Social Support and Self-management Behavior and Quality of Life among Rural People with Type 2 Diabetes in Eastern China: The Mediating Role of Self-efficacy

Abstract

Abstract BACKGROUND Type 2 diabetes (T2D) patients in rural China often demonstrate inadequate diabetes self-management (DSM) and a lower quality of life (QoL). Social support and self-efficacy can directly influence DSM or QoL. However, the mediating effect of self-efficacy on social support and DSM and social support and QoL among Chinese rural T2D patients remains unclear. METHODS Based on a survey among rural T2D Patients in eastern China, we employed structural equation modeling (SEM) to explore the direct and indirect influences of social support on DSM and QoL and to investigate the mediating role of self-efficacy. RESULTS It was found that the DSM score was less than half of the maximum theoretical score. The dimension of medication adherence behaviors exhibited the highest score (5.92) and blood glucose monitoring behaviors showed the lowest score (1.23). The QoL score accounted for 36% of the maximum theoretical score. The dimension of social relationships demonstrated the lowest score (1.33) and physiological function garnered the highest score (2.03). Social support directly and positively affected the DSM and QoL of Chinese rural T2D patients and exhibited an indirect positive influence mediated by self-efficacy. The mediating effect of self-efficacy accounted for 30.2% and 28.6%, respectively, of the total effect of social support on DSM and QoL. CONCLUSIONS The study confirmed the direct and indirect influences of social support on DSM and QoL and elucidated the mediating effect of self-efficacy. Interventions aimed at both fostering social support and self-efficacy should be developed to create a positive cycle of mutual reinforcement to improve DSM and QoL among rural T2D patients.