title: Predicting Self-Rated Health in Diabetes and Chronic Heart Failure - A Multiple Mediation Model.
abstract: OBJECTIVE
  Self-rated health (SRH) is a powerful predictor of health-related outcomes such as morbidity and mortality. Aim of the current study was to examine the role of comorbidity, well-being, functional health, and physical limitations as possible predictors of SRH in diabetes and chronic heart failure (CHF).
  
  
  METHODS
  Three large samples with persons suffering from diabetes (n = 974), CHF (n = 955), or both diseases combined (n = 934) were analyzed longitudinally over the course of 4 months. To test the mediating effect of comorbidity, well-being, functional health, and physical limitations in association with former and future SRH multiple mediator models were applied.
  
  
  RESULTS
  Across all groups emotional well-being was a consistent and powerful determinant of SRH. The effects of functional health and physical limitations on SRH were also significant but varied between diagnostic groups. The number of comorbid diseases did not predict SRH.
  
  
  CONCLUSIONS
  Emotional well-being and physical health appraisal were strong predictors of SRH. Thus, SRH may be improved by influencing well-being and physical health appraisal via targeted interventions.
authors.affiliation: Department of Psychology, Freie Universität Berlin , Berlin , Germany.
authors.forename: Sylvia
authors.initials: S
authors.lastname: Böhme
authors.affiliation: Department of Psychology, Freie Universität Berlin , Berlin , Germany.
authors.forename: Babette
authors.initials: B
authors.lastname: Renneberg
keywords: chronic disease; comorbidity; functional health; multimorbidity; self-rated health; well-being