Department of Health Policy, Health Management College, Harbin Medical University, 157 Baojian Road, Nangang District, Harbin, Heilongjiang, China.
Department of Social Medicine, School of Public Health, Harbin Medical University, 157 Baojian Road, Nangang District, Harbin, Heilongjiang, China.
Health Qual Life Outcomes. 2021 Nov 12;19(1):254. doi: 10.1186/s12955-021-01881-y.
Elderly patients with type 2 diabetes mellitus are highly vulnerable due to severe complications. However, there is a contradiction in the relationship between social support and quality of life, which warrants further exploration of the internal mechanism. This study assessed the quality of life and its interfering factors in this patient population.
In total, 571 patients with type 2 diabetes mellitus over 60 years old were recruited from two community clinics in Heilongjiang Province, China. We collected data on health status, quality of life, self-management behavior, fasting plasma glucose (FPG) level, and social support. Structural equation modeling and the bootstrap method were used to analyze the data.
The average quality of life score was - 29.25 ± 24.41. Poorly scored domains of quality of life were "Psychological feeling" (- 8.67), "Activity" (- 6.36), and "Emotion" (- 6.12). Of the 571 patients, 65.32% had normal FPG, 9.8% had high-risk FPG, 15.94% had good self-management behavior, and 22.07% had poor social support. Significant correlations among social support, self-management behavior, FPG level, and quality of life were noted. A multiple mediator model revealed that social support influenced quality of life in three ways: (1) directly (c' = 0.6831); (2) indirectly through self-management behavior (a1b1 = 0.1773); and (3) indirectly through FPG control (a2b2 = 0.1929). Self-management behavior influenced the quality of life directly and indirectly through FPG control.
Improving self-management behavior and monitoring hypoglycemia should become priority targets for future intervention. Scheduled social support to self-management projects should be put into the standardized management procedure. Physicians should provide substantial and individualized support to the elderly patients with type 2 diabetes mellitus regarding medication, blood glucose monitoring, and physical exercise.
老年 2 型糖尿病患者由于严重并发症而非常脆弱。然而，社会支持与生活质量之间存在矛盾关系，这需要进一步探讨其内在机制。本研究评估了该人群的生活质量及其影响因素。
共纳入中国黑龙江省 2 家社区诊所的 571 名 60 岁以上 2 型糖尿病患者。我们收集了健康状况、生活质量、自我管理行为、空腹血糖（FPG）水平和社会支持的数据。采用结构方程模型和自举法进行数据分析。
平均生活质量评分为-29.25±24.41。生活质量评分较差的领域包括“心理感受”（-8.67）、“活动”（-6.36）和“情绪”（-6.12）。571 例患者中，65.32%的 FPG 正常，9.8%的 FPG 处于高风险，15.94%的自我管理行为良好，22.07%的社会支持较差。社会支持、自我管理行为、FPG 水平与生活质量之间存在显著相关性。多中介模型显示，社会支持通过三种方式影响生活质量：（1）直接影响（c'=0.6831）；（2）通过自我管理行为间接影响（a1b1=0.1773）；（3）通过 FPG 控制间接影响（a2b2=0.1929）。自我管理行为通过 FPG 控制直接和间接影响生活质量。
改善自我管理行为和监测低血糖应成为未来干预的重点目标。应将有计划的社会支持纳入自我管理项目的规范化管理程序。医生应为老年 2 型糖尿病患者提供关于药物治疗、血糖监测和体育锻炼的实质性和个性化支持。
