Nursing Department, Peking University Third Hospital, Beijing, China.
School of Nursing, Nanjing University of Chinese Medicine, Nanjing, China.
J Clin Nurs. 2023 Oct;32(19-20):7238-7246. doi: 10.1111/jocn.16786. Epub 2023 Jun 20.
This study aimed to investigate the role of the family in supporting diabetes self-management and explore the possible mechanisms between family and diabetes self-management among rural patients in China.
The prevalence of Type 2 diabetes mellitus (T2DM) is growing rapidly in rural areas of China, where healthcare resources remain relatively poor and family members play an important role in chronic disease self-management.
This was a multicentre cross-sectional study.
A total of 276 adults with T2DM were recruited from nine county hospitals in China. Diabetes self-management, family support, family function, and family self-efficacy were evaluated using the mature scales. A theoretical model was built based on the social learning family model and previous studies and then verified using a structural equation model. The STROBE statement was used to standardise the study procedure.
Family support and general family factors, including family function and self-efficacy, were positively correlated with diabetes self-management. Family support fully mediates the relationship between family function and diabetes self-management and partially mediates the relationship between family self-efficacy and diabetes self-management. The model explained 41% of the variability in diabetes self-management and had a good model fit.
General family factors can explain nearly half of the change in diabetes self-management in rural areas of China, while family support is a mediator between general family factors and diabetes self-management. Family self-efficacy, a potential intervention point of family based diabetes self-management education, can be improved by building special lessons for family members.
This study emphasises the role of family in diabetes self-management and proposes suggestions for diabetes self-management intervention among patients with T2DM in rural areas of China.
Patients and their family members completed the questionnaire which was used for data collection.
本研究旨在探讨家庭在支持糖尿病自我管理中的作用，并探讨中国农村患者家庭与糖尿病自我管理之间可能存在的机制。
中国农村地区 2 型糖尿病（T2DM）的患病率迅速增长，而农村地区的医疗资源仍然相对匮乏，家庭成员在慢性病自我管理中起着重要作用。
这是一项多中心横断面研究。
共招募了来自中国 9 家县级医院的 276 名 T2DM 成年患者。使用成熟的量表评估糖尿病自我管理、家庭支持、家庭功能和家庭自我效能感。根据社会学习家庭模型和以往研究建立了一个理论模型，并使用结构方程模型进行验证。采用 STROBE 声明来规范研究程序。
家庭支持和一般家庭因素，包括家庭功能和自我效能感，与糖尿病自我管理呈正相关。家庭支持完全中介了家庭功能与糖尿病自我管理之间的关系，部分中介了家庭自我效能感与糖尿病自我管理之间的关系。该模型解释了糖尿病自我管理 41%的可变性，具有良好的模型拟合度。
一般家庭因素可以解释中国农村地区糖尿病自我管理变化的近一半，而家庭支持是一般家庭因素与糖尿病自我管理之间的中介因素。家庭自我效能感是家庭为基础的糖尿病自我管理教育的潜在干预点，可以通过为家庭成员制定专门课程来提高。
本研究强调了家庭在糖尿病自我管理中的作用，并为中国农村地区 T2DM 患者的糖尿病自我管理干预提供了建议。
患者及其家属完成了调查问卷，用于数据收集。
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