Study On The Relationship Between Illness Perception,Coping Style And Health Promotion Behavior In Middle-aged And Elderly Patients With Type 2 Diabetes Mellitus

Objectives:(1)To understand the demographic and sociological differences of middle-aged and elderly patients with type 2 diabetes,and to analyze the status quo and influencing factors of their health promotion behaviors.(2)To understand the relationship between disease perception,level of coping style and health promotion behavior.(3)Explore the role of disease perception,coping style and health promotion behavior,and whether there is a mediating role.Methods:(1)Using cross-sectional survey method,online and offline convenience sampling was conducted among 289 middle-aged and elderly patients with type 2 diabetes in endocrinology inpatients and some outpatient clinics in a large tertiary hospital in Changsha City.Questionnaire","Medical Coping Style Questionnaire","Diabetes Health Promotion Scale" to measure the general demographic data and diseaserelated data,disease perception,medical coping style and health promotion behavior status of middle-aged and elderly patients with type 2diabetes;(2)Spearman correlation was used to analyze the correlation between disease perception,coping style and health promotion behavior;(3)Multivariate stepwise regression analysis was used to analyze the influencing factors of health promotion behaviors in middle-aged and elderly patients with type 2 diabetes;(4)Bootstrap method was used to test the mediating effect,and AMOS23.0 software was used to conduct path analysis on disease perception,coping style and health promotion behavior of middle-aged and elderly patients with type 2 diabetes.Results:(1)The total score of disease perception of middle-aged and elderly patients with type 2 diabetes was(45.28±8.81)points,of which disease course,treatment control,disease concern,and disease impact were higher;the face dimension was(16.27±5.48)points,and the avoidance dimension was(15.50±5.36)points,the yield dimension is(11.33±3.49)points,and the yield and avoidance dimensions have high scores;the total score of health promotion behavior is(73.71±16.44)points,which is at a medium level,of which the lowest score is the motor dimension and the highest score dimension for healthy eating.(2)The results of univariate analysis showed that there were differences in the level of health promotion behavior of middle-aged and elderly patients with type 2 diabetes in the duration of diabetes,educational level,per capita monthly income of the family,whether they had received diabetes education,and whether they had combined with other chronic diseases,and the differences were statistically significant.(3)The results of correlation analysis showed that the total score of illness perception in middle-aged and elderly patients with type 2 diabetes was negatively correlated with the coping dimension(rs=-0.357,P<0.01);it was positively correlated with the dimension of avoidance and coping(rs=0.331;rs=0.387,P<0.01);the total score of health promotion behavior was negatively correlated with the dimensions of self-control(rs=-0.427),degree of concern(rs=-0.426),and cognitive understanding(rs=-0.364)(P<0.01);the face dimension was positively correlated with the total score of health promotion behavior(rs=0.571,P<0.01);the yield dimension(rs=-0.501)or avoidance dimension(rs=-0142)was positively correlated with the total score of health promotion behavior(P<0.01).(4)The results of multiple stepwise regression showed that: facing,yielding,per capita monthly income of the family,educational level,having or not having other chronic diseases,having received diabetes education,and the score of illness perception were the influencing factors of the total score of health promotion behavior(P<0.01).(5)The results of path analysis indicate that illness perception has a direct impact on the three coping styles of facing,avoiding and yielding(β=-0.357,β=0.398,β=0.401,P<0.05);illness perception has a direct effect on health promotion behavior(β=-0.384,β=-0.218,β=-0.216,P<0.05);facing and yielding coping styles have a direct effect on health promotion behavior(β=0.493,β=-0.442,P<0.05),and at the same time as a mediating variable had an indirect effect on health promotion behavior(β=-0.176,β=-0.178,P<0.05).Conclusions:(1)The disease perception of middle-aged and elderly patients with type 2 diabetes is at a general level.Moderate disease course,treatment control,disease concern,and disease influence dimensions are higher;negative coping styles(yield dimension and avoidance dimension)have higher scores;health promotion behavior is at a medium level overall,with the lowest score being the dimension of healthy exercise and the highest being healthy diet dimension.(2)Facing and surrendering coping style,per capita monthly income of family,educational level,presence or absence of other chronic diseases,received diabetes education,and disease perception are the main factors for the health promotion behavior of middle-aged and elderly patients with type 2 diabetes.(3)The total score of disease perception among middle-aged and elderly patients with type 2 diabetes was negatively correlated with coping styles of confrontation and avoidance,and positively correlated with coping style of surrender;the total score of negative perception and health promotion behaviors in the dimensions of disease concern,personal control,and cognition and understanding were negatively correlated;facing coping style,yielding or avoiding coping style were positively and negatively correlated with the total score of health promotion behaviors,respectively.(4)Disease perception in middle-aged and elderly patients with type2 diabetes can directly affect health-promoting behaviors,and can also indirectly affect health-promoting behaviors through confrontation and surrender.6figures,18 tables,110references.