Wang Hongjuan, Ge Lin, Yan Yan Kwok Jojo, Zhang Zhuo, Wiley James, Guo Jia
Xiangya School of Nursing, Central South University, Changsha, Hunan Province, China.
Department of Alcohol Addiction and Internet Addiction, The School of Clinical Medicine, Hunan University of Chinese Medicine, Changsha, Hunan Province, China.
Ann Behav Med. 2025 Jan 4;59(1). doi: 10.1093/abm/kaae075.
The mechanisms through which the blended mindfulness-based stress reduction (MBSR) program improves diabetes self-management among individuals with Type 2 diabetes mellitus (T2DM) remain unclear.
This study aims to evaluate the effectiveness of blended MBSR on perceived stress, anxiety, and depressive symptoms, while also exploring the potential mechanisms underlying its effects on improving diabetes self-management.
One hundred individuals with T2DM were recruited and randomly assigned to two groups (50 participants each) from March 2020 to July 2020. A randomized clinical trial, combined with generalized estimating equations for repeated measures, was employed to assess the intervention effects of the blended MBSR on perceived stress, anxiety, and depressive symptoms compared to standard care. Mediation analyses using Model 4 in SPSS PROCESS were conducted to evaluate the contributions of the blended MBSR to diabetes self-management.
Participants in the blended MBSR group showed a significant reduction in perceived stress, anxiety, and depressive symptoms compared to the control group over 12 weeks. Bootstrap mediation analyses indicated that changes in perceived stress and anxiety fully mediated the effect of the blended MBSR on diabetes self-efficacy. In contrast, depressive symptoms were not associated with diabetes self-efficacy and therefore did not qualify as mediators. Additionally, diabetes distress was found to be an insignificant mediator. Furthermore, changes in diabetes self-efficacy served as a partial mediator of the positive effects of the blended MBSR on diabetes self-management.
The blended MBSR program effectively reduced perceived stress, anxiety, and depressive symptoms in individuals with T2DM. The intervention's impact on perceived stress and anxiety contributed to an increase in diabetes self-efficacy, subsequently enhancing diabetes self-management. Interventions that aim to reduce perceived stress and anxiety, while also increasing diabetes self-efficacy, are recommended to develop diabetes self-management strategies with clearly defined mechanistic pathways.
基于正念减压（MBSR）的综合项目改善2型糖尿病（T2DM）患者糖尿病自我管理的机制尚不清楚。
本研究旨在评估综合MBSR对感知压力、焦虑和抑郁症状的有效性，同时探讨其改善糖尿病自我管理效果的潜在机制。
2020年3月至2020年7月招募了100名T2DM患者，并随机分为两组（每组50名参与者）。采用随机临床试验，并结合重复测量的广义估计方程，评估综合MBSR与标准护理相比对感知压力、焦虑和抑郁症状的干预效果。使用SPSS PROCESS中的模型4进行中介分析，以评估综合MBSR对糖尿病自我管理的作用。
与对照组相比，综合MBSR组的参与者在12周内感知压力、焦虑和抑郁症状显著减轻。自助中介分析表明，感知压力和焦虑的变化完全介导了综合MBSR对糖尿病自我效能的影响。相比之下，抑郁症状与糖尿病自我效能无关，因此不符合中介条件。此外，糖尿病困扰被发现是一个不显著的中介。此外，糖尿病自我效能的变化是综合MBSR对糖尿病自我管理积极作用的部分中介。
综合MBSR项目有效降低了T2DM患者的感知压力、焦虑和抑郁症状。该干预对感知压力和焦虑的影响有助于提高糖尿病自我效能，进而增强糖尿病自我管理。建议开展旨在减轻感知压力和焦虑，同时提高糖尿病自我效能的干预措施，以制定具有明确作用机制途径的糖尿病自我管理策略。
