The Effect Of Social Participation On Self-management Of Elderly Patients With Type 2 Diabetes: Moderated Mediating Effect

Objective This research aims to investigate the social participation,self-efficacy,depression and self-management status of elderly patients with type 2 diabetes.To Explore the mechanism of social participation on the self-management of elderly patients with type 2 diabetes,and to analyze the mediating effect of self-efficacy between social participation and self-management;the moderating effect of different depression levels on mediating process;In order to improve the elderly type 2 diabetes patients social participation to improve their self-management level to provide a theoretical basis.Methods Objective to select 297 elderly patients with type 2 diabetes who were treated in the Department of endocrinology of a third class hospital in Hefei from June2020 to December 2020 as the research objects for cross-sectional survey.They were investigated by using the general information questionnaire,Impact on Participation and Autonomy Questionnaire(IPA),Diabetes Self-Care Scale(DSCS),Self-efficacy for diabetes(SED)and 15-item Geriatric Depression Scale(GDS-15).Results(1)The social participation score of elderly patients with type 2 diabetes is(37.89±15.86).There were statistical differences in the scores of social participation in gender,age,disease course,and education level,marriage(P<0.05).(2)The self-management score of elderly patients was(62.83±12.11)points.Only 9.1%of patients had good self-management skills.There are statistical differences in self-management in monthly income,education level,previous occupation,complications,place of residence,Hb A1 c scores(P<0.05).(3)The self-efficacy score of elderly patients was(6.80±1.48)points.There were statistical differences in self-efficacy in gender,marriage,monthly income,education level,residence,living status,and previous occupation scores(P<0.05).(4)Among elderly patients with type 2 diabetes,167(56.2%)suffer from depressive symptoms.Mainly with mild to moderate depression.There were statistically significant differences in depression in age,marriage,education level,residence,residence status,previous occupation,monthly income,and scores of complications(P<0.05).(5)Correlation analysis shows that self-management of elderly patients with T2 DM is negatively correlated with social participation scores and depression,and positively correlated with self-efficacy;social participation scores are negatively correlated with self-efficacy and positively correlated with depression;depression is significantly negatively correlated with self-efficacy.(6)Self-efficacy plays a partially mediating role between social participation and self-management,and the mediating effect accounts for 32.26% of the total effect;Depression moderates the first half mediating path of self-efficacy(β=-0.12,P<0.05).Conclusion(1)The social participation,self-efficacy,and self-management of elderly patients with type 2 diabetes are at a moderate level,and the detection rate of depression is 56.2%;(2)social participation,self-efficacy,depression and self-management has a significant correlation;(3)self-efficacy partially mediated the impact of social self-management in elderly patients with type 2 diabetes participation;(4)Depression moderates the relationship between social participation and self-efficacy.Depression moderates the mediating effect of self-efficacy,and a moderated mediating model is established.