373-1381. doi: 10.1111/jocn.70114. Epub 2025 Sep 19.J Clin Nurs. 2026.PMID: 40970574Free PMC article. * [ Dyadic Coping and Its Influencing Factors in Patients With Prostate Cancer Undergoing Androgen Deprivation Therapy and Their Spouses: A Latent Class Analysis. ](https://pubmed.ncbi.nlm.nih.gov/42215288/) Chen H, Li Y, He H, Lin H, Song X, Li K.Chen H, et al.J Clin Nurs. 2026 Sep;35(9):3867-3878. doi: 10.1111/jocn.70378. Epub 2026 May 29.J Clin Nurs. 2026.PMID: 42215288Free PMC article.Review. * [ Behavioural modification interventions for medically unexplained symptoms in primary care: systematic reviews and economic evaluation. ](https://pubmed.ncbi.nlm.nih.gov/32975190/) Leaviss J, Davis S, Ren S, Hamilton J, Scope A, Booth A, Sutton A, Parry G, Buszewicz M, Moss-Morris R, White P.Leaviss J, et al.Health Technol Assess. 2020 Sep;24(46):1-490. doi: 10.3310/hta24460.Health Technol Assess. 2020.PMID: 32975190Free PMC article. [ See all similar articles ](https://pubmed.ncbi.nlm.nih.gov/?linkname=pubmed_pubmed&from_uid=42669206) ## References 1. 1. Abdollahi, F. , Bikdeli H., Zeabadi S. M., Sepasi R. R., Kalhor R., and Motalebi S. A.. 2022. “Predicting Role of Illness Perception in Treatment Self‐Regulation Among Patients With Type 2 Diabetes.” Journal of Preventive Medicine and Hygiene 63, no. 4: E604–E610. 10.15167/2421-4248/jpmh2022.63.4.2727. - [DOI](https://doi.org/10.15167/2421-4248/jpmh2022.63.4.2727) - [PMC](https://pmc.ncbi.nlm.nih.gov/articles/PMC9986977/) - [PubMed](https://pubmed.ncbi.nlm.nih.gov/36890999/) 2. 1. Almeida, A. C. , Leandro M. E., and Pereira M. G.. 2020. “Individual and Family Management in Portuguese Adolescents With Type 1 Diabetes: A Path Analysis.” International Journal of Behavioral Medicine 27, no. 4: 455–465. 10.1007/s12529-020-0
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