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BMC Public Health
Published in: BMC Public Health 1/2024

Open Access 01-12-2024 | Type 2 Diabetes | Research

The effect of social support, diabetes management self-efficacy, and diabetes distress on resilience among patients with type 2 diabetes: a moderated mediation analysis

Authors: Ali Mohammad Parviniannasab, Zohreh Faramarzian, Seyyed Ali Hosseini, Saeed Hamidizadeh, Mostafa Bijani

Published in: BMC Public Health | Issue 1/2024

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Abstract

Background

Diabetes can result in distress. Improving Resilience is important in managing these conditions. It is also important to consider the mediating role of diabetes management self-efficacy (DMSE) between diabetes distress (DD) and Resilience. Likewise, understanding how social support (SS) buffers the impact of diabetes distress on Resilience is equally important.

Methods

The present study used a cross-sectional design and included 403 participants diagnosed with type 2 diabetes (T2D). The study was conducted in the south of Iran. The participants were selected through convenience sampling from July 2022 to January 2023. Self-reported questionnaires, namely the Diabetes Distress Scale (DDS), Diabetes Management Self-Efficacy Scale (DMSE), Perceived Social Support Scale (PSSS), and Resilience Scale, were used for data collection in the present study. Structural equation modelling was used for moderated mediation analysis.

Results

The results of the Pearson correlation analysis were indicative of a significant negative correlation (p < 0.01) between diabetes distress and diabetes management self-efficacy (r = − 0.607), social support (r = − 0.417), and Resilience (r = − 0.552). The findings further revealed that diabetes management self-efficacy had fully mediated the correlation between diabetes distress and Resilience. Moreover, the results indicated that social support had a moderating role in the DD-resilience link.

