Coping Strategies among Patients with Type 2 Diabetes Mellitus Attending Secondary Healthcare Facilities in Kaduna State, Nigeria: A Mixed-methods Cross-sectional Study

Background: Millions of individuals throughout the world suffer with diabetes mellitus (DM), which is a chronic and complex metabolic condition. It is one of the most prevalent non-communicable diseases in the world. Its rising prevalence puts a significant strain on patients and healthcare systems. This study explored the coping strategies used by patients with type 2 diabetes mellitus attending selected secondary healthcare facilities in Kaduna State, Nigeria. Objective: The aim was to identify dominant coping mechanisms and explore their perceived role in self-management from the patients' perspective. Methods: A mixed-method descriptive cross-sectional design was used. A multi-stage sampling technique was employed to select 332 adults with T2DM from secondary healthcare facilities in Kaduna South and Chikun Local Government Areas. The mean age of participants was 49.5 years (SD ± 12.3), and the majority were female (56.0%). Data were collected using the Brief COPE Inventory and open-ended questions. Quantitative data were analysed using descriptive statistics only (frequencies, percentages, means), and qualitative responses were thematically analysed. Results: Six major coping themes were identified. The most common were Constructive Engagement (236; 71.1%), Adaptive Cognitive Reframing (218; 65.7%), Social Support (204; 61.4%), and Spiritual and Religious Anchoring (192; 57.8%). Less frequent were Emotional Regulation and Distraction (138; 41.6%) and Withdrawal and Maladaptive Responses (94; 28.3%). Adaptive strategies reflected active problem-solving, acceptance, and reliance on social and faith networks, while maladaptive responses included denial, self-blame, and disengagement from self-care. Conclusion: Most participants demonstrated adaptive coping strategies. However, the presence of maladaptive coping in nearly one-third of participants highlights the need for targeted psychosocial interventions in diabetes care.