Diabetes distress as mediators of loneliness and health promotion behaviour: a cross-sectional study

Objectives The purpose of this study was to explore whether diabetes distress mediated the relationship between loneliness and health promotion in older adults with diabetes.Design A cross-sectional study.Setting The study was conducted at three tertiary hospitals in Changsha, Hunan Province, China....

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Main Authors: Tingting Yang, Lu Deng, Feiyang Zhou, Chunbo Guo, Keyu Long, Linlin Xie, Qian Lv
Format: Article
Language:English
Published: BMJ Publishing Group 2023-12-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/13/12/e079674.full
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author Tingting Yang
Lu Deng
Feiyang Zhou
Chunbo Guo
Keyu Long
Linlin Xie
Qian Lv
author_facet Tingting Yang
Lu Deng
Feiyang Zhou
Chunbo Guo
Keyu Long
Linlin Xie
Qian Lv
author_sort Tingting Yang
collection DOAJ
description Objectives The purpose of this study was to explore whether diabetes distress mediated the relationship between loneliness and health promotion in older adults with diabetes.Design A cross-sectional study.Setting The study was conducted at three tertiary hospitals in Changsha, Hunan Province, China.Participants The sample included 140 patients with diabetes (65 years and older, mean age 72.6 years, SD=4.6).Methods We employed path models to analyse data on diabetes distress, loneliness and health promotion behaviours. We collected diabetes distress, loneliness and health promotion behaviour with self-reported questionnaires including the Diabetes Distress Scale, the University of California at Los Angeles (UCLA) Loneliness Scale and the Elderly Health Promotion Scale from January 2022 to October 2022. Mediation analysis was performed by SPSS V.26.0’s PROCESS macro.Result The findings of this study indicated diabetes distress acted as a mediator between loneliness and health promotion behaviour. According to bootstrapping results, the total effect of loneliness on health promotion behaviour was significantly negative (β=−0.312, p=0.006). Loneliness significantly and negatively correlated with diabetes distress (β=−0.043, p<0.001), while diabetes distress significantly and negatively correlated with health promotion behaviours (β=−2.724, p=0.008). Both the indirect effect and the direct effect of loneliness on health promotion behaviour were significant.Conclusion Our study illustrated that loneliness was negatively associated with health promotion behaviours, and diabetes distress acted as a mediator in this relationship. It is suggested that healthcare providers should prioritise the identification and management of diabetes distress in older patients with diabetes who experience loneliness to improve health promotion behaviours and optimise disease management outcomes.
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spelling doaj-art-10a855ab0187478bbd1d01bc8b5dcf712025-08-20T02:11:18ZengBMJ Publishing GroupBMJ Open2044-60552023-12-01131210.1136/bmjopen-2023-079674Diabetes distress as mediators of loneliness and health promotion behaviour: a cross-sectional studyTingting Yang0Lu Deng1Feiyang Zhou2Chunbo Guo3Keyu Long4Linlin Xie5Qian Lv6Bone Marrow Transplantation Center of The First Affiliated Hospital and Liangzhu Laboratory, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China1 School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, ChinaClinical Nursing Teaching and Research Section, The Second Xiangya Hospital of Central South University, Changsha, ChinaClinical Nursing Teaching and Research Section, The Second Xiangya Hospital of Central South University, Changsha, ChinaCentral South University, Changsha, ChinaCentral South University, Changsha, ChinaClinical Nursing Teaching and Research Section, The Second Xiangya Hospital of Central South University, Changsha, ChinaObjectives The purpose of this study was to explore whether diabetes distress mediated the relationship between loneliness and health promotion in older adults with diabetes.Design A cross-sectional study.Setting The study was conducted at three tertiary hospitals in Changsha, Hunan Province, China.Participants The sample included 140 patients with diabetes (65 years and older, mean age 72.6 years, SD=4.6).Methods We employed path models to analyse data on diabetes distress, loneliness and health promotion behaviours. We collected diabetes distress, loneliness and health promotion behaviour with self-reported questionnaires including the Diabetes Distress Scale, the University of California at Los Angeles (UCLA) Loneliness Scale and the Elderly Health Promotion Scale from January 2022 to October 2022. Mediation analysis was performed by SPSS V.26.0’s PROCESS macro.Result The findings of this study indicated diabetes distress acted as a mediator between loneliness and health promotion behaviour. According to bootstrapping results, the total effect of loneliness on health promotion behaviour was significantly negative (β=−0.312, p=0.006). Loneliness significantly and negatively correlated with diabetes distress (β=−0.043, p<0.001), while diabetes distress significantly and negatively correlated with health promotion behaviours (β=−2.724, p=0.008). Both the indirect effect and the direct effect of loneliness on health promotion behaviour were significant.Conclusion Our study illustrated that loneliness was negatively associated with health promotion behaviours, and diabetes distress acted as a mediator in this relationship. It is suggested that healthcare providers should prioritise the identification and management of diabetes distress in older patients with diabetes who experience loneliness to improve health promotion behaviours and optimise disease management outcomes.https://bmjopen.bmj.com/content/13/12/e079674.full
spellingShingle Tingting Yang
Lu Deng
Feiyang Zhou
Chunbo Guo
Keyu Long
Linlin Xie
Qian Lv
Diabetes distress as mediators of loneliness and health promotion behaviour: a cross-sectional study
BMJ Open
title Diabetes distress as mediators of loneliness and health promotion behaviour: a cross-sectional study
title_full Diabetes distress as mediators of loneliness and health promotion behaviour: a cross-sectional study
title_fullStr Diabetes distress as mediators of loneliness and health promotion behaviour: a cross-sectional study
title_full_unstemmed Diabetes distress as mediators of loneliness and health promotion behaviour: a cross-sectional study
title_short Diabetes distress as mediators of loneliness and health promotion behaviour: a cross-sectional study
title_sort diabetes distress as mediators of loneliness and health promotion behaviour a cross sectional study
url https://bmjopen.bmj.com/content/13/12/e079674.full
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