The Relationship Between The Status Quo Of Stigma,social Support And Selfefficacy In Middle-aged And Young Patients With Type 2 Diabetes

Background: The youthful trend of diabetes in is obvious,and the young and middle-aged population has become the group with the fastest increase in the prevalence of diabetes in China.Diabetes itself as a source of stress can cause patients to produce a certain psychological stress response,and stigma is one of them.Studies have shown that diabetic patients have stigma,but the research on diabetic patients mostly focuses on the elderly,and less attention is paid to the young and middle-aged groups.Based on the cognitive model of stress and coping and modified label theory,this study explored the relationship between social support,self-efficacy and stigma in young and middle-aged patients with type 2 diabetes.Aims: This study investigates the status quo of stigma in middle-aged and young patients with type 2 diabetes and its correlation with social support and self-efficacy,and explores the influence paths between social support,self-efficacy and stigma of middleaged and young patients with type 2 diabetes.In the future,my country will provide a theoretical basis for further intervention research on stigma of diabetic patients.Material and methods: The convenience sampling method was adopted to select218 young and middle-aged T2 DM patients in the wards or endocrinology outpatient clinics of two tertiary A hospitals in Shiyan City from June 2019 to March 2020.A total of 218 diabetic patients were interviewed on diabetes stigma,social support,self-efficacy using the following self-administered questionnaires: Type 2 Diabetes Stigma Assessment Scale(DSAS-2),The Social Support Rating Scale,General Self-efficacy Scale.SPSS22.0 is used for data analysis,measurement data is expressed by(?X ± S)and counting data is expressed by frequency and percentage.The stigma scores of binary variables were compared using independent sample t-tests,the data of multi-categorical variables were analyzed by one-way analysis of variance,and the influencing factors of stigma were analyzed by multiple linear regression.Results:1.The total score for stigma of young and middle-aged patients with type 2 diabetes is(60.9?9.84),and the scores in each dimension from high to low are blame and judgment(22.87?3.68),self-shame(19.17?4.36),difference treatment(18.87?3.39),the overall stigma was moderate.The total score of social support for young and middle-aged patients with type 2 diabetes is(37.9?5.78),which is at a medium level.The scores for each dimension are subjective support(21.99?3.74),objective support(9.51?1.97),and support utilization(6.4?1.75).High-level social supporters accounted for 18.8%,medium-level social supporters accounted for 85.3%,and low-level social supporters accounted for 1.8%.The total score of self-efficacy of young and middle-aged patients with type 2 diabetes was(26.22?4.13).2.Univariate analysis shows that the patient’s age,marital status,education level,employment status,family monthly income(yuan),medical insurance type,course of disease(years),number of complications or comorbidities are statistically significant in diabetes stigma scores(P<0.05).3.Pearson correlation analysis shows that the total scores of social support and the scores of various dimensions of young and middle-aged type 2 diabetes patients are negatively correlated with the total scores of stigma and the scores of each dimension(P<0.01);the total scores of social support and the scores of each dimension and the total score of self-efficacy are positively correlated;the total score of self-efficacy is negatively correlated with the total score of stigma and the scores of various dimensions,(P<0.01).4.Multiple linear regression analysis shows that patients’ age,family monthly income(yuan),and disease duration(years),social support and self-efficacy are the main factors affecting the stigma of patients.These variables explained 50.3% of the variance in the stigma score.5.The structural equation model shows that social support for young and middleaged patients with type 2 diabetes has a negative effect on stigma(β=-0.282,P=0.003),and self-efficacy plays a part of mediating role between social support and stigma.Conclusion:1.The mentality of blame and judgment of young and middle-aged patients due to illness is the most obvious.Their stigma is generally at a medium level.The social support of young and middle-aged patients with type 2 diabetes is generally at a medium level;the self-efficacy level of patients is relatively high.2.Social support,self-efficacy,and stigma are all significantly correlated.The lower the social support the patient receives,the lower the level of self-efficacy.Longterm treatment makes them feel frustrated and slack.At the same time,the symptoms and treatment of the disease subtly make the patient and others solidify the "patient" label and the level of diabetes stigma gets higher.3.According to the results of structural equation analysis,social support for young and middle-aged patients with type 2 diabetes can not only directly affect the stigma,but also indirectly affect the stigma through the summary effect of self-efficacy.4.Diabetes treatment-related consumables can be appropriately included in the scope of medical insurance,to provide consultations on related disease response skills for diabetic patients,increase the popularization of diabetes-related knowledge in the society,and use certain methods to guide patients to build confidence in fighting the disease to reduce patients Stigma level.