首页|社会参与在老年2型糖尿病患者自我管理与社会隔离间的中介效应

社会参与在老年2型糖尿病患者自我管理与社会隔离间的中介效应

Mediating effect of social participation on self-management and social isolation in elderly patients with type 2 diabetes mellitus

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目的 探讨老年2型糖尿病(type 2 diabetes mellitus,T2DM)患者的自我管理对社会隔离的影响路径,并分析社会参与的中介作用.方法 采用便利抽样,使用Lubben社会网络量表-6、糖尿病自我管理活动问卷及自主参与问卷,调查2023年5-11月在北京市三甲医院内分泌科或社区卫生服务中心就诊或住院的496例老年2型糖尿病患者的社会隔离现状,构建社会隔离与自我管理及社会参与的结构方程模型,分析社会参与的中介效应.结果 496例老年2型糖尿病患者中227例发生社会隔离,发生率为45.77%;发生家庭维度与朋友维度社会隔离人数分别为74例(14.92%)与239例(48.19%).结构方程模型参数估计收敛良好,后验预测P值为0.371>0.05,拟合较好.模型显示,自我管理中的运动管理与吸烟对社会隔离有负向直接效应(-0.136与-0.132),还通过社会参与间接影响社会隔离(-0.201和-0.079),中介效应比分别为59.47%和37.44%.结论 老年2型糖尿病患者的自我管理(运动与吸烟)及社会参与可以预测社会隔离的发生,社会参与在糖尿病自我管理(运动与吸烟)与社会隔离的关系中起中介作用.
Objective To analyze the influence pathway of self-management on social isolation in elderly patients with type 2 diabetes mellitus(T2DM)and the mediating role of social participation.Methods The social isolation status of older adults with T2DM treated in hospitals or community health service centers in Beijing from May to November 2023 was investigated with the Lubben social network scale-6,the summary of diabetes self-care activities and impact on partic-ipation and autonomy questionnaire.Structural equation model of social isolation and self-management and social partici-pation were constructed to analyze the mediating effects of social participation.Results Among 496 older adults with T2DM,227 experienced social isolation,and the incidence was 45.77%.The older adults experienced social isolation in family dimension and friend dimension were 74(14.92%)and 239(48.19%),respectively.The structural equation model parameter estimated converge well,while the posterior predicted P-value of the model was 0.371>0.05,which meant a good fit.The model showed that exercise management and smoking had a negative direct effect on social isolation(-0.136 and-0.132),and also indirect effected through social participation(-0.201 and-0.079),with a mediation effect ratio of 59.47%and 37.44%.Conclusion Self-management(exercise and smoking)and social participation in elderly patients with type 2 diabetes can predict the occurrence of social isolation.Social participation plays a mediating role in the relationship between diabetes self-management(exercise and smoking)and social isolation.

Type 2 diabetes mellitusOlder adultSocial isolationSocial participationSelf-managementMediating effect

王静、林可可、孙超、武全莹、白小燕、卫亦文、刘宇

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北京中医药大学护理学院,北京 100029

北京医院护理部国家老年医学中心中国医学科学院老年研究所,北京 100730

2型糖尿病 老年 社会隔离 社会参与 自我管理 中介效应

北京市社会科学基金资助项目北京中医药大学2022年度基本科研业务费项目(揭榜挂帅项目)

18SRB0092022-JYB-JBZR-026

2024

中华全科医学
中华预防医学会,安徽省全科医学会

中华全科医学

CSTPCD
影响因子:1.688
ISSN:1674-4152
年,卷(期):2024.22(9)