Heo Seongkum, Kang JungHee, Barbé Tammy, Kim JinShil, Slocumb Rhonda H, Haley Brandy, Wright Nina
J Cardiovasc Nurs. 2025;40(2):133-142. doi: 10.1097/JCN.0000000000001118. Epub 2024 Jul 16.
Self-care in people with diabetes is poor, which could be influenced by positive and negative psychosocial factors. Self-efficacy is an important factor affecting self-care, and depressive symptoms and diabetes distress may directly and indirectly affect self-efficacy.
The aim of this study was to examine the relationships of depressive symptoms, diabetes distress, age, sex, self-compassion, resilience, self-esteem, and social support to diabetes self-efficacy and the mediating roles of diabetes distress and depressive symptoms in the relationships among people with diabetes.
In this cross-sectional, correlational study, data on all the psychosocial and demographic factors were collected (N = 148; 57.6 years old) through Research Electronic Data Capture in 2023. The PROCESS macro for SPSS was used to address the purpose.
The mean score of diabetes self-efficacy was 28.6 (range, 8-40). In 1 model, depressive symptoms were directly and indirectly associated with diabetes self-efficacy through diabetes distress (direct effect, -3.524; t = -3.020, P = .003; indirect effect, -2.089; 95% bootstrap confidence interval, -3.494 to -0.911). In another model, diabetes distress was directly and indirectly associated with diabetes self-efficacy through depressive symptoms (direct effect, -3.778; t = -3.638, P < .001; indirect effect, -0.785; 95% bootstrap confidence interval, -1.868 to -0.089). In addition, self-esteem was associated with both depressive symptoms and diabetes distress. Resilience was associated with diabetes self-efficacy in 1 model.
Negative psychological factors were directly and indirectly associated with diabetes self-efficacy. Depressive symptoms, diabetes distress, self-esteem, and resilience can be important targets of interventions to improve diabetes self-efficacy.
糖尿病患者的自我护理情况较差，这可能受到积极和消极的社会心理因素影响。自我效能感是影响自我护理的一个重要因素，而抑郁症状和糖尿病困扰可能直接或间接地影响自我效能感。
本研究旨在探讨抑郁症状、糖尿病困扰、年龄、性别、自我同情、心理韧性、自尊和社会支持与糖尿病自我效能感之间的关系，以及糖尿病困扰和抑郁症状在糖尿病患者关系中的中介作用。
在这项横断面相关性研究中，于2023年通过研究电子数据采集系统收集了所有社会心理和人口统计学因素的数据（N = 148；平均年龄57.6岁）。使用SPSS的PROCESS宏程序来实现研究目的。
糖尿病自我效能感的平均得分为28.6（范围为8 - 40）。在1个模型中，抑郁症状通过糖尿病困扰与糖尿病自我效能感直接和间接相关（直接效应，-3.524；t = -3.020，P = 0.003；间接效应，-2.089；95%自抽样置信区间，-3.494至-0.911）。在另一个模型中，糖尿病困扰通过抑郁症状与糖尿病自我效能感直接和间接相关（直接效应，-3.778；t = -3.638，P < 0.001；间接效应，-0.785；95%自抽样置信区间，-1.868至-0.089）。此外，自尊与抑郁症状和糖尿病困扰均相关。在1个模型中，心理韧性与糖尿病自我效能感相关。
消极心理因素与糖尿病自我效能感直接和间接相关。抑郁症状、糖尿病困扰、自尊和心理韧性可能是改善糖尿病自我效能感干预措施的重要目标。
