Influencing Factors And Mediating Effect Of Diabetes Distress In Young Patients With Type 2 Diabetes

Objective:To investigate the status of diabetes distress and its influencing factors in young patients with type 2 diabetes,and to analyze the correlation between diabetes distress,self-efficacy,social support and coping style.To explore the mediating effect of social support and coping style between self-efficacy and diabetes distress in young patients with type 2 diabetes from the perspective of mediating mechanism.Provide a reference basis and a new perspective to effectively reduce the level of diabetes distress.Methods:The convenience sampling method was used to select the patients who were admitted to the Department of Endocrinology of a 3A grade hospital in Nanjing from December 2019 to December 2020.The general data questionnaire,diabetes distress scale,social support rating scale,medical coping modes questionnaire and diabetes self-efficacy scale were used to conduct questionnaire investigation.SPSS22.0 and Process plugin were used for data analysis.Results:1.General information of young people with type 2 diabetes.A total of 212 cases of young patients with type 2 diabetes were enrolled in this study,their mean age was(36.5±6.95)years old.And among them,148 cases(69.8%)were male,140 patients(66.0%)with college degree or above,191 patients(90.1%)lived with family members,170 patients(80.2%)were married,187 patients(88.2%)were on-the-job,144 patients(67.9%)of family per capita monthly income over 5000.Among 212 young T2DM patients,the mean course of disease was 4.75±4.45 years,122 patients(57.5%)had a family history of diabetes,135 patients(63.7%)were overweight or obese,162 patients(76.4%)with HbAlc≥7,and 35 patients(16.5%)had diabetes complications.2.The prevalence and influencing factors of diabetes distress in young patients with type 2 diabetes.Among the 212 young patients with type 2 diabetes,136 patients had diabetes distress with the detection rate of 64.2%,including 80 cases of moderate distress and 56 cases of severe distress.The results of univariate analysis showed that the average family monthly income,Payment method of medical expenses,the course of disease and the level of HbAlc were the important factors affecting the incidence of diabetes distress(P<0.05).3.The status quo of social support,self-efficacy and coping style in young patients with type 2 diabetes.The total score of social support in young patients with type 2 diabetes was 39.82±8.35,which was in the middle level.The average score of diabetic self-efficacy was 3.37±0.73,which was in the general level.The score of coping style avoidance dimension was significantly higher than the domestic norm(P<0.05).4.The correlation between self-efficacy,social support,coping style and diabetes distress in young patients with type 2 diabetes.The results of correlation analysis showed that diabetic self-efficacy was significantly positively correlated with social support level and coping style(P<0.01),and negatively correlated with yield coping style and diabetes distress(P<0.01)in young patients with type 2 diabetes.Social support was positively correlated with face coping style(P<0.05),and negatively correlated with yield coping style and diabetes distress(P<0.01).Avoidance and yield coping styles were positively correlated with diabetes distress(P<0.05).5.Taking self-efficacy as the independent variable,diabetes distress as the dependent variable,social support and yield coping style as mediating variables.Bootstrap was used to test the mediating effect and the results showed that the mediating effect of social support between self-efficacy and diabetes distress was-0.102,accounting for 10.5%of the total effect,95%confidence interval do not contain 0(0.229,0.022),indicates that the mediation effect exists;The mediating effect of yield coping style between self-efficacy and diabetes distress was-0.421,accounting for 43.2%of the total effect,and the 95%confidence interval do not contain 0(-0.654,-0.245),indicating the existence of a mediating effect.6.Taking self-efficacy as the independent variable,diabetes distress as the dependent variable,social support and yield as the mediating variables,the results of the chain mediating effect showed that the chain mediating effect of self-efficacy on diabetes distress through social support and yield was-0.037,and the 95%confidence interval do not include 0(-0.095,-0.007),indicates that the chain mediating effect was significant.Conclusions1.Young patients with type 2 diabetes have a moderate level of diabetes distress with a higher rate of detection.It is necessary to focus on the patients with low per capita monthly household income,out-of-pocket payment,short disease duration,and high levels of HbAlc.2.Diabetes distress was significantly correlated with self-efficacy,social support,avoidance coping style and yield coping style in young patients with type 2 diabetes.3.Social support mediated the relationship between self-efficacy and diabetes distress in young patients with type 2 diabetes;yield coping style mediated the relationship between self-efficacy and diabetes distress.Social support and yield coping style had a chain mediating effect between self-efficacy and diabetes distress.