Key result
Self-efficacy significantly mediated the negative impacts of diabetes distress and depressive symptoms on self-care behaviors, glycemic control, and health-related quality of life among adults with type 2 diabetes.
Why the study?
There was limited evidence in rural China untangling the underlying pathways between diabetes distress, depressive symptoms, type 2 diabetes management, and glycemic control.
Observational (n=1,574)
Yes
In rural Chinese adults with type 2 diabetes, self-efficacy mediates the negative impacts of diabetes distress and depressive symptoms on self-care behaviors, glycemic control, and quality of life, suggesting it as a key target for behavioral interventions.
Answers are grounded in this paper and cite their sources.
May support targeting self-efficacy in type 2 diabetes care; leaves open need for interventional trials.
BackgroundDiabetes distress has been distinguished from depressive symptoms in the linkages to type 2 diabetes management and glycemic control. There are few evidences in rural China untangled the underlying pathways among them. The aim of our study was to examine whether self-efficacy reduced the detrimental effects of psychological variables on diabetes outcomes such as self-care behaviors, glycemic control and health-related quality of life (HRQoL).Methods1574 adults diagnosed with type 2 diabetes from 31 rural clinics in China were assessed for psychological variables, self-management and HRQoL. Hemoglobin A1c (HbA1c) data at 6 months after the survey were extracted from electronic medical records. Hierarchical regression model examined independent effects of psychological variables, self-efficacy on diabetes outcomes. KHB method and bootstrapping confidence intervals were employed to test the mediating effect of self-efficacy.ResultsHierarchical regression analysis showed both diabetes distress and depressive symptoms were significantly related to diet and HRQoL, but not related to glycemic control and medication adherence. Depressive symptoms, but not diabetes distress, was directly associated with physical activity. Mediation analysis demonstrated self-efficacy mediated the relationships of both diabetes distress and depressive symptoms on self-care behaviors, glycemic control and HRQoL.ConclusionsSelf-efficacy may contribute to better diabetes outcome by ameliorating the effects of diabetes distress and depressive symptoms. Patients with psychological conditions may need tailored intervention that enhance self-efficacy to improve diabetes management.
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Gao et al. (2020) conducted an observational in Type 2 diabetes (n=1,574). Diabetes distress and depressive symptoms vs. Lower levels of distress or depressive symptoms was evaluated on Mediating effect of self-efficacy on the relationship between psychological variables and diabetes outcomes (self-care behaviors, HbA1c, and HRQoL). Self-efficacy significantly mediated the negative impacts of diabetes distress and depressive symptoms on self-care behaviors, glycemic control, and health-related quality of life among adults with type 2 diabetes.
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