Investigation And Correlation Of Patient Activation,Hope Level And Social Support In Patients With Type 2 Diabetes Mellitus

Objective:This study was to understand the current situation of patient activation,hope level and social support in patients with type 2 diabetes,analyze the influencing factors of patient activation,hope level and social support in patients with type 2 diabetes and the relationship among them,and to establish a patient activation,hope level and social support between the intermediary effect model to explore the effect of path and the mediation effect.The feasibility suggestion of improving patient activation degree was put forward to provide theoretical basis for future intervention research.Methods:This study is a cross-sectional study,using convenience sampling method,256 patients with type 2 diabetes who were hospitalized in Department of endocrinology of three grade a hospital in Nanning from March 2021 to October 2021 were selected according to inclusion and exclusion criteria.The general information questionnaire,positive scale of patients（PAM）,Herth Hope Scale（HHI）and social support rating scale（SSRS）were used to conduct a questionnaire survey among patients with type2 diabetes.SPSS23.0 statistical software was used for data analysis.The data analysis method is as follows:（1）The counting data were expressed by frequency（N）,rate（%）and constituent ratio（%）,the measurement data were expressed in mean±standard deviation（（?）±s）or median（M）and quartile(P₂₅,P₇₅).（2）Two independent sample T test,ANOVA,Mann-Whitney U test and Kruskal-Walis H test were used for univariate analysis,and multiple linear regression analysis was used for multivariate analysis.（3）Pearson and Spearman linear correlation analysis were used for correlation analysis.（4）Model 4 of process plug-in in SPSS23.0 software was used to test the mediation effect model,and Bootstrap was used to analyze the mediation effect.Results:（1）The patient activation of type 2 diabetes patients ranged from 34.62～80.77 points,with an overall mean score of（55.08±7.39）points,of which 31 cases（12.1%）with level 1 score of（43.30±3.36）points;the second level 98 cases（38.3%）were all scored（51.12±2.26）points;115patients（44.9%）scored at the third level,with an average score of（59.93±3.11）points;12 cases（4.7%）with the fourth level were all scored（71.50±4.13）points.Multiple linear regression analysis of patient activation showed that education level,compliance of blood glucose monitoring before hospitalization,regular exercise,diet control,age,whether or not to receive diabetes health education before hospitalization,home address and Hb A1c entered the regression equation model,which could explain 32.9%of the equation variation（F=16.650,P<0.001）.（2）The score range of hope level of type 2 diabetes patients ranged from 21 to 47,and the overall score was 34.00（32.00,36.00）.Among them,the dimension of positive attitude towards reality and future is divided into11.00（10.00,12.00）,the dimension of taking positive action is divided into11.50（10.00,12.00）,and the dimension of keeping close contact with others is divided into 12.00（11.00,13.00）.Multiple linear regression analysis of hope level showed that education level,age and regular exercise entered the regression equation model,which could explain 20.7%of the equation variation（F=23.126,P<0.001）.（3）The social support score of type 2 diabetes patients ranged from 22to 58 points,with an overall mean score of（36.93±7.18）.The objective support dimension is divided into 8.00（7.00,10.00）score,the subjective support dimension is divided into 22.00（18.00,25.00）score,and the support utilization dimension is divided into 7.00（5.00,9.00）score.Multiple linear regression analysis of social support showed that married,educational level,regular exercise,age,use of insulin,and compliance of blood glucose monitoring before hospitalization entered the linear regression model,which could explain 30.3%of the equation variation（F=16.800,P<0.001）.（4）Correlation analysis showed that there was a positive correlation between social support and positive degree of patients with type 2 diabetes（r=0.318～0.525,P<0.01）.Social support and all dimensions were positively correlated with hope level and all dimensions（r=0.137-0.661,P<0.05）.Hope level and all dimensions were positively correlated with patient positivity（r=0.386～0.575,all P<0.01）.（5）The mediating effect test showed that social support had a direct positive predictive effect on patient activation（Coeff=0.528,P<0.001）,social support had a direct positive predictive effect on hope level（Coeff=0.392,P<0.001）,and hope level had a direct positive predictive effect on patient activation（Coeff=0.758,P<0.001）.The standardized indirect effect of hope level on the relationship between social support and patient activation was0.297（95%CI:0.197,0.407）,the standardized direct effect of social support on patient activation was 0.231（95%CI:0.100,0.361）,and the mediating effect accounted for 56.25%of the total effect.Conclusion:（1）The patient activation of patients with type 2 diabetes was in the second level,and education level,compliance of blood glucose monitoring before hospitalization,regular exercise,diet control,age,health education of diabetes before hospitalization,home address,Hb A1c were the influencing factors of patient activation.（2）The hope level and social support of type 2 diabetes patients were at medium level,among which education level,age and regular exercise were the influencing factors of hope level,while married,education level,regular exercise,age,use of insulin and compliance of blood glucose monitoring before hospitalization were the influencing factors of social support.（3）The patient activation of type 2 diabetes patients was positively correlated with the hope level and social support,namely,social support was positively correlated with the patient activation and hope level,and the hope level was positively correlated with the patient activation.（4）Both hope level and social support had positive effects on patient activation,and hope level partially mediated the relationship between social support and patient activation in type 2 diabetes patients.