Mediating effects of self-efficacy and self-management behaviors on depressive symptoms and glycemic control among elderly patients with type 2 diabetes mellitus
LU Lijun1, YUAN Lei2, LI Dianjiang1, LU Kun3, ZHU Yixuan1, WANG Zhiyong4, LIU Sijun1
1. School of Public Health, Nanjing Medical University, Nanjing, Jiangsu 211166, China; 2. Huainan Center for Disease Control and Prevention, Huainan, Anhui 232033, China; 3. Jiangbei New District Public Health Service Center, Nanjing, Jiangsu 210044, China; 4. Nanjing Center for Disease Control and Prevention, Nanjing, Jiangsu 210003, China
Abstract：Objective To analyze the mediating effects of self-efficacy and self-management behaviors on the relationship between depression symptoms and glycemic control among elderly patients with type 2 diabetes mellitus (T2DM), so as to provide references for optimizing health management of elderly T2DM patients. Methods T2DM patients aged ≥60 years from 8 community health service centers in Nanjing City were selected using a convenience sampling method. Basic information such as gender and age was collected through questionnaires. Depressive symptoms, self-efficacy, and self-management behaviors were assessed using the Patient Health Questionnaire, the Diabetes Self-Efficacy Scale, and the Diabetes Self-Management Behavior Scale, respectively. Glycated hemoglobin (HbA1c) was measured to evaluate glycemic control. A mediating effect model was constructed to analyze the mediating effects of self-efficacy and self-management behaviors on the relationship between depressive symptoms and glycemic control. Results A total of 567 elderly T2DM patients were included, with a median age of 70.00 (interquartile range, 7.50) years. There were 248 males (43.74%) and 319 females (56.26%). The median scores of self-efficacy, self-management behaviors, depressive symptoms, and HbA1c were 3.89 (interquartile range, 0.78), 4.45 (interquartile range, 1.55), 4.00 (interquartile range, 6.00), and 6.80% (interquartile range, 1.40%), respectively. The mediating effect analysis showed that depressive symptoms indirectly affected glycemic control among elderly T2DM patients through the independent mediating effects of self-efficacy (β=0.028, 95%CI: 0.016-0.043) and self-management behaviors (β=0.009, 95%CI: 0.003-0.016), as well as the chain mediating effect of both (β=0.025, 95%CI: 0.017-0.035). The mediating effects of self-efficacy and self-management behaviors accounted for 36.66% and 11.35% of the total effect, respectively, while the chain mediating effect accounted for 32.15% of the total effect. Conclusions Self-efficacy and self-management behaviors play mediating roles in the relationship between depressive symptoms and glycemic control among elderly T2DM patients.
陆丽君, 袁磊, 李殿江, 卢昆, 朱怡萱, 王志勇, 刘思浚. 老年2型糖尿病患者自我效能、自我管理行为在抑郁症状与血糖控制间的中介效应分析[J]. 预防医学, 2025, 37(5): 455-459.
LU Lijun, YUAN Lei, LI Dianjiang, LU Kun, ZHU Yixuan, WANG Zhiyong, LIU Sijun. Mediating effects of self-efficacy and self-management behaviors on depressive symptoms and glycemic control among elderly patients with type 2 diabetes mellitus. Preventive Medicine, 2025, 37(5): 455-459.
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