Enggarwati Pandan, Dahlia Debie, Maria Riri
Faculty of Nursing, Universitas Indonesia, Depok, West Java.
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J Public Health Res. 2021 Dec 1;11(2):2734. doi: 10.4081/jphr.2021.2734.
People with type 2 DM are at risk of experiencing depression, which in turn can affect their self-care activities. Recent evidence has shown that social support is beneficial in reducing the risk of depression and positively affecting increases in self-care activities. However, the role of social support in the relationship between depressive symptoms and self-care activities has not been studied. This study aims to determine the mediating effects of social support on the relationship between depressive symptoms and self-care activities of people with type 2 DM.
A cross-sectional consecutive sampling approach was used with 94 respondents with type 2 diabetes in East Jakarta, Indonesia, who were undergoing diabetes treatments during May-June 2020. The instruments used were the Centre for Epidemiologic Studies-Depression Scale (CES-D), Summary of Diabetes Self Care Activities (SDSCA), and Duke-UNC Functional Social Support Questionnaire (DUFSSQ). All three questionnaires have been tested for validity and reliability. Data analysis was carried out using multiple linear regression, path analysis, and the Sobel test.
The results of multiple linear regression analysis on the variables age, sex, education level, socioeconomic status, duration of type 2 DM, and complications of type 2 DM showed that only complications of type 2 diabetes affected self-care activities (p = 0,000; R2 = 0.515). The results of the path analysis and Sobel test showed that social support significantly mediated the effects of the relationship between depressive symptoms and self-care activities (z = -0,162 > table 1.96; direct effect = -0,499; indirect effect = -0,0789; total effect = 40, 3%).
Screening for depressive symptoms and interventions involving social support are strongly suggested for patients with type 2 DM who are suspected of showing a decline in self-care activities.
2型糖尿病患者有患抑郁症的风险，而抑郁症反过来又会影响他们的自我护理活动。最近的证据表明，社会支持有助于降低抑郁症风险，并对自我护理活动的增加产生积极影响。然而，社会支持在抑郁症状与自我护理活动之间的关系中所起的作用尚未得到研究。本研究旨在确定社会支持对2型糖尿病患者抑郁症状与自我护理活动之间关系的中介作用。
采用横断面连续抽样方法，对2020年5月至6月在印度尼西亚雅加达东部接受糖尿病治疗的94名2型糖尿病患者进行了调查。所使用的工具包括流行病学研究中心抑郁量表（CES-D）、糖尿病自我护理活动总结（SDSCA）和杜克大学-北卡罗来纳大学功能性社会支持问卷（DUFSSQ）。所有这三份问卷均经过了效度和信度测试。数据分析采用多元线性回归、路径分析和索贝尔检验。
对年龄、性别、教育水平、社会经济地位、2型糖尿病病程和2型糖尿病并发症等变量进行多元线性回归分析的结果表明，只有2型糖尿病并发症会影响自我护理活动（p = 0.000；R2 = 0.515）。路径分析和索贝尔检验的结果表明，社会支持显著中介了抑郁症状与自我护理活动之间关系的影响（z = -0.162 > 临界值1.96；直接效应 = -0.499；间接效应 = -0.0789；总效应 = 40.3%）。
对于怀疑自我护理活动出现下降的2型糖尿病患者，强烈建议筛查抑郁症状并开展涉及社会支持的干预措施。
