Evidence map›Paper›PMID 42238240›Full record

ArticleFrontiers in endocrinology2026

The relationship between physical activity and quality of life among community-dwelling middle-aged and older adults with type 2 diabetes: a chain mediation model of psychological resilience and exercise self-efficacy.

Wanying Su, Jiang Xie, Hui Wu, Chao Yang, Xuan Dai, Lin Ma, Sirui Lu, Yan Chen

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Article in Frontiers in endocrinology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

8 authors.

Wanying Su *Joint Surgery and Sport Medicine Department, Hunan Provincial People's Hospital (The First Affiliated Hospital of Hunan Normal University), Changsha, Hunan, China.
Jiang Xie *Nursing Department, Hunan Normal University Hunan Provincial People's Hospital, Changsha, China.
Hui WuNursing Department, Hunan Provincial People's Hospital (The First Affiliated Hospital of Hunan Normal University), Changsha, Hunan, China.
Chao YangJoint Surgery and Sport Medicine Department, Hunan Provincial People's Hospital (The First Affiliated Hospital of Hunan Normal University), Changsha, Hunan, China.
Xuan DaiDepartment of Burns and Wound Repair Surgery, Shenzhen People's Hospital (The First Affiliated Hospital, Southern University of Science and Technology; The Second Clinical Medical College, Jinan University), Shenzhen, Guangdong, China.
Lin MaDepartment of Endocrinology, Hunan Provincial People's Hospital (The First Affiliated Hospital of Hunan Normal University), Changsha, Hunan, China.
Sirui LuNursing Department, Hunan Normal University Hunan Provincial People's Hospital, Changsha, China.
Yan ChenGraduate Department, Hunan Academy of Chinese Medicine, Changsha, Hunan, China.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Middle-aged and older adults with type 2 diabetes mellitus (T2DM) often experience insufficient physical activity (PA) and reduced quality of life (QOL). Understanding how psychosocial factors are associated with this relationship is important for developing effective nursing interventions. Therefore, this study aimed to investigate the mediating roles of psychological resilience and exercise self-efficacy in the association between PA and QOL among community-dwelling populations. Methods: A cross-sectional survey was conducted among 328 middle-aged and older adults (≥ 45 years old) with T2DM in Changsha, China. Data were collected using validated instruments, including the International Physical Activity Questionnaire (IPAQ-SF), Connor-Davidson Resilience Scale (CD-RISC), Exercise Self-Efficacy Scale, and the Medical Outcomes Study 36-Item Short Form Health Survey (SF-36). Structural equation modeling and 5,000-bootstrap resampling were used to test mediation effects. Results: Given the high collinearity observed between physical activity and exercise self-efficacy in the partial mediation model, a full mediation model was retained as the final model. PA was indirectly and positively associated with QOL primarily through exercise self-efficacy (standardized indirect effect = 0.195, 95% CI [0.103, 0.287]). The sequential pathway through psychological resilience and exercise self-efficacy was also significant (standardized indirect effect = 0.009, 95% CI [0.002, 0.017]), whereas psychological resilience alone was not a significant mediator. The final model demonstrated acceptable fit (χ²/df = 3.26, RMSEA = 0.083, CFI = 0.960, NFI = 0.944, IFI = 0.961, TLI = 0.920). Conclusions: This study tested a chain mediation model suggesting that the observed association between PA and QOL may be partly explained by a sequential psychosocial pathway involving psychological resilience and exercise self-efficacy. These findings highlight the potential value of integrating psychological empowerment and behavioral strategies in future interventions aimed at supporting better QOL among middle-aged and older adults with T2DM.

Indexed as

Diabetes Mellitus, Type 2ExerciseIndependent LivingQuality of LifeResilience, PsychologicalSelf EfficacyAgedChinaCross-Sectional StudiesFemaleHumansMaleMiddle AgedSurveys and Questionnaireschain mediation modelexercise self-efficacyphysical activitypsychological resiliencequality of lifetype 2 diabetes mellitus

Identifiers

PMID42238240
PMCPMC13226107

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.