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从积极心理学视角探讨自我效能感、心理韧性和自我管理对2型糖尿病患者生活质量的影响:一种有调节的中介效应分析方法

Exploring the dynamics of self-efficacy, resilience, and self-management on quality of life in type 2 diabetes patients: A moderated mediation approach from a positive psychology perspective.

作者信息

Ting Zheng, Huicai Wang, Kudelati Zakeer, Yongkang Ge, Alimu Ayimire, Xiaotian Zhang, Xingge Qu, Tong Li

机构信息

Nursing School, Xinjiang Medical University, Urumqi, China.

Department of Undergraduate Educational Management, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, China.

出版信息

PLoS One. 2025 Jan 24;20(1):e0317753. doi: 10.1371/journal.pone.0317753. eCollection 2025.

Abstract

OBJECTIVES

Type 2 diabetes mellitus (T2DM) significantly deteriorates patients' quality of life (QOL). This study examined the dynamic interplay of factors that influence QOL in patients with T2DM, utilizing concepts from positive psychology and intrinsic mechanisms, to lay the groundwork for improving patient outcomes. Improving self-management behaviors is essential for effective disease management.

METHODS

Using a cross-sectional design, this study incorporated 408 patients with T2DM from the endocrinology department of a public hospital in Urumqi, who were selected through convenience sampling from December 29, 2023 to June 30, 2024. Data collection tools included the General Data Questionnaire, Summary of Diabetes Self-Care Activities, Self-Efficacy for Diabetes Questionnaire, Connor-Davidson Resilience Scale, and Diabetes-Specific Quality of Life Scale. Structural equation modeling and Model 15 of Hayes' SPSS-Process program facilitated the moderated mediation analysis.

RESULTS

The findings demonstrated that self-efficacy significantly enhanced the QOL (β = -0.8557, p < 0.01), with resilience serving as a partial mediator, accounting for 43.1% of this effect. Interactions between self-efficacy and self-management, and resilience and self-management, were also significant predictors of QOL (β = -0.0751, p < 0.01 and β = -0.0073, p < 0.05, respectively).

CONCLUSION

These findings introduce a novel theoretical framework for T2DM from the perspective of positive psychology, which will be beneficial for intervention development. This study underscores the importance of promoting diabetes self-management as an effective strategy to enhance QOL. Additionally, healthcare providers must focus on fostering patients' positive psychological traits and reliable self-management behaviors.

摘要

目的

2型糖尿病(T2DM)显著降低患者的生活质量(QOL)。本研究利用积极心理学和内在机制的概念,探讨影响T2DM患者生活质量的因素之间的动态相互作用,为改善患者预后奠定基础。改善自我管理行为对于有效的疾病管理至关重要。

方法

本研究采用横断面设计,纳入了乌鲁木齐一家公立医院内分泌科的408例T2DM患者,这些患者于2023年12月29日至2024年6月30日通过便利抽样选取。数据收集工具包括一般资料问卷、糖尿病自我护理活动总结、糖尿病自我效能量表、康纳-戴维森韧性量表和糖尿病特异性生活质量量表。结构方程模型和Hayes的SPSS-Process程序中的模型15促进了调节中介分析。

结果

研究结果表明,自我效能显著提高了生活质量(β = -0.8557,p < 0.01),韧性起到了部分中介作用,占该效应的43.1%。自我效能与自我管理之间的相互作用,以及韧性与自我管理之间的相互作用,也是生活质量的显著预测因素(分别为β = -0.0751,p < 0.01和β = -0.0073,p < 0.05)。

结论

这些发现从积极心理学的角度为T2DM引入了一个新的理论框架,这将有利于干预措施的制定。本研究强调了促进糖尿病自我管理作为提高生活质量的有效策略的重要性。此外,医疗服务提供者必须注重培养患者积极的心理特质和可靠的自我管理行为。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b703/11759368/2ed6046f9950/pone.0317753.g001.jpg

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