Understanding the Impact of Illness Perception on Health-Promoting Behaviors in Type 2 Diabetes: A Life Orientation Perspective

This study examined the relationship between illness perception and health-promoting behaviors in individuals with type 2 diabetes mellitus (T2DM), with a focus on the mediating role of life orientation. A cross-sectional, quantitative research design was employed, involving 300 adult patients diagnosed with T2DM from urban and semi-urban clinics in South Punjab, Pakistan. Participants completed validated Urdu versions of the Revised Illness Perception Questionnaire (IPQ-R), the Life Orientation Test–Revised (LOT-R), and a health-promoting lifestyle profile. Data were analyzed using Pearson correlation, multiple regression, and PROCESS macro for mediation analysis. Findings indicated that negative illness perceptions—particularly beliefs about severe consequences and lack of control—were significantly associated with lower engagement in health-promoting behaviors such as physical activity, nutrition, stress management, and interpersonal relations. Life orientation was positively correlated with all health behavior domains and significantly mediated the relationship between illness perception and health-promoting lifestyle practices. Specifically, dispositional optimism attenuated the negative impact of maladaptive illness beliefs on self-care behaviors. The results underscore the importance of addressing both cognitive and dispositional psychological factors in diabetes management. Interventions that correct maladaptive illness perceptions and simultaneously enhance optimism may improve patient adherence and long-term outcomes. Given the sociocultural context of Pakistan, these findings support the development of culturally sensitive, person-centered education and counselling strategies. Future research employing longitudinal or mixed-method designs is recommended to establish causal relationships and inform targeted psychological interventions for individuals living with T2DM.