Table 2 Old and new factor structure with factor loadings

Consequences

External Consequences [(EXT) CON]: (relationships/work/family)

1. My diabetes reduces the control I have over my life.

.287

2. My diabetes has harmed my relationship with others close to me.

.820

3. My diabetes has caused difficulties in my relationships with family and friends.

.941

4. My diabetes has caused my relationships with family and friends to be less close.

.866

5. My diabetes reduces my participation in social activities within the community.

.384

Internal Consequences [(PL)CON]: personal life consequences

6. My diabetes takes away the ability to enjoy food in my daily life.

.347

7. My diabetes has taken away my ability to eat the food I grew up eating.

.478

8. My diabetes is a serious condition.

.816

9. My diabetes has major consequences on my life.

.681

Personal Control

Control [CONT (PC&TC)]: PC refers to control through family and self, while TC refers to control through medications

PC

10. My friends and family encourage me to manage my diabetes.

.558

11. I have the power to influence my diabetes.

.486

Treatment Control

TC

12. Medications can help with my diabetes.

.472

13. Medications can help me survive with my diabetes.

.473

14. My treatment will be effective in curing my diabetes.

.512

15. The negative effects of my diabetes can be prevented (avoided) by my treatment.

.526

16. My treatment can control my diabetes.

.328

SCI

17. SCI: As a black person, I have to advocate for myself if I want to live with diabetes

.428

Illness Coherence

Illness Interpretation (II) Active process of interpretation of illness

18. I understand how I get diabetes.

.248

.405

19. I have a clear picture or understanding of my condition.

20. It is important not to worry about my diabetes so as to protect my physical and mental health.

.315

21. Faith in God helps control my diabetes.

.441

22. God helps me not to worry about my diabetes.

.457

Emotional Representations

Present Emotional Representations (ERp): current feelings and worries

23. It is hard for me to accept that I have diabetes.

.455

24. It makes me mad that I have to change my life because of diabetes.

.721

25. I am frustrated while having diabetes.

.718

26. I am depressed because I have diabetes.

.726

27. My diabetes controls my life.

.536

28. I am upset I have diabetes.

.547

29. I am concerned about dying from my diabetes.

.357

30. I am worried about my children/grandchildren getting diabetes.

.562

31. I get depressed when I think about my diabetes.

.894

32. When I think about my diabetes I get upset.

1.023

33. My diabetes makes me feel angry.

.947

34. Having this diabetes makes me feel anxious.

.526

35. My diabetes makes me feel afraid.

.608

Future Emotional Representations (ERf): Worries about future complications & outcomes

36. I am scared of having complications from my diabetes.

.560

37. The experiences of my family and friends has led me to fear diabetes complications.

.602

38. Having diabetes makes me worry about my future.

.603

39 I am worried my diabetes will stop me from seeing my children and grandchildren grow up.

.617

None

Sociocultural Influences (SCI):

40. Being Black decreases my chances of knowing about diabetes control.

.830

41. Being Black reduces my chances of getting information about diabetes.

.982

42. Being Black makes me more likely to get diabetes.

.436

43. Diabetes is a disease not discussed within the Black community.

.355

44. My friends and family discourage me from being open about my diabetes.

.341

45. Being poor contributed to my getting diabetes.

.479

Timeline (Acute/Chronic)

Timeline

46. My diabetes is likely to be permanent rather than temporary.

.577

47. My diabetes will last for a long time.

.957

48. I expect to have diabetes for the rest of my life.

.751

49. Nothing can make my diabetes go away.

.188

Timeline Cyclical

Timeline Cyclical

50. The symptoms of my diabetes change a great deal from day to day.

.778

51. My symptoms come and go in cycles.

.695

52. My diabetes is very unpredictable.

.691

53. I go through cycles in which my diabetes gets better and worse.

.412

54. My diabetes is a big part of who I am.

.332