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糖尿病困扰和自我效能在中青年2型糖尿病患者的家庭功能与应对之间起中介作用。

Diabetes Distress and Self-Efficacy Mediate the Relationship Between Family Function and Coping in Young and Middle-Aged Patients with Type 2 Diabetes Mellitus.

作者信息

Wei Yulian, Zhang Jingyue, Tai Xia, Weng Shan, Wang Yan, Zhu Guohong

机构信息

Department of Nephrology, Taizhou People's Hospital, Taizhou, 225300, People's Republic of China.

The Affiliated Stomatological Hospital of Nanjing Medical University, Nanjing, 210000, People's Republic of China.

出版信息

Diabetes Metab Syndr Obes. 2025 Sep 6;18:3283-3295. doi: 10.2147/DMSO.S530882. eCollection 2025.

Abstract

AIM

To explore the parallel mediating effects of diabetes distress and self-efficacy on the relationship between family function and coping and adaptation ability in young and middle-aged patients with type 2 diabetes mellitus (T2DM).

METHODS

From February to December 2023, a convenience sample of 236 young and middle-aged patients with T2DM was recruited from the endocrinology departments of two tertiary hospitals. Questionnaires were administered to collect sociodemographic and disease characteristics, the short version of the Coping and Adaptation Processing Scale (CAPS-SF-C), the Adaptation, Partnership, Growth, Affection, and Resolve (APGAR), the Diabetes Distress Scale (DDS), and the Self-Efficacy for Diabetes (SED). The SPSS 26.0 software was used for univariate analysis and Pearson correlation analysis. Model 4 of the SPSS macro program Process v3.4.1 was used to assess parallel mediation effects, with Bootstrap resampling set to 5,000 iterations.

RESULTS

Pearson correlation analysis revealed that coping and adaptation ability was positively associated with family function (=0.545, < 0.01) and self-efficacy (=0.578, < 0.01) and negatively associated with diabetes distress (=-0.508, < 0.01). Additionally, diabetes distress and self-efficacy were found to play a parallel mediation between family function and coping and adaptation ability. The indirect effect of self-efficacy (0.081), and the indirect effect of diabetes distress (0.065) accounted for 19.06%, and 15.29% of the total effect (0.466).

CONCLUSION

As the first study confirming dual-channel mediation in this population, we demonstrate that diabetes distress and self-efficacy functioned as parallel mediators in the relationship between family function and coping and adaptation ability. Healthcare professionals are encouraged to incorporate family-focused interventions into the management of T2DM. Reducing psychological stress and routinely monitoring self-efficacy levels are crucial for enhancing patients' coping and adaptation ability.

摘要

目的

探讨糖尿病困扰和自我效能感在2型糖尿病(T2DM)中青年患者家庭功能与应对及适应能力关系中的平行中介作用。

方法

2023年2月至12月,从两家三级医院的内分泌科选取236例T2DM中青年患者作为便利样本。采用问卷调查收集社会人口学和疾病特征、应对与适应处理量表简版(CAPS-SF-C)、适应、伙伴关系、成长、情感和决心量表(APGAR)、糖尿病困扰量表(DDS)以及糖尿病自我效能量表(SED)。使用SPSS 26.0软件进行单因素分析和Pearson相关性分析。采用SPSS宏程序Process v3.4.1的模型4评估平行中介效应,Bootstrap重抽样设置为5000次迭代。

结果

Pearson相关性分析显示,应对及适应能力与家庭功能呈正相关(=0.545,<0.01),与自我效能感呈正相关(=0.578,<0.01),与糖尿病困扰呈负相关(=-0.508,<0.01)。此外,发现糖尿病困扰和自我效能感在家庭功能与应对及适应能力之间起平行中介作用。自我效能感的间接效应(0.081)和糖尿病困扰的间接效应(0.065)分别占总效应(0.466)的19.06%和15.29%。

结论

作为第一项证实该人群双通道中介作用的研究,我们证明了糖尿病困扰和自我效能感在家庭功能与应对及适应能力的关系中起到平行中介作用。鼓励医护人员将以家庭为中心的干预措施纳入T2DM的管理中。减轻心理压力并定期监测自我效能感水平对于提高患者的应对及适应能力至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4b8d/12422127/0ad1ddb2ac51/DMSO-18-3283-g0001.jpg

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