2型糖尿病病人低血糖恐惧与心理幸福感的关系:生命质量的中介作用

Mediator role of quality of life between fear of hypoglycaemia and psychological well-being in patients with type 2 diabetes mellitus

目的:分析2型糖尿病(T2DM)病人低血糖恐惧与心理幸福感之间的关系,探讨生命质量在低血糖恐惧与心理幸福感之间的中介作用。方法:对420例T2DM病人分别进行低血糖恐惧、生命质量和心理幸福感评价,共354例病人完成。先行Pearson相关性分析低血糖恐惧、生活质量与心理幸福感之间的相关性。再行中介效应分析验证生命质量在T2DM病人低血糖恐惧与心理幸福感之间的中介效应。结果:T2DM病人的低血糖恐惧量表(CHFSⅡ-WS)得分为(11.05±5.67)分,生命质量量表(EQ-5D VAS)得分为(72.94±14.41)分,幸福感指数量表(WHO-5)得分为(70.67±16.98)分。经Pearson相关性分析,CHFSⅡ-WS评分与WHO-5评分呈负相关(r=-0.398,P<0.01),与EQ-5D VAS评分也呈负相关(r=-0.564,P<0.01),EQ-5D VAS评分与WHO-5评分呈正相关(r=0.511,P<0.01);经中介效应分析,T2DM病人的生命质量在低血糖恐惧、幸福感之间的总效应为-1.191,直接效应为-0.481,中介效应为-0.709,中介效应占总效应的比例为59.61%,且间接效应的Bootstrap 95%置信区间不包含0,中介效应有统计学意义(P<0.05)。结论:生命质量在T2DM病人的低血糖恐惧与心理幸福感之间具有显著中介效应,且起部分中介效应。

Objective:To analyze the relationship between fear of hypoglycemia and psychological well-being in patients with type 2 diabetes mellitus(T2 DM),to explore the mediating effect of quality of life on hypoglycemia fear and psychological well-being.Methods:A total of 420 T2 DM patients were evaluated with hypoglycemic fear,quality of life and psychological well-being.Firstly,Pearson correlation was used to analyze the correlation between hypoglycemia fear,life quality and psychological well-being.Further mediating effect analysis verified the mediating effect of quality of life between hypoglycemia fear and psychological well-being in T2 DM patients.Results:The total score of Chinese Version of Hypoglycemia Fear Scale(CHFSⅡ-WS)score in T2 DM patients was(11.05±5.67),the score of EuroQol-5 D Visual Analogue Scale(EQ-5 D VAS)was(72.94±14.41),the score of World Health Organization-5 Well-being Index(WHO-5)was(70.67±16.98).The Pearson correlation analysis showed that CHFSⅡ-WS score was negatively correlated with WHO-5 score(r=-0.398,P<0.01),and also was negatively correlated with EQ-5 D VAS score(r=-0.564,P<0.01),the EQ-5 D VAS score was positively correlated with the WHO-5 score(r=0.511,P<0.01);The analysis of mediating effect showed that the total effect of quality of life between hypoglycemia fear and happiness in T2 DM patients was-1.191,the direct effect was-0.481,and the mediating effect was-0.709.The proportion of mediating effect in the total effect was 59.61%,and the 95%confidence interval of the indirect effect did not include 0,and the mediating effect was statistically significant(P<0.05).Conclusions:Quality of life had a significant mediating effect between hypoglycemia fear and psychological well-being in T2 DM patients,and played the mediating effect partly.