The Influence of Self-management Ability on Comorbid Depression and Its Mediating Effect in Middle-aged and Elderly Patients with Type 2 Diabetes Mellitus
Objective:To observe the effect of self-management behavior on comorbid depression in middle-aged and elderly patients with type 2 diabetes,and to explore the possible mechanisms throughmediation effect analysis.Methods:A total of 301 middle-aged and elderly patients with type 2 diabetes mellitus hospitalized in a tertiary hospital in Shanxi Province were selected,and all the selected patients signed an informed consent form.The general information questionnaire was conducted face-to-face and the clinical indicators of patient admission were collected,the depression status and self-management level of patients were evaluated by the Depression Screening Scale(PHQ-9)and the Self-Management Scale(SDSCA),the risk factors of type 2 diabetes mellitus complicated with depression were analyzed by logistic regression,the relationship between them was analyzed by Pearson correla-tion,and the mediating effect was analyzed by the PROCESS plug-in.Results:The prevalence of co-morbid depression in patients with type 2 diabetes was 16.61%.The fasting plasma glucose(FPG)and glycated hemoglobin(HbA1c)in the depressed group were significantly higher than those in the non-depressed group(P<0.05),and the serum 25-hydroxyvitamin D[25(OH)D]was significantly lower than that in the non-depressed group(P<0.05).Multifactorial logistic regression analysis showed that 25(OH)D and HbA1c were independent risk factors for co-morbid depression in type 2 diabetes mellitus(P=0.002,P<0.001).The total self-management score of patients of type 2 diabetes mellitus co-morbid in the depression group,was significantly lower than that of patients in the non-depression group,and the difference was statistically significant(P<0.01).The results of the mediating effect showed that the relationship between self-management behavior and comorbid depression in patients with type 2 diabetes mellitus,the mediating effect of 25(OH)D was-0.005(-0.011,-0.001),accounting for 10.42%of the total effect.The mediating effect of HbA1c was-0.018(-0.037,-0.002),accounting for 40.00%of the total effect.Conclusion:Self-management behaviors in patients with type 2 diabetes mellitus can prevent the development of co-morbid depression,which may mainly play a role in regula-ting serum 25(OH)D and HbA1c levels through rational diet and regular exercise.
type 2 diabetesself-management behaviordepressionmediation effect
NETL
NSTL
万方数据
维普