Conclusions

The present study’s findings offer a new theoretical framework for T2DM that can benefit intervention designers. The results further suggest that promoting diabetes management self-efficacy can be an effective strategy to enhance Resilience and decrease diabetes distress. Also, nurses and other healthcare providers must pay close attention to support resources to improve the patients’ Resilience and evaluate the distress associated with diabetes.
Literature
1.
Care D. 6. Glycemic targets: standards of medical care in diabetes—2019. Diabetes Care. 2019;42(Supplement 1):S61–70.MathSciNet
2.
Sun H, Saeedi P, Karuranga S, Pinkepank M, Ogurtsova K, Duncan BB, et al. IDF diabetes atlas: global, regional and country-level diabetes prevalence estimates for 2021 and projections for 2045. Diabetes Res Clin Pract. 2022;183:109119.PubMedCrossRef
3.
Dehghani A, Korozhdehi H, Hossein Khalilzadeh S, Fallahzadeh H, Rahmanian V. Prevalence of diabetes and its correlates among Iranian adults: results of the first phase of Shahedieh cohort study. Health Sci Rep. 2023;6(4):e1170.PubMedPubMedCentralCrossRef
4.
Connor KM, Davidson JR. Development of a new resilience scale: the Connor-Davidson resilience scale (CD-RISC). Depress anxiety. 2003;18(2):76–82.PubMedCrossRef
5.
Babić R, Babić M, Rastović P, Ćurlin M, Šimić J, Mandić K, et al. Resilience in health and illness. Psychiatr Danub. 2020;32(suppl. 2):226–32.PubMed
6.
Fowler MJ. Microvascular and macrovascular complications of diabetes. Clin diabetes. 2011;29(3):116–22.CrossRef
7.
Wu C-S, Hsu L-Y, Wang S-H. Association of depression and diabetes complications and mortality: a population-based cohort study. Epidemiol psychiatric sci. 2020;29:e96.CrossRef
8.
Kalra S, Jena BN, Yeravdekar R. Emotional and psychological needs of people with diabetes. Ind j endocrinol metab. 2018;22(5):696.CrossRef
9.
Parviniannasab AM, Rakhshan M, Momennasab M, Soltanian M, Rambod M, Akbarzadeh M. The mediating role of courageous coping in the relations between spirituality and social support with resilience among adolescents with hemophilia. Clin Child Psychol Psychiatry. 2022;27(4):1141–54.PubMedCrossRef
10.
Parviniannasab AM, Rakhshan M, Momennasab M, Soltanian M, Bijani M. The relationship between coping strategies and resilience among adolescents with beta-thalassemia major. J Child Adoles Psychiatric Nurs. 2021;34(4):329–34.CrossRef
11.
Haase JE, Kintner EK, Monahan PO, Robb SL. The resilience in illness model (RIM) part 1: exploratory evaluation in adolescents and young adults with cancer. Cancer Nurs. 2014;37(3):E1.PubMedPubMedCentralCrossRef
12.
Onu DU, Ifeagwazi CM, Prince OA. Social support buffers the impacts of diabetes distress on health-related quality of life among type 2 diabetic patients. J Health Psychol. 2022;27(10):2305–17.PubMedCrossRef
13.
Fisher L, Hessler DM, Polonsky WH, Mullan J. When is diabetes distress clinically meaningful? Establishing cut points for the diabetes distress scale. Diabetes Care. 2012;35(2):259–64.PubMedPubMedCentralCrossRef
14.
Nicolucci A, Burns KK, Holt R, Comaschi M, Hermanns N, Ishii H, et al. Educational and psychological issues diabetes attitudes, wishes and needs second study (DAWN2TM): cross-national benchmarking of diabetes-related psychosocial outcomes for people with diabetes. Diabet Med. 2013;30:767–77.PubMedCrossRef
15.
Hsu HC, Chen SY, Lee YJ, Chen WY, Wang RH. Pathways of diabetes distress, decisional balance, self-efficacy and resilience to quality of life in insulin-treated patients with type 2 diabetes: a 9-month prospective study. J Clin Nurs. 2021;30(7–8):1070–8.PubMedCrossRef
16.
Wang RH, Chen SY, Lee CM, Lu CH, Hsu HC. Resilience, self-efficacy and diabetes distress on self-management behaviours in patients newly diagnosed with type 2 diabetes: a moderated mediation analysis. J Adv Nurs. 2023;79(1):215–22.PubMedCrossRef
17.
Bandura A. Self-efficacy: toward a unifying theory of behavioral change. Psychol Rev. 1977;84(2):191.PubMedCrossRef
18.
Dehghan H, Charkazi A, Kouchaki GM, Zadeh BP, Dehghan BA, Matlabi M, et al. General self-efficacy and diabetes management self-efficacy of diabetic patients referred to diabetes clinic of Aq Qala, north of Iran. J Diabet Metab Disord. 2017;16:1–5.CrossRef
19.
Wang RH, Hsu HC, Kao CC, Yang YM, Lee YJ, Shin SJ. Associations of changes in psychosocial factors and their interactions with diabetes distress in patients with type 2 diabetes: a longitudinal study. J Adv Nurs. 2017;73(5):1137–46.PubMedCrossRef
20.
Khan A, Choudhary P. Investigating the association between diabetes distress and self-management behaviors. J Diabetes Sci Technol. 2018;12(6):1116–24.PubMedPubMedCentralCrossRef
21.
Xu Y, Yang G, Yan C, Li J, Zhang J. Predictive effect of resilience on self-efficacy during the COVID-19 pandemic: the moderating role of creativity. Front Psychiatry. 2022;13:1066759.PubMedPubMedCentralCrossRef
22.
Torabizadeh C, Poor ZA, Shaygan M. The effects of resilience training on the self-efficacy of patients with type 2 diabetes: a randomized controlled clinical trial. Int j commun based nurs midwifery. 2019;7(3):211.
23.
Beverly EA, Ritholz MD, Dhanyamraju K. The buffering effect of social support on diabetes distress and depressive symptoms in adults with type 1 and type 2 diabetes. Diabet Med. 2021;38(4):e14472.PubMedCrossRef
24.
Lee AA, Piette JD, Heisler M, Rosland A-M. Diabetes distress and glycemic control: the buffering effect of autonomy support from important family members and friends. Diabetes Care. 2018;41(6):1157–63.PubMedPubMedCentralCrossRef
25.
Rees T, Freeman P. Social support moderates the relationship between stressors and task performance through self-efficacy. J Soc Clin Psychol. 2009;28(2):244–63.CrossRef
26.
Barrera M Jr. Distinctions between social support concepts, measures, and models. Am J Commun Psychol. 1986;14(4):413–45.CrossRef
