Influential Factors for Self-Management Among Patients with Diabetic Retinopathy: A Structural Equation Model Analysis

Purpose: To investigate the influencing factors of self-management of diabetic retinopathy (DR) by constructing a structural equation model (SEM) to analyze the relationships among self-management behavior, perceived social support, and trait coping style as well as to determine the influencing path in order to provide a theoretical reference for exploring a multipath health management model that can be used to improve the quality of life of DR patients. Patients and Methods: A total of 388 patients with DR were enrolled in this cross-sectional study conducted from January 2020 to January 2023. All subjects completed a general questionnaire and were assessed by the Self-management Scale for Patients with Diabetic Retinopathy, the Perceived Social Support Scale, and the Trait Coping Style Scale. Structural equation modeling was employed to examine the relationship between self-management and its influencing factors. The bootstrap method was used to examine the path relationships among self-management, perceived social support, and trait coping styles in DR patients. Results: A total of 346 valid questionnaires were collected in this study, with a response rate of 89% (346/388). The average score of self-management of DR patients was 69.50± 18.32, and it was significantly positively correlated with perceived social support and positive coping (r=0.624, r=0.578, both P < 0.01). The total effect of perceived social support on DR self-management was 1.439, with a direct effect of 1.056 and an indirect effect of 0.384. Positive coping played a mediating role in perceived social support and self-management. Conclusion: The self-management of DR was at an intermediate level. Perceived social support and trait coping styles were important influencing factors for self-management behavior in DR patients. Therefore, improving perceived social support and trait coping styles can promote the self-management behavior of DR patients, reduce their psychological burden, and improve their compliance and quality of life.