ArticleBMJ open2023
Diabetes distress as mediators of loneliness and health promotion behaviour: a cross-sectional study.
Article in BMJ open, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.
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Who cites it
3 citing papers in PubMed, 1 synthesis or guideline pooled it, 3 citations in OpenAlex.
- Efficacy of Technology-Based Interventions on the Reduction of Loneliness: Systematic Review and Meta-Analysis.Journal of medical Internet research · 2026Pooled it
- The effect of a primary care intervention on diabetes distress in individuals with newly diagnosed type 2 diabetes: a cluster-randomized controlled trial.BMC primary care · 2026Trial
- Challenges in postoperative self-management for patients with bladder cancer and urinary stoma: a qualitative study.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2026Article
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Authors and funding
7 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesThe purpose of this study was to explore whether diabetes distress mediated the relationship between loneliness and health promotion in older adults with diabetes.
designA cross-sectional study.
settingThe study was conducted at three tertiary hospitals in Changsha, Hunan Province, China.
participantsThe sample included 140 patients with diabetes (65 years and older, mean age 72.6 years, SD=4.6).
methodsWe employed path models to analyse data on diabetes distress, loneliness and health promotion behaviours. We collected diabetes distress, loneliness and health promotion behaviour with self-reported questionnaires including the Diabetes Distress Scale, the University of California at Los Angeles (UCLA) Loneliness Scale and the Elderly Health Promotion Scale from January 2022 to October 2022. Mediation analysis was performed by SPSS V.26.0's PROCESS macro.
resultThe findings of this study indicated diabetes distress acted as a mediator between loneliness and health promotion behaviour. According to bootstrapping results, the total effect of loneliness on health promotion behaviour was significantly negative (β=-0.312, p=0.006). Loneliness significantly and negatively correlated with diabetes distress (β=-0.043, p<0.001), while diabetes distress significantly and negatively correlated with health promotion behaviours (β=-2.724, p=0.008). Both the indirect effect and the direct effect of loneliness on health promotion behaviour were significant.
conclusionOur study illustrated that loneliness was negatively associated with health promotion behaviours, and diabetes distress acted as a mediator in this relationship. It is suggested that healthcare providers should prioritise the identification and management of diabetes distress in older patients with diabetes who experience loneliness to improve health promotion behaviours and optimise disease management outcomes.
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