27.
Gellert P, Häusler A, Suhr R, Gholami M, Rapp M, Kuhlmey A, et al. Testing the stress-buffering hypothesis of social support in couples coping with early-stage dementia. PLoS One. 2018;13(1):e0189849.PubMedPubMedCentralCrossRef
28.
Hempler NF, Joensen LE, Willaing I. Relationship between social network, social support and health behaviour in people with type 1 and type 2 diabetes: cross-sectional studies. BMC Public Health. 2016;16(1):1–7.CrossRef
29.
Baek RN, Tanenbaum ML, Gonzalez JS. Diabetes burden and diabetes distress: the buffering effect of social support. Ann Behav Med. 2014;48(2):145–55.PubMedCrossRef
30.
Wolf EJ, Harrington KM, Clark SL, Miller MW. Sample size requirements for structural equation models: an evaluation of power, bias, and solution propriety. Educ Psychol Meas. 2013;73(6):913–34.CrossRef
31.
32.
Nourian M, Mohammadi Shahboulaghi F, Nourozi K, Rassouli M, Biglarrian A. Psychometric properties of the Persian version of Wagnild and Young’s resilience scale in institutionalized adolescents. Iran J Psychiatry Clin Psychol. 2015;21(3):262–73.
33.
Bijl JV, Av P-E, Shortridge-Baggett L. The psychometric properties of the diabetes management self-efficacy scale for patients with type 2 diabetes mellitus. J Adv Nurs. 1999;30(2):352–9.PubMedCrossRef
34.
Noroozi A, Tahmasebi R. The diabetes management self-efficacy scale: translation and psychometric evaluation of the Iranian version. Nurs Pract Today. 2014;1(1):9–16.
35.
Polonsky WH, Fisher L, Earles J, Dudl RJ, Lees J, Mullan J, et al. Assessing psychosocial distress in diabetes: development of the diabetes distress scale. Diabetes Care. 2005;28(3):626–31.PubMedCrossRef
36.
Baradaran HR, Mirghorbani S-M, Javanbakht A, Yadollahi Z, Khamseh ME. Diabetes distress and its association with depression in patients with type 2 diabetes in Iran. Int J Prev Med. 2013;4(5):580.PubMedPubMedCentral
37.
Zimet GD, Dahlem NW, Zimet SG, Farley GK. The multidimensional scale of perceived social support. J Pers Assess. 1988;52(1):30–41.CrossRef
38.
Bagherian-Sararoudi R, Hajian A, Ehsan HB, Sarafraz MR, Zimet GD. Psychometric properties of the Persian version of the multidimensional scale of perceived social support in Iran. Int J Prev Med. 2013;4(11):1277.PubMedPubMedCentral
39.
Lt H. Bentler PM: cutoff criteria for fit indexes in covariance structure analysis: conventional criteria versus new alternatives. Struct Equ Model Multidiscip J. 1999;6(1):1–55.CrossRef
40.
Hooper D, Coughlan J, Mullen M. Structural equation modelling: guidelines for determining model fit. Elect J bus res Methods. 2008;6(1):53–60.
41.
Hunt CW, Wilder B, Steele MM, Grant JS, Pryor ER, Moneyham L. Relationships among self-efficacy, social support, social problem solving, and self-management in a rural sample living with type 2 diabetes mellitus. Rese theor nurs pract. 2012;26(2):126–41.CrossRef
42.
Karimy M, Koohestani HR, Araban M. The association between attitude, self-efficacy, and social support and adherence to diabetes self-care behavior. Diabetol metab syndrome. 2018;10:1–6.CrossRef
43.
Hayes AF: Mediation, moderation, and conditional process analysis. Introduction to mediation, moderation, and conditional process analysis: A regression-based approach 2013, 1:20.
44.
Li C. Little's test of missing completely at random. Stata J. 2013;13(4):795–809.CrossRef
45.
Kline RB. Principles and practice of structural equation modeling (3. Baskı), vol. 14. New York NY: Guilford; 2011. p. 1497–513.
46.
Mohammadi F, Tehranineshat B, Farjam M, Rahnavard S, Bijani M. The correlation between resilience, self-efficacy and illness perception in patients with type 2 diabetes: a cross-sectional study. Clin Diabetol. 2022;11(3):175–82.CrossRef
47.
Luo D, Wang Y, Cai X, Li R, Li M, Liu H, et al. Resilience among parents of adolescents with type 1 diabetes: associated with fewer parental depressive symptoms and better pediatric glycemic control. Front Psychiatry. 2022;13:834398.PubMedPubMedCentralCrossRef
48.
Gao Y, Xiao J, Han Y, Ji J, Jin H, Mawen DG, et al. Self-efficacy mediates the associations of diabetes distress and depressive symptoms with type 2 diabetes management and glycemic control. Gen Hosp Psychiatry. 2022;78:87–95.PubMedCrossRef
49.
Gharaibeh B, Gajewski BJ, Al-smadi A, Boyle DK. The relationships among depression, self-care agency, self-efficacy and diabetes self-care management. J Res Nurs. 2016;21(2):110–22.CrossRef
50.
Amankwah-Poku M, Amoah AG, Sefa-Dedeh A, Akpalu J. Psychosocial distress, clinical variables and self-management activities associated with type 2 diabetes: a study in Ghana. Clin Diabet Endocrinol. 2020;6(1):1–10.CrossRef
51.
Wang Y, Yao L, Liu L, Yang X, Wu H, Wang J, et al. The mediating role of self-efficacy in the relationship between big five personality and depressive symptoms among Chinese unemployed population: a cross-sectional study. BMC psychiatry. 2014;14(1):1–8.CrossRef
52.
Ozbay F, Johnson DC, Dimoulas E, Morgan Iii C, Charney D, Southwick S. Social support and resilience to stress: from neurobiology to clinical practice. Psychiatry (Edgmont). 2007;4(5):35.PubMedPubMedCentral
53.
Cohen S, Wills TA. Stress, social support, and the buffering hypothesis. Psychol Bull. 1985;98(2):310.PubMedCrossRef
Metadata
Title
The effect of social support, diabetes management self-efficacy, and diabetes distress on resilience among patients with type 2 diabetes: a moderated mediation analysis
Authors
Ali Mohammad Parviniannasab
Zohreh Faramarzian
Seyyed Ali Hosseini
Saeed Hamidizadeh
Mostafa Bijani
Publication date
01-12-2024
Publisher
BioMed Central
Keyword
Type 2 Diabetes
Published in
BMC Public Health / Issue 1/2024
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/s12889-024-18022-x

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