Current Status And Correlation Of Cognitive Emotion Regulation Strategies And Self-Management Behaviors In Young And Middle-Aged Patients With Type 2 Diabetes Mellitus

Objective:To understand the current status and influencing factors of cognitive emotion regulation strategies and self-management behaviors in young and middle-aged patients with type 2 diabetes,and to analyze the characteristics of cognitive emotion regulation and the specific factors of behavior change in young and middle-aged patients with type 2 diabetes.And to provide further theoretical basis for the individualized management strategies for diabetes patients.Methods:This study adopted a mixed research approach.Quantitative research is a descriptive study.A questionnaire survey was conducted among 173 young and middle-aged T2 DM patients who were admitted to the endocrinology,geriatrics,ophthalmology,and cardiology departments of a third-grade hospital in Changsha City from June to December 2018.Standard young and middle-aged patients with type 2 diabetes were surveyed.The survey tools included a self-designed basic data questionnaire,Cognitive Emotion Regulation Questionnaire(CERQ),and Diabetes Self-care Scale(DSCS).The data were statistically analyzed by SPSS23.0.The data were statistically described by means of mean,standard deviation,frequency and composition ratio.Single factor analysis was performed by independent sample t test,Kruskal Wallis H test,analysis of variance,LSD-t;correlation was analyzed by Spearman correlation analysis.The difference was statistically significant at P ? 0.05.Qualitative research adopted the purpose sampling method.Qualitative research adopted the method of destination sampling,and selected 19 young and middle-aged T2 DM patients who had been included in thequantitative research as interviewees.Through semi-structured interviews and observation methods,the in-depth analysis was carried out,and the interview data was sorted and refined according to the subject analysis method.Results:1.Among the nine dimensions of CERQ in young and middle-aged patients with type 2 diabetes,the highest score is accepted(12.94± 4.21),followed by re-focusing on the plan(12.68± 4.73),positive re-evaluation(11.65 ± 4.74),active re-focus(11.09 ± 4.50),self-censorship(10.90 ± 4.20),contemplation(9.44 ± 3.97),rational analysis(8.45± 3.64),and catastrophe(7.29± 3.34).The lowest score is to blame others.(1)age,place of residence,number of family economic sources,occupation,education level,marital status,family monthly income,ability to pay,other chronic diseases or metabolic diseases,glycated hemoglobin The scores of the scores in the CERQ-P total score and some dimensions were statistically significant(P < 0.05).(2)Gender,education level,place of residence,marital status,number of family economic sources,monthly income per capita,type 2 diabetes mellitus in the CERQ-N total score and partial dimension scores were statistically significant(P <0.05).2.The self-management behavior standard of young and middle-aged type 2 diabetes patients is divided into(72.46± 14.72).Smoking history,diabetes education,glycosylated hemoglobin compliance,diabetes pathology,main treatment methods,and main payment method and self-management behaviors were statistically significant(P <0.05).3.(1)Diet control was positively correlated with CERQ-P total score(r= 0.195,0.214).(2)blood glucose control was positively correlated with re-focusing plan,positive re-evaluation and CERQ-P total score(r = 0.161,0.168,0.158).(3)prevention and treatment of high/low blood glucose was positively correlated with re-focusing(r=0.193);positive correlation with self-censorship(r=0.163).(4)The total score of self-management behavior was positively correlated with re-focusing plan,positive re-evaluation and CERQ-P total score(r =0.166,0.151,0.160).(5)Regular exercise was negatively correlated with contemplation(r=-0.149).4.Qualitative research results:(1)Topic 1: Lack of cognitive experience in the early stage of illness/Emotional adjustment bias:(1)ignorance/lack of ignorance-poor experience of pre-symptoms;(2)suspicion/denial-heavy burden of role;(3)compromise-self-regulation;(4)comparison-patient's Disease status;(5)reflection behavior-positive optimism;(2)Topic 2: Supportive factors and obstacle factors of behavior change:(1)Supportive factors include: family members' disease knowledge and promotion;symptom recognition and exploration of their own laws;(2)The obstacle factors include: the short-term treatment effect of the disease itself is not obvious,lack of internal motivation;the health care education information lacks systematic and individualized;the social and cultural customs are different,the influence of the surrounding social role model;the difference of personal values,subjective normative.Conclusion:1.The self-management behavior of young and middle-aged type 2diabetes is generally at a medium level,and in the face of negative events,they tend to adopt adaptive cognitive emotion regulation strategies.2.The young and middle-aged type 2 diabetes patients tend to adopt adaptive cognitive emotion regulation strategies,the higher their self-management behavior level,including diet control,blood glucose monitoring and prevention and treatment of high and low blood sugar;the more inclined to contemplation,the worse the behavior of regularmovements;the more inclined to self-censor,the higher the level of behavior to prevent and treat high and low blood sugar.