| Objective This study aims to investigate the current situation of social support,self-management ability,loneliness and discharge readiness of elderly type 2 diabetes patients,explore the influence mechanism of social support on self-management of elderly type 2 diabetes patients,analyze the role of mediation between loneliness and discharge readiness,and provide theoretical basis for improving social support of the elderly type 2 diabetes patients to improve their self-management level.Methods From April to October 2022,222 elderly inpatients with type 2 diabetes in purpose sampling method were seleted from the Endocrinology Department of using tertiary hospital in Anhui province by cross-sectional survey design.The general data questionnaire,diabetes self-management scale,social support scale,UCLA loneliness scale,the Chinese version of the discharge preparation scale were used to patients’ general situation,self-management social support loneliness and discharge preparation.Statistical analysis of data was performed using SPSS26.0,general data,self-management,social support,loneliness,frequency,composition ratio,mean ± standard deviation;self-management,social support,loneliness,and discharge readiness in demographic characteristics were compared by independent sample t-test or one-way variance analysis;correlation of them were analyzed by Pearson;SPSS Process 4.0 plug-in model 4 for simple mediation effect analysis,and chain mediation analysis by model 6.Result(1)Total score of self-management of elderly T2DM(84.09±17.54),dietary control(19.30±5.85),exercise(11.39±5.25);medication compliance(13.63±2.89);glucose monitoring(8.74±4.13),foot care(18.02±4.44);and high and hypoglycemic treatment dimensions(12.98±3.59).Significant difference in self-management scores among elderly T2 DM patients by age,educational level,number of children,and self-rated health status(P <0.05).(2)The total score of social support for elderly T2 DM patients(63.99±10.90),the family support dimension score(25.69±2.71),the friend support dimension score(19.30±5.85),and the other support dimensions score(19.32±4.94).Significant differences in social support scores for different numbers of children and elderly T2 DM patients with self-rated health status(P <0.05).(3)The loneliness score of elderly T2 DM patients was classified as(36.44±11.04),and the results showed that the difference in loneliness scores of elderly T2 DM patients with different self-rated health status was statistically significant(P <0.05).(4)The total score of discharge readiness for elderly T2 DM patients(98.49±19.31),the personal state dimension score(24.13±6.53),the dimension score of adaptability(41.56±11.06),and the anticipatory support dimension score(32.94±7.10).The discharge readiness scores for elderly T2 DM patients with different educational level,residence status,number of children,self-rated health and presence of complications(P <0.05).(5)Related analysis showed that social support and discharge readiness scores were positively associated with self-management(r=0.241,r=0.306,P <0.01),and loneliness negatively associated with self-management(r=-0.256,P <0.01); discharge readiness positively associated with social support(r=0.492,P <0.01)and loneliness negatively(r=-0.602,P <0.01);and loneliness negative associated with discharge readiness(r=-0.511,P <0.01).(6)The mediation analysis showed that loneliness played a partial mediation role between social support and self-management ability in elderly T2 DM patients,accounting for 43.56% of the total effect.Discharge readiness played a partial mediating role between social support and self-management in elderly patients with type 2 diabetes,with an effect ratio of 50.52%.The effect value of chain mediation between social support and self-management in elderly type 2 DM was 0.072,the chain mediation effect was significant,and the total indirect effect accounted for69.85% of the total effect.Conclusion(1)The self-management level of elderly patients with T2 DM is at a medium level,and there is still a large room for improvement.Age,educational level,number of children,and self-rated health are the main factors affecting the self-management of elderly T2 DM patients.(2)The social support of elderly patients with T2 DM is at a medium level,and the number of children and self-rated health are the main factors affecting the social support of elderly patients with T2 DM patients.(3)Elderly patients with T2 DM have loneliness and discharge readiness at moderate levels.(4)There is a significant correlation between social support,self-management ability,loneliness and discharge readiness of elderly T2 DM patients.The higher the level of social support,lower loneliness,and higher readiness for discharge,the better their self-management ability.(5)Loneliness in elderly T2 DM patients is partly a mediator between social support and self-management;discharge readiness partially mediated between social support and self-management;loneliness and discharge readiness played a chain-mediating role between social support and self-management in elderly patients with type 2 diabetes. |
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