Skip to main content
Top
Published in: BMC Public Health 1/2023

Open Access 01-12-2023 | Research

The relationship between psychological resilience and quality of life among the Chinese diabetes patients: the mediating role of stigma and the moderating role of empowerment

Authors: Yujin Mei, Xue Yang, Jiaofeng Gui, Yuqing Li, Xiaoyun Zhang, Ying Wang, Wenyue Chen, Mingjia Chen, Changjun Liu, Lin Zhang

Published in: BMC Public Health | Issue 1/2023

Login to get access

Abstract

Background

Although some factors, such as stigma and empowerment, influence the complex relationship between psychological resilience and quality of life, few studies have explored similar psychological mechanisms among patients with diabetes. Therefore, this study explored the mediating role of stigma and the moderating role of empowerment in the psychological mechanisms by which psychological resilience affects quality of life.

Methods

From June to September 2022, data were collected by multi-stage stratified sampling and random number table method. Firstly, six tertiary hospitals in Wuhu were numbered and then selected using the random number table method, resulting in the First Affiliated Hospital of Wannan Medical College being selected. Secondly, two departments were randomly selected from this hospital: endocrinology and geriatrics. Thirdly, survey points were set up in each department, and T2DM patients were randomly selected for questionnaire surveys. In addition, we used the Connor-Davidson Elasticity Scale (CD-RISC) to measure the psychological resilience of patients, and used the Stigma Scale for Chronic Illness (SSCI) to measure stigma. Empowerment was measured by the Diabetes Empowerment Scale (DES). Quality of Life was assessed by the Diabetes Quality of Life Scale (DQoL). We used SPSS (version 21) and PROCESS (version 4.1) for data analysis.

Results

(1) Psychological resilience was negatively correlated with stigma and quality of life, and positively correlated with empowerment. Stigma was positively associated with empowerment and quality of life. Empowerment was negatively correlated with quality of life. (2) The mediation analysis showed that psychological resilience had a direct predictive effect on the quality of life, and stigma partially mediated the relationship; Empowerment moderates the first half of "PR → stigma → quality of life"; Empowerment moderates the latter part of "PR → stigma → quality of life."

