| ObjectiveThis study was aimed to investigate the status quo of cognitive frailty,illness perception and fear of progression in elderly patients with type 2 diabetes mellitus,analyze the influencing factors,and analyze the relationship among them based on Common-Sense Model,and explore the mediating effect of illness perception between cognitive frailty and fear of progression,so as to provide reference for the intervention measures to reduce the prevalence rate of cognitive frailty,correctly guide the illness perception and alleviate the fear of progression in elderly type 2 diabetes mellitus patients,promoting their physical and mental health and improving quality of life.MethodsThis study is a cross-sectional study using convenient sampling method to select226 elderly type 2 diabetes mellitus patients who were treated in the endocrinology department of Grade 3A Hospital from March 2022 to September 2022 and met the inclusion and exclusion criteria.The investigation tools included the general information questionnaire,FRAIL scale,Montreal Cognitive Assessment,Brief Illness Perception Questionnaire,Progression Questionnaire-Short Form.The data were recorded,sorted and analyzed by Excel,SPSS 26.0 software and macro program Process: use frequency,composition ratio and mean ± standard deviation to describe the status quo of the general information,cognitive frailty,illness perception and fear of progression;use chi-square test,t test and one-way variance Univariate analysis for single factor analysis;use logistic regression and multiple linear regression for multivariate analysis;use Pearson correlation analysis to explore the relationship between cognitive frailty,illness perception and fear of progression.With cognitive frailty as independent variable,illness perception as mediating variable and fear of progression as dependent variable,the model 4 of the macro program PROCESS plugin compiled by Hayes was used to analyze the mediating effect of illness perception in elderly patients with type 2 diabetes mellitus.This study used the bilateral test method and the test level was α = 0.05.Results1.Descriptive analysis: Among the 226 elderly type 2 diabetes mellitus patients,47(20.8%)of the patients suffered from cognitive frailty;the total score of illness perception was(45.69 ±5.30)points;the total score of fear of progression was(29.72±3.73)points,and 34 patients(15.0%)had mental disorders among them.2.Univariate analysis: There were statistically significant differences in different age,education level,personal income,course of diabetes and the number of complications in elderly patients with type 2 diabetes mellitus for cognitive frailty(P<0.05).There were statistically significant differences in age,education level,personal income,marital status,living status,course of type 2 diabetes mellitus,treatment and the number of complications for illness perception(P < 0.05).There were statistically significant differences in education level,working status,personal income,place of residence,course of type 2 diabetes mellitus,treatment and the number of complications for fear of progression(P < 0.05).3.Multivariate analysis: Age and the number of complications in elderly type 2diabetes mellitus patients were the influencing factors of cognitive frailty.Age,education level,the course of type 2 diabetes mellitus and the number of complications were the influencing factors of illness perception.The education level,working status,number of complications,cognitive frailty and illness perception were the influencing factors of fear of progression.4.Correlation analysis: In the elderly patients with type 2 diabetes mellitus,cognitive frailty was positively correlated with illness perception(r=0.474,P<0.01);cognitive frailty was positively correlated with fear of progression(r = 0.419,P <0.01);illness perception was positively correlated with fear of progression(r = 0.704,P < 0.01).5.Mediating effect analysis: Cognitive frailty in elderly type 2 diabetes mellitus patients had a significant effect on fear of disease progression.Illness perception had a mediating effect between cognitive frailty and fear of progression,and the mediating effect was 1.032,and the Bootstrap95%CI was(0.534～1.626),accounting for39.77% of the total effect.ConclusionsIn this study,the prevalence of cognitive frailty in elderly patients with type 2diabetes mellitus is 20.8%,illness perception is at a moderate level,and fear of progression is at a medium level.Cognitive frailty,illness perception and fear of progression are affected by demography and disease-related factors,and there is a correlation among them.Cognitive frailty can directly affect the fear of progression,and it can also affect the fear of progression through the mediating effect of illness perception.Therefore,medical staff and elderly caregivers should not only pay attention to the blood glucose control of the elderly,but also pay attention to the screening of cognitive frailty of the elderly,correctly guide patients’ views on the disease,reduce patients’ fear,and formulate effective prevention and intervention measures as soon as possible,and maintain the physical and mental health and quality of life of elderly type 2 diabetes mellitus patients in all aspects. |
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