Interaction of self-efficacy and sense of personal control on diabetes distress in older adults with type 2 diabetes: a cross-sectional study.

BACKGROUND

Diabetes distress (DD) constitutes a significant barrier to effective diabetes management, impacting self-care behaviors and complication incidence rates. It directly influences quality of life and healthcare resource utilization among gerontal patients. Research on alleviating DD offers a novel perspective for developing personalized self-management plans in clinical practice.

METHODS

This cross-sectional study randomly selected 342 older adults with type 2 diabetes registered at community hospitals. Factors influencing disease distress were assessed using a demographic questionnaire, Diabetes Distress Scale (DDS), Personal Mastery Scale (PMS), General Self-Efficacy Scale (GSES), and Diabetes Self-Management Behavior Scale (DSMB-O). Structural equation modeling was employed for moderated mediation analysis.

RESULTS

Findings revealed that 59.06% of older adults with T2DM experienced distress. Independent risk factors for DDS included disease duration ≥10 years (β = 1.181), living alone (β = 1.592), low educational attainment (β = -1.639), low household income (β = 1.432), PMS score <20 (β = 0.828), and GSES score <30 (β = 0.887). Under the hypothetical model, the structural equation model revealed that the indirect path coefficients for self-efficacy and general sense of control via self-management on perceived illness distress were significant (-0.081, -0.066, p < 0.005). Concurrently, the chained path was also significant (-0.020, -0.009, p < 0.05).

CONCLUSION

Factors influencing disease distress in older adults with T2DM are diverse. The complex interplay between personal mastery and self-efficacy offers new intervention strategies for clinically alleviating diabetes distress.