健康素养在2型糖尿病患者相关情绪困扰与自我管理间的中介效应

Mediating effect of health literacy on emotional distress and self-management associated with type 2 diabetes mellitus

目的探讨2型糖尿病患者健康素养、情绪困扰与自我管理间的相互作用。方法采用便利抽样方法,选取2019年9月至2020年4月镇江市2所三级甲等医院239例内分泌代谢科门诊及住院的2型糖尿病患者。使用2型糖尿病患者健康素养、情绪困扰及自我管理量表对其进行调查,其三者关系应用AMOS 24.0软件依据Pearson相关分析结果,建立结构方程模型验证中介效应。结果健康素养得分为61.91分;Pearson相关分析显示,情绪困扰与自我管理(r=-0.352,P<0.001)、健康素养(r=-0.479,P<0.001)均呈负相关,健康素养与自我管理呈正相关(r=0.345,P<0.001)。在中介检验中,健康素养是情绪困扰和自我管理的中介变量,中介效应值为41.67%。结论健康素养在2型糖尿病患者情绪困扰与自我管理间起部分中介作用。临床工作者应重视提升存在情绪困扰患者的健康素养水平,以促进患者自我管理能力的提升。

Objective To explore the interaction between health literacy,emotional distress and self-management in type 2 diabetes mellitus.Methods A total of 239 patients with type 2 diabetes were selected by convenience sampling,who were admitted to the Department of Endocrinology and Metabolism of 2 level-A tertiary hospitals in Zhenjiang from September 2019 to April 2020.An investigation was made of the relationship between health literacy in type 2 diabetes,emotional distress and self-management.Using AMOS 24.0,Pearson correlation analysis established a structural equation model to verify the mediating effect.Results The score of health literacy was 61.91.Pearson correlation analysis showed that emotional distress was negatively correlated to self-management(r=-0.352,P<0.001)and health literacy(r=-0.479,P<0.001),and that health literacy and self-management had positive correlation(r=0.345,P<0.001).In the mediation test,health literacy was a mediating variable between emotional distress and self-management,with a mediating effect value of 41.67%.Conclusion Health literacy partially mediates emotional distress and self-management in the patients with type 2 diabetes mellitus.Clinicians should pay attention to improving the health literacy of patients with emotional distress to improve the patients′self-management.