Path Analysis Of Diabetes-related Distress On Subjective Well-being In T2DM Patients Based On Social Support

Objectives:The purpose of this study is to investigate the current status of diabetes-related distress,self-efficacy,social support and subjective well-being in patients with type 2diabetes;To investigate the correlation and its influencing factor;To investigate whether diabetes-related distress through social support and self-efficacy as mediator to have an indirect effect on the patient's subjective well-being,this in order to provide targeted intervention measures,and to promote the patient's blood glucose achieve the standard,delay the occurrence of complications,improve the quality of life.So as to improve the patient's self-confidence and the positivity of patients with diabetes,etc.Methods:With convenience sampling method,we selected 185 T2 DM patients as research subjects in three 3-A general hospitals in Changchun from June 2016 to November.A general demographic survey scale,Diabetes Distress Scale,Memorial University of Newfoundland Scale of Happiness,perceived social support scale and the self-efficacy for diabetes were included in the questionnaires.Epidata 3.1 software was used to enter the data into the computer,Statistical Package for the Social Sciences(SPSS)17.0 for Windows was used to perform the statistical analyses,Structural Equation Modeling was constructed by using Amos software.Data analysis included descriptive statistics,one-factor analysis of variance,t-text,Pearson's correlation analysis multiple linear stepwise regression analysis and path analysis.Results:1.The total score of diabetes-related distress in patients was 45.93±12.87,the total average score was 2.70±0.76,and the score of emotional burden,physician-related distress,regimen distress,and diabetes-related interpersonal distresswas respectively 15.36±5.37,9.55±3.43,14.06±4.78 and 6.95±2.78,the average score was respectively 3.07±1.07,2.39±0.86,2.81±0.96 and 2.32±0.93.2.The one-factor analysis of variance of the diabetes-related distress showed that the education,times of hospitalization,age,complications,family per capita monthly income and body mass index had statistical significance(P<0.05).3.The total score of subjective well being in patients was 27.84±10.63,the total average score was 1.16±0.44,and the score of positive affective,negative affective,positive experience and negative experience was respectively5.28±3.29,4.04±3.03,7.72±3.63 and 5.13±3.51,the average score was respectively 1.06±0.66,0.81±0.61,1.10±0.52 and 0.73±0.50.4.The total score of social support in patients was 61.54±11.90,the total average score was 5.13±0.99,and the score of family support,friend support and other support was respectively21.72±3.97,18.74±4.74and21.08±4.54,the average score was respectively 5.43±0.99,4.69±1.19,1.10±0.52 and 5.27±1.14.5.The total score of self efficacy in patients was 29.71±6.53,the total average score was 3.30±0.73,and the score of dietetic efficiency,exercise efficacy,blood glucose management efficacy and disease control efficacy was respectively10.28±2.84,6.66±1.78,7.32±1.87 and 5.45±1.99,the average score was respectively 3.43±0.95,3.33±0.89,3.66±0.94 and 2.73±1.00.6.Correlation analysis revealed that the diabetes-related distress,self-efficacy,social support and subjective well-being in type 2 diabetes mellitus were correlated with each other(P<0.05).7.The results of multiple linear stepwise regression analysis showed that perceived social support,self-efficacy and subjective well-being were the influencing factors of diabetes-related distress in patients,and all these three factors could explain49.3%of the total variation(R2=0.493).8.Social support as a mediator has an impact on the subjective well-being of the patients,and the mediating effect explained 26.8% of the total variance of subjective well-being.Conclusions:1.The level of diabetes-related distress in T2 DM patients was higher,the education,times of hospitalization,age,complications,family per capita monthly income and body mass index were the main factors that affected diabetes-related distress.2.The subjective well-being of patients was in the middle level,the overall social support level was higher,the self-efficacy of patients was at the medium level.3.Social support has mediating effects on diabetes-related distress and subjective well-being in diabetes,which can indirectly affect patient's subjective well-being through social support.Among them,regimen distress has the most significant influence on subjective well-being through social support.4.Social support as mediator can be used to alleviate the diabetes-related distress and improve the subjective well-being of patients.