The Status And Influencing Factors Of Dyadic Coping In Patients With Type 2 Diabetes And Their Spouses

Objectives:To find out the current situation and influencing factors of dyadic coping of patients with type 2diabetes mellitus(T2DM)and their spouses,to verify the Actor-Partner Interdependence Model of marital quality and dyadic coping,and to provide theoretical evidence for intervention studies for patients with T2DM from the perspective of both the patients and spouses.Methods:(1)Questionnaire survey method:convenience sampling method was used to survey 329 pairs of inpatients with T2DM and their spouses from October 2021 to July 2022,using general information questionnaire,the Dyadic Coping Inventory,the Summary of Diabetes Self Care Activities scale,the General Self-Efficacy Scale and the Locke-Wallace Marriage Adjustment Test.(2)Statistical analysis method:SPSS 26.0 was used for descriptive statistical analysis,Mono-factor analysis,Pearson correlation analysis,and multiple linear regression analysis;the mediating effects of patient self-management and spouse self-efficacy between marital quality of the patients and spouses and dyadic coping were analyzed through AMOS 24.0,and the Actor-Partner Interdependence Model was established to analyze the actor-partner effects among variables.The variances are statistically valid when the result P<0.05.Results:(1)With the total dyadic coping score of T2DM patients(120.02±20.47),the numbers of low,medium and high level were 99(30.1%),195(59.3%),35(10.6%)respectively.With the total dyadic coping score of spouses of T2DM patients(122.94±19.96),the numbers of low,medium and high level were 82(24.9%),212(64.4%),and 35(10.6%).(2)Correlation analysis:(i)T2DM patients:patient dyadic coping was significantly positively associated with patient marital quality(r=0.484,P<0.01),patient self-management(r=0.444,P<0.01),spouse self-efficacy(r=0.376,P<0.01),spouse marital quality(r=0.466,P<0.01),and spouse dyadic coping(r=0.677,P<0.01);(ii)spouses:spousal dyadic coping was significantly positively correlated with patient marital quality(r=0.433,P<0.01),patient self-management(r=0.301,P<0.01),patient dyadic coping(r=0.677,P<0.01),spousal marital quality(r=0.481,P<0.01),and spousal self-efficacy(r=0.428,P<0.01).(3)The results of the Actor-Partner Interdependence Model:fit indexχ~2=388.745,df=309,χ~2/df<5,RMSEA<0.08,PGFI>0.5,CFI>0.9,TLI>0.9,there were actor-partner effects of patient marital quality and spouse marital quality on the dyadic coping of T2DM patients and their spouses(P<0.05);the mediating effect of the patient self-management between patient marital quality and patient/spouse dyadic coping was0.139 and 0.080,accounting for 37.3%and 31.1%of the total effect,respectively;the mediating effect of spouse self-efficacy between spouse marital quality and spouse/patient dyadic coping was 0.130 and 0.106,accounting for 32.6%and 36.9%of the total effect,respectively.(4)Multiple linear regression results:(i)patients:the eight factors of patients’gender,education level,work status,comorbidity,self-management,marital quality and spouse’s self-efficacy and dyadic coping were the influencing factors of dyadic coping of T2DM patients;(ii)spouses:spouse’s self-efficacy,spouse’s marital quality and patient’s dyadic coping were the influencing factors of spouse’s dyadic coping,and the variances were statistically significant(P<0.05).Conclusions:(1)Both the investigated T2DM patients and their spouses had moderate levels of dyadic coping and mutual influences.(2)The Actor-Partner Interdependence Model between marital quality and dyadic coping of T2DM patients and their spouses was valid.Combined with the results of the multiple linear regression results,the marital quality of patients/spouses directly influenced their respective dyadic coping,but had no effect on each other’s dyadic coping.(3)Spouse’s self-efficacy influenced the dyadic coping of both patients and spouses,and played a mediating role in spouse’s marital quality and dyadic coping.Patient’s self-management influenced the dyadic coping of patients,and played a mediating role in patient’s marital quality and dyadic coping.(4)Male gender,low education level,unemployment,comorbidity,low self-management,low marital quality,low spousal self-efficacy,and low spousal dyadic coping are risk factors for dyadic coping of patients with T2DM.The risk factors for dyadic coping of spouses of patients with T2DM are low level of dyadic coping,low marital quality of spouses,and low self-efficacy of spouses.Therefore,systematic interventions should be implemented for T2DM patients and their spouses with those characteristics.