Huang Jing, Ding Shenglan, Xiong Shuyuan, Liu Zhiping
Department of Endocrinology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
Department of Nursing, Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China.
Front Psychol. 2021 Oct 20;12:697051. doi: 10.3389/fpsyg.2021.697051. eCollection 2021.
To explore the relationship between neuroticism and fear of hypoglycemia (FoH) among patients with type 2 diabetes (T2D), as well as the mediating effects of diabetes distress, anxiety, and cognitive fusion on the relationship between neuroticism and FoH. A total of 494 patients with T2D (39.9% females, = 197) were analyzed using the neuroticism scale of the Eysenck Personality Questionnaire-Revised Short Scale (EPQ-RS), the Fear of Hypoglycemia-15 Scale (FH-15), the Diabetes Distress Scale (DDS), the Self-Rating Anxiety Scale (SAS), and the Cognitive Fusion Questionnaire (CFQ). The bootstrapping method was used to test the separate and parallel mediation models. FoH was noted in 17.4% ( = 86) of patients. The correlations between neuroticism, diabetes distress, anxiety, cognitive fusion, and FoH were positive. Diabetes distress, anxiety, and cognitive fusion were significant mediators in the association between neuroticism and FoH in both separate and parallel mediation models. In the parallel mediation model, the mediating effect of anxiety was the highest, and the mediating effect of diabetes distress was the lowest, but no significant differences were found in the comparison of these three indirect effects. This study indicated that neuroticism not only directly affected FoH, but also indirectly influenced FoH the increase of diabetes distress, anxiety, and cognitive fusion in patients with T2D. The results provide a theoretical basis for the development of intervention programs to ameliorate patients' FoH directly and indirectly. Healthcare providers should be encouraged to develop appropriate programs based on improving diabetes distress, anxiety, and cognitive fusion to help patients with T2D improve FoH.
探讨2型糖尿病（T2D）患者的神经质与低血糖恐惧（FoH）之间的关系，以及糖尿病困扰、焦虑和认知融合在神经质与FoH关系中的中介作用。使用艾森克人格问卷修订简式量表（EPQ-RS）的神经质量表、低血糖恐惧-15量表（FH-15）、糖尿病困扰量表（DDS）、自评焦虑量表（SAS）和认知融合问卷（CFQ）对494例T2D患者（39.9%为女性，n = 197）进行分析。采用bootstrap法检验单独和并行中介模型。17.4%（n = 86）的患者存在FoH。神经质、糖尿病困扰、焦虑、认知融合与FoH之间的相关性均为正。在单独和并行中介模型中，糖尿病困扰、焦虑和认知融合在神经质与FoH的关联中均为显著中介变量。在并行中介模型中，焦虑的中介效应最高，糖尿病困扰的中介效应最低，但这三种间接效应的比较未发现显著差异。本研究表明，神经质不仅直接影响FoH，还通过增加T2D患者的糖尿病困扰、焦虑和认知融合间接影响FoH。研究结果为直接和间接改善患者FoH的干预方案制定提供了理论依据。应鼓励医疗服务提供者制定基于改善糖尿病困扰、焦虑和认知融合的适当方案，以帮助T2D患者改善FoH。
