The Effects Of The Uncertainty In Illness,perceived Stress And Perceived Social Support On Quality Of Life Among Patients With Type 2 Diabetes In Community

Objective: Type 2 diabetes mellitus(T2DM)is a chronic disease with a long course of disease,which can not be cured.Long-term diagnosis and drug treatment make patients suffer from both physical and psychological suffering,which can seriously impaires their quality of life.In recent years,researches on social and psychological health of T2 DM patients have increased,but less attention has been paid to the quality of life.Therefore,this study aims to explore the quality of life of T2 DM patients and its related factors,and focuses on the relationship among uncertainty in illness,perceived stress,perceived social support and quality of life,and provides ideas for improving quality of life of T2 DM patients and carrying out targeted psychological intervention.Methods: A random sampling method was used in our study.From September to November in 2020,participants were recruited from ten communities in a distinct of Dalian City,Liaoning Province.All T2 DM patients who met the inclusion criteria were selected from each community to complete self-administered questionnaires about demographic characteristics questionnaire,uncertainty in illness scale(MUIS),perceived stress scale(PSS-10),perceived social support scale(PSSS)and quality of life scale(SF-36)to assess the general characteristics,illness uncertainty,perceived stress,perceived social support and quality of life of T2 DM patients.Out of 250 questionnaires,213 effective questionnaires were collected,with an effective rate of 85.2%.SF-36 divided into physical component summary(PCS)and mental component summary(MCS)was used as dependent variables.One way ANOVA and t-test were used to compare the differences of quality of life among T2 DM patients in different general characteristics;Pearson correlation analysis was used to evaluate the correlation between illness uncertainty,perceived stress,perceived social support and quality of life;hierarchical regression analysis was applied to test the effects of affecting factors of quality of life,and to explore whether the perceived social support mediates the relationships between illness uncertainty and quality of life(PCS and MCS),perceived stress and quality of life(PCS and MCS).Bootstrap method was used to verify the mediating effect of perceived social support.Results: 1.The average score of physical and mental health of T2 DM patients was 55.16±17.0 and 56.59 ±18.32.Most T2 DM patients were shown to have low physical and mental health.2.Family monthly average income and BMI of T2 DM patients might be the influencing factors of quality of life(PCS and MCS)in T2 DM patients.3.Uncertainty in illness and perceived stress were significantly negatively related to quality of life(PCS and MCS)(p<0.01);perceived social support were significantly positively related to quality of life(PCS and MCS)(p<0.01).4.After excluding the control factors,uncertainty in illness and perceived stress were the important factors of physical health,which explained 10.5% and 20.1% of the variation of quality of life,respectively.Uncertainty in illness and perceived stress were the important factors of mental health,which explained 11.5% and 23.7% of the variation of quality of life,respectively.5.Perceived social support played partly mediating roles in the relationship between illness uncertainty and quality of life(PCS and MCS),perceived stress and quality of life(PCS and MCS),respectively.Conclusion: Most T2 DM patients have low level of physical and mental health.Patient’s uncertainty in illness and perceived stress were important factors influencing quality of life(PCS and MCS).Perceived social support were a key positive psychological resource to promote patient’s quality of life(PCS and MCS)and it played partly mediating roles in the relationships between quality of life(PCS and MCS)and its related factors.Community medical staff should establish a community-centered social support network,strengthen publicity and education,popularize the knowledge of diagnosis and treatment of T2 DM to reduce the uncertainty of patients’ disease and provide psychological counseling and relaxation training for patients with T2 DM to relieve their preceived stress;at the same time,relatives and friends should give spiritual and material support to patients with T2 DM to make patients keep a good psychological state,and effectively reduce the adverse effect of uncertainty in illness and perceived stress to the quality of life of patients with T2 DM.