Conclusions

Under the mediating effect of stigma, psychological resilience can improve quality of life. Empowerment has a moderating effect on the relationship between psychological resilience and stigma, and it also has a moderating effect on the relationship between stigma and quality of life. These results facilitate the understanding of the relationship mechanisms between psychological resilience and quality of life.
Literature
2.
13.
go back to reference Boškailo E, Franjić D, Jurić I, Kiseljaković E, Marijanović I, Babić D. Resilience and Quality of Life of Patients with Breast Cancer. Psychiatr Danub. 2021;33:572–9.PubMed Boškailo E, Franjić D, Jurić I, Kiseljaković E, Marijanović I, Babić D. Resilience and Quality of Life of Patients with Breast Cancer. Psychiatr Danub. 2021;33:572–9.PubMed
19.
go back to reference Browne J.L., Ventura A.D., Mosely K., Speight J. Measuring the Stigma Surrounding Type 2 Diabetes: Development and Validation of the Type 2 Diabetes Stigma Assessment Scale (DSAS-2) Diabetes Care. 2016;39:2141–2148. https://doi.org/10.2337/dc16-0117 Browne J.L., Ventura A.D., Mosely K., Speight J. Measuring the Stigma Surrounding Type 2 Diabetes: Development and Validation of the Type 2 Diabetes Stigma Assessment Scale (DSAS-2) Diabetes Care. 2016;39:2141–2148. https://​doi.​org/​10.​2337/​dc16-0117
20.
go back to reference Nicolucci A, Burns KK, Holt RIG, Comaschi M, Hermanns N, Ishii H, Kokoszka A, Pouwer F, Skovlund SE, Stuckey H, et al. Diabetes Attitudes, Wishes and Needs second study (DAWN2™): Cross-national benchmarking of diabetes-related psychosocial outcomes for people with diabetes. Diabet Med. 2013;30:767–77. https://doi.org/10.1111/dme.12245.CrossRefPubMed Nicolucci A, Burns KK, Holt RIG, Comaschi M, Hermanns N, Ishii H, Kokoszka A, Pouwer F, Skovlund SE, Stuckey H, et al. Diabetes Attitudes, Wishes and Needs second study (DAWN2™): Cross-national benchmarking of diabetes-related psychosocial outcomes for people with diabetes. Diabet Med. 2013;30:767–77. https://​doi.​org/​10.​1111/​dme.​12245.CrossRefPubMed
33.
go back to reference Yazdanmanesh M, Esmaeili R, Nasiri M, Vasli P. Relieving care burden and promoting health-related quality of life for family caregivers of elderly people with Alzheimer's disease via an empowerment program. Aging Clin Exp Res. 2022:1–11. https://doi.org/10.1007/s40520-022-02277-8. Yazdanmanesh M, Esmaeili R, Nasiri M, Vasli P. Relieving care burden and promoting health-related quality of life for family caregivers of elderly people with Alzheimer's disease via an empowerment program. Aging Clin Exp Res. 2022:1–11. https://​doi.​org/​10.​1007/​s40520-022-02277-8.
35.
go back to reference Thompson B. Ten commandments of structural equation modeling. In:Grimm LG, Yarnold PR, editors. Reading and Understanding More Multivariate Statistics. Washington, DC: American Psychological Association; (2000). Thompson B. Ten commandments of structural equation modeling. In:Grimm LG, Yarnold PR, editors. Reading and Understanding More Multivariate Statistics. Washington, DC: American Psychological Association; (2000).
40.
go back to reference Anderson RM, Fitzgerald JT, Funnell MM, Feste C. Diabetes empowerment scales(DES): a measure of psychosocial self-efficacy (Abstract). Diabetes. 1997;46:269A. Anderson RM, Fitzgerald JT, Funnell MM, Feste C. Diabetes empowerment scales(DES): a measure of psychosocial self-efficacy (Abstract). Diabetes. 1997;46:269A.
46.
go back to reference Olson KL, Howard M, McCaffery JM, Dutton GR, Espeland MA, Simpson FR, et al; Look AHEAD Research Group. Psychological resilience in older adults with type 2 diabetes from the Look AHEAD Trial. J Am Geriatr Soc. 2022. https://doi.org/10.1111/jgs.17986. Olson KL, Howard M, McCaffery JM, Dutton GR, Espeland MA, Simpson FR, et al; Look AHEAD Research Group. Psychological resilience in older adults with type 2 diabetes from the Look AHEAD Trial. J Am Geriatr Soc. 2022. https://​doi.​org/​10.​1111/​jgs.​17986.
59.
go back to reference Cardoso Barbosa H, de Queiroz Oliveira JA, Moreira da Costa J, de Melo Santos RP, Gonçalves Miranda L, de Carvalho Torres H, et al. Empowerment-oriented strategies to identify behavior change in patients with chronic diseases: An integrative review of the literature. Patient Educ Couns. 2021;104:689–702. https://doi.org/10.1016/j.pec.2021.01.011. Cardoso Barbosa H, de Queiroz Oliveira JA, Moreira da Costa J, de Melo Santos RP, Gonçalves Miranda L, de Carvalho Torres H, et al. Empowerment-oriented strategies to identify behavior change in patients with chronic diseases: An integrative review of the literature. Patient Educ Couns. 2021;104:689–702. https://​doi.​org/​10.​1016/​j.​pec.​2021.​01.​011.
Metadata
Title
The relationship between psychological resilience and quality of life among the Chinese diabetes patients: the mediating role of stigma and the moderating role of empowerment
Authors
Yujin Mei
Xue Yang
Jiaofeng Gui
Yuqing Li
Xiaoyun Zhang
Ying Wang
Wenyue Chen
Mingjia Chen
Changjun Liu
Lin Zhang
Publication date
01-12-2023
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2023
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/s12889-023-16927-7

Other articles of this Issue 1/2023

BMC Public Health 1/2023 Go to the issue