School of Nursing, College of Medicine, National Taiwan University, Taipei City, Taiwan.
School of Nursing, The University of Texas at Austin, Austin, Texas.
Sci Diabetes Self Manag Care. 2023 Dec;49(6):438-448. doi: 10.1177/26350106231205029. Epub 2023 Oct 24.
The purposes of this study were to (1) examine the relationships between fatigue, its influencing factors, and diabetes self-management and (2) test the mediation effects of fatigue on the link between the influencing factors and diabetes self-management in adults with type 2 diabetes.
This cross-sectional, correlational study was guided by the theory of unpleasant symptoms. Data were collected using structured questionnaires. Fatigue was measured by the Fatigue Symptom Inventory and the Multidimensional Fatigue Inventory. Diabetes self-management was measured by the Summary of Diabetes Self-Care Activities. From March to July 2021, a convenience sample of 150 participants was recruited from 2 diabetes outpatient clinics of a regional hospital in Taiwan. Data were analyzed using structural equation modeling.
A more recent diagnosis of diabetes, more depressive symptoms, and lower sleep quality were related to higher fatigue. Higher fatigue correlated with less performance in diabetes self-management. Fatigue mediated the relationship between depressive symptoms, sleep quality, and diabetes self-management.
Fatigue had a mediating effect on the link between psychological influencing factors and diabetes self-management. Future development of fatigue interventions integrating depressive symptoms and sleep management will likely increase the performance of diabetes self-management and improve the health outcomes in adults with type 2 diabetes. The study tested the theory of unpleasant symptoms using empirical data and will assist in building theory-guided fatigue interventions to improve diabetes self-management in people with type 2 diabetes.
本研究旨在（1）检验疲劳及其影响因素与糖尿病自我管理之间的关系，（2）检验疲劳对 2 型糖尿病患者影响因素与糖尿病自我管理之间关系的中介效应。
本横断面相关性研究以不适症状理论为指导。使用结构化问卷收集数据。疲劳采用疲劳症状量表和多维疲劳量表进行测量。糖尿病自我管理采用糖尿病自我护理活动综合量表进行测量。2021 年 3 月至 7 月，从台湾一家地区医院的 2 个糖尿病门诊招募了 150 名方便样本参与者。采用结构方程模型进行数据分析。
糖尿病的近期诊断、更多的抑郁症状和更低的睡眠质量与更高的疲劳相关。更高的疲劳与糖尿病自我管理的表现更差相关。疲劳中介了抑郁症状、睡眠质量与糖尿病自我管理之间的关系。
疲劳对心理影响因素与糖尿病自我管理之间的联系具有中介作用。未来整合抑郁症状和睡眠管理的疲劳干预措施的发展可能会提高糖尿病自我管理的效果，并改善 2 型糖尿病患者的健康结局。该研究使用实证数据检验了不适症状理论，并将有助于构建基于理论的疲劳干预措施，以改善 2 型糖尿病患者的糖尿病自我管理。
