营养素养在2型糖尿病患者健康赋权与饮食依从性间的中介效应

Mediating effect of nutritional literacy on health empowerment and dietary adherence in patients with type 2 diabetes

目的:探讨2型糖尿病患者营养素养在健康赋权与饮食依从性间的中介效应。方法:采用便利抽样法选取2022年7月至2023年6月广西医科大学第一附属医院内分泌科住院部及门诊的426例2型糖尿病患者作为研究对象,应用一般资料调查表、中文版简明营养素养评价工具、中文版慢性病赋权量表和饮食控制行为量表进行资料收集,运用结构方程模型深入剖析营养素养在健康赋权与饮食依从性间的中介效应。结果:2型糖尿病患者健康赋权与饮食依从性呈正相关关系(r=0.493,P<0.001),健康赋权与营养素养呈正相关关系(r=0.589,P<0.001),营养素养与饮食依从性呈正相关关系(r=0.412,P<0.001);健康赋权对饮食依从性的总效应为0.197(95%CI:0.164~0.230),直接效应为0.153(95%CI:0.113~0.194),营养素养在健康赋权与饮食依从性间的中介效应为0.044(95%CI:0.018~0.070),占总效应的22.33%。结论:2型糖尿病患者营养素养在健康赋权及饮食依从性间的存在中介效应,医护人员可以通过加强2型糖尿病患者的健康赋权水平来提高营养素养,从而改善饮食依从性。

Objective:To investigate the mediating effect of nutritional literacy on health empowerment and dietary adherence in patients with type 2 diabetes.Methods:A total of 426 patients with type 2 diabetes in inpatient department and outpatient department of Endocrinology Department of the First Affiliated Hospital of Guangxi Medical University from July 2022 to June 2023 were selected as the research objects by convenience sampling method.General data Questionnaire,Chinese version Concise nutritional literacy assessment tool,Chinese version Chronic Disease Empowerment Scale and diet Control Behavior Scale were used to collect data.Structural equation model was used to analyze the mediating effect of nutritional literacy on health empowerment and dietary adherence.Results:Health empowerment was positively correlated with dietary adherence(r=0.493,P<0.001),health empowerment was positively correlated with nutritional literacy(r=0.589,P<0.001),and nutritional literacy was positively correlated with dietary adherence(r=0.412,P<0.001).The total effect of health empowerment on dietary adherence was 0.197(95%CI:0.164-0.230),the direct effect was 0.153(95%CI:0.113-0.194),and the mediating effect of nutritional literacy on health empowerment and dietary adherence was 0.044(95%CI:0.018-0.070),accounting for 22.33%of the total effect.Conclusion:Nutritional literacy has a mediating effect between health empowerment and dietary adherence in patients with type 2 diabetes.Medical staff can improve nutritional literacy by strengthening the level of health empowerment of patients with type 2 diabetes,so as to promote the dietary adherence.