Relationship between diabetes knowledge and mental, psychological, and emotional states of T2DM patients based on structural equation model

This study showed that 90.41%, 8.93%, and 0.66% of the subjects had diabetes-related knowledge scores of less than 60 points, 60-79 points, and 80 points or more, respectively, indicating the diabetes-related knowledge level of T2DM patients. is suggested to be very low. , which is consistent with his Zhu research results.⁷. Furthermore, the PAID-5 scores of 44.05% and 55.95% of the subjects were 0-39 (mild affective disorder) and 40-100 (severe affective disorder), respectively, indicating that T2DM patients commonly have affective disorders. It was suggested. This study confirms that the prevalence of depression, which affects the quality of life of DM patients, is higher than that of non-DM patients.⁸. In total, 15.21%, 19.64%, and 65.15% of participants had WHO-5 scores below 28 (possible depression), between 29 and 50 (decreased happiness), and above 50 (well-being), respectively. This suggests that depression is more common in T2DM. There are more patients than in the general population. Knowledge about DM is one of the important factors influencing self-management behavior of DM patients⁹, education is the most direct way to acquire knowledge. Currently, improving the knowledge level of DM patients is mainly achieved through health education of medical staff.^Ten. Therefore, medical staff should strengthen information sharing and education regarding diabetes knowledge for T2DM patients. In addition, we pay close attention to the mood and psychological state of DM patients, provide timely psychological counseling, enhance effective communication, and provide long-term caregivers with comprehensive and individualized nursing care and social support. must be provided.

This model shows that low exercise time is a risk factor for emotional disorders and well-being. Research shows that exercise interventions can increase an individual’s self-efficacy, strengthen their self-concept, reduce stress and anxiety, and generate pleasant feelings.¹¹.Meanwhile, a meta-analysis also showed that exercise intervention can improve depression and anxiety in T2DM patients to some extent.¹². Studies have shown that increasing exercise time (30-60 minutes) improves psychological well-being, fatigue, and self-efficacy (tasks, time, coping strategies) in people with T2DM.¹³. However, some scholars have proposed that the modulatory effect of exercise on insulin sensitivity in diabetic patients largely depends on exercise intensity rather than exercise duration.¹⁴. Currently, high-intensity intermittent exercise and moderate-intensity continuous training are recommended for patients with T2DM. Regardless of the type of exercise, regular exercise is considered an effective means to prevent and manage T2DM and its complications and promote an individual’s physical and mental health.

The cost of treatment for DM is high, the disease course is long, the number of hospitalizations for diabetes is high, and the number of acute and chronic complications is also a risk factor for emotional disturbance and well-being. DM is recognized as the third major chronic disease threatening human health, after tumors, cardiovascular diseases, and cerebrovascular diseases.¹⁵.According to the study, direct DM medical expenditures exceeded the GDP growth rate and total national medical expenditures over the same period.¹⁶. In this study, out of 1512 subjects, 45.04% were between the ages of 60 and 74, the most common occupation was retired, and 50.79% belonged to this category . Regarding income, 55.89% of the subjects had an income of 1,000 to 3,000 yuan. Regarding the financial burden of medical expenses, 82.54% is borne by individuals. In total, 67.32% of patients had DM for more than 5 years. Additionally, 33.6% and 60.65% of her had acute and chronic complications, respectively. Overall, these findings indicate that T2DM patients typically have a high financial burden, undergo long-term treatment, are repeatedly hospitalized, incur a high proportion of medical costs, have low pensions or no fixed source of income, and It shows that you are concerned about the burden on patients. This puts tremendous financial pressure on families, resulting in increased feelings of self-blame and psychological strain. Therefore, governments and society should attach great importance to the treatment of chronic diseases such as diabetes. In the future, we will need to increase investment in social pension funds, improve the social security system, and expand the share of medical expenses. In addition, diabetic patients and their families should also pay attention to blood sugar control to prevent further progression of the disease, reduce medical costs, and ease the financial burden.

Diabetes-related knowledge scores also influenced emotional disturbance and well-being. The higher the diabetes-related knowledge score, the higher the happiness index. In this study, patients’ knowledge of diabetes was not ideal. They often have little knowledge about the disease, feel anxious and fearful, experience great psychological burden, worry about the prognosis of the disease, and rely on family members and caregivers to improve their psychological state. I did. All of these factors contributed to patients’ emotional disorders, such as depression and anxiety, and decreased well-being. Although health education has received increasing attention in recent years, the knowledge of diabetes among clinical nurses and community nurses is generally low, and patients’ educational levels and acceptance of diabetes-related knowledge vary.An urgent challenge is to improve the diabetes knowledge level of nursing teams¹⁷ We also develop personalized health education for patients so that diabetes-related knowledge is better understood and accepted and the effectiveness of treatment activities is improved.

Loneliness is a risk factor for poor well-being in T2DM patients. Family members are the best emotional support for patients. Effective family support can help patients gain psychological and emotional support and reduce psychological burden. La et al.¹⁸ When comparing support from family and support from friends, family support had a greater impact on blood sugar monitoring, insulin injections, diet, and exercise. Some studies have shown that higher levels of family support are associated with lower rates of depression and a more stable psychological state.¹⁹. Appropriate family support can help patients reduce the pain of the disease, increase confidence in life, and improve quality of life. Therefore, it is recommended that diabetic patients live with family members as much as possible, encourage family members to accompany them and increase communication, enjoy family warmth and support, and improve well-being.

In conclusion, we used structural equation modeling to investigate the effects of self-management, medical history/treatment, and knowledge on emotions and well-being, as well as the direct and indirect effects of influencing factors on affective disorders and well-being. Currently, diabetes-related knowledge regarding T2DM patients is very low, and these patients commonly experience emotional disturbances. Medical teams should not only develop personalized health education so that diabetic patients can obtain relevant knowledge, but also create a good social health governance environment, pay more attention to patients’ emotions, and ensure that DM patients are fully It is necessary to cooperate with society and families so that they can receive support from their families. and social support.