| Objective1 To understand the current status of illness perception,health locus of control and disease adaptability of patients with type 2 diabetes mellitus.2 To clarify the correlation between illness perception,health locus of control and disease adaptation in patients with type 2 diabetes mellitus.3 To explore the influencing factors of disease adaptability of patients with type 2diabetes mellitus.4 To investigate the mediating effect of health locus of control on illness perception and disease adaptation in patients with type 2 diabetes mellitus.MethodA cross-sectional survey was conducted on 245 patients admitted to the Department of Endocrinology of a third-grade hospital in Dalian city from December2019 to September 2020.The research tools included the general data questionnaire,the Brief Illness Perception Questionnaire,Multi-dimensional Health Locus of Control,Short Form of Diabetes Adjustment Assessment Scales,and the concise diabetes disease adaptation locus scale.Data were input into Excel,and descriptive analysis,univariate analysis,linear regression analysis,Pearson correlation analysis and structural equation model were performed using SPSS 20.0 and AMOS 21.0 for statistical analysis.P<0.05 indicated statistically significant differences.Result1 The total score of illness perception in patients with type 2 diabetes was(40.05±13.60),and the average score of dimension items from high to low was(5.39±3.05)in emotional dimension,(4.99±1.70)in cognitive dimension,and(4.32±2.19)in comprehension dimension.2 The scores of the three dimensions of health locus of control sources in T2 DM patients were: I-HLC score(21.68±5.57),C-HLC score(23.69±4.62),and P-HLC score(24.21±4.58).Compared with the domestic norm [4],the scores of P-HLC dimension and C-HLC dimension were higher than the domestic norm(both P <0.001),and the scores of I-HLC dimension were lower than the domestic norm(P<0.001).3 The total score of disease adaptability of T2 DM patients was(61.51±13.61),lower than the medium level,and 93 patients with the score rate of more than 50%,accounting for 38.0% of the total.The scores of each dimension were 15.48±5.24 for early self-management,9.92±3.15 for advanced self-management,9.72±3.96 for seeking social support,6.98±2.59 for daily life after disease,7.97±2.53 for disease readjust,and 11.43±3.71 for initial impression of disease.4 There was a negative correlation between disease perception and disease adaptation ability in T2 DM patients(r=-0.643,P < 0.01).Internal control sources,powerful other-type control sources,and opportunity control sources were negatively correlated with disease perception(r=-0.585,P < 0.01),positively correlated with disease perception(r=0.571,P<0.01),and positively correlated with disease perception(r=0.479,P<0.01).Internal control sources,powerful other-type control sources,and opportunity control sources were positively correlated(r=0.616,P<0.01),negatively correlated(r=-0.588,P < 0.01),and negatively correlated(r=-0.580,P < 0.01)with disease adaptation ability,respectively.5 The total score of disease adaptability was used as the dependent variable,and the five variables(family per capita monthly income,occupation,family history of diabetes,course of diabetes,Hb A1c),sources of psychological control and the dimensions of disease perception in univariate analysis that affected the total score of disease adaptability were included as independent variables in the linear regression analysis.The results showed that the three dimensions of family per capita monthly income,family history of diabetes,course of diabetes,source of psychological control,and cognitive dimension entered the regression equation,together explaining 66.9% of the variation.6 Structural equation model analysis showed that psychological control sources played a partial mediating role in the relationship between disease perception and disease adaptation in T2 DM patients.Conclusions1 The inpatients with T2 DM showed a moderate level of illness perception,which was higher than that of patients with common diseases,and the score of emotional dimension was the highest.Medical staff should pay attention to the emotional response of patients,and adopt effective intervention strategies to ease patients’ negative emotions and reduce their disease perception.2 P-HLC and C-HLC were most commonly used in T2 DM inpatients.Nursing staff should formulate intervention plans to improve the level of health locus of control according to the theoretical framework in combination with patients’ tendency of health locus of control.3 The overall disease adaptation ability of T2 DM inpatients is below the medium level.Medical staff should timely evaluate the disease adaptation ability of patients,analyze the dimensions of patients with low scores,and on this basis,improve their disease adaptation ability more targeted.4 The illness perception of T2 DM inpatients was negatively correlated with disease adaptation ability,and negatively correlated with I-HLC,P-HLC,and C-HLC,respectively.The disease adaptability was positively,negatively and negatively correlated with I-HLC,P-HLC and C-HLC,respectively.According to the correlation between the three,medical staff can take targeted intervention strategies to reduce the illness perception of T2 DM inpatients,improve their level of health locus of control,and further improve their ability to adapt to disease.5 Ability to adapt the diabetes disease hospitalized patients with T2 DM,family income level,family history of diabetes psychological control source,the influence of the cognitive level,medical workers should pay more attention to short duration,low income,no family history of diabetes patients,improve the patient’s level of psychological control source,reduce its negative cognition,help patients better adapt to the disease.6 Health locus of control played a mediating role in the relationship between illness perception and disease adaptation ability in T2 DM inpatients.Illness perception can directly affect disease adaptation,and it can also indirectly affect disease adaptation through health locus of control.Medical staff can improve the disease adaptation ability of T2 DM inpatients from two perspectives of illness perception and health locus of control. |
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