Observational Study
Copyright ©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Psychiatry. May 19, 2025; 15(5): 104766
Published online May 19, 2025. doi: 10.5498/wjp.v15.i5.104766
Self-care activities mediate self-perceived burden and depression in Chinese patients with type 2 diabetes
Rong Zhang, Mei-Yan Wang, Xue-Qing Zhang, You-Wen Gong, Ya-Fen Guo, Jin-Hua Shen
Rong Zhang, Department of Endocrinology, Changde Hospital, Xiangya School of Medicine, Central South University (The First People’s Hospital of Changde City), Changde 415000, Hunan Province, China
Mei-Yan Wang, Department of Neurosurgery, Changde Hospital, Xiangya School of Medicine, Central South University (The First People’s Hospital of Changde City), Changde 415000, Hunan Province, China
Xue-Qing Zhang, You-Wen Gong, Ya-Fen Guo, Jin-Hua Shen, Department of Nursing, Changde Hospital, Xiangya School of Medicine, Central South University (The First People’s Hospital of Changde City), Changde 415000, Hunan Province, China
Jin-Hua Shen, Department of General Surgery, Changde Hospital, Xiangya School of Medicine, Central South University (The First People’s Hospital of Changde City), Changde 415000, Hunan Province, China
Co-first authors: Rong Zhang and Mei-Yan Wang.
Author contributions: Zhang R, Wang MY, Zhang XQ, Gong YW, Guo YF, and Shen JH designed the research study; Zhang R and Wang MY contributed equally to this article, and are co-first authors; Zhang R, Wang MY, Zhang XQ, and Gong YW performed the research; Zhang XQ, Guo YF, and Shen JH contributed new reagents and analytic tools; Zhang R, Zhang XQ, Guo YF, and Shen JH analyzed the data and wrote the manuscript; and all authors have read and approve the final manuscript.
Supported by the Hunan Provincial Natural Science Foundation of China, No. 2025JJ80413.
Institutional review board statement: This study was approved by the Medical Ethics Committee of the First People’s Hospital of Changde City, approval No. YX-2023-082-01.
Informed consent statement: All participants agreed to participate in the survey. We use an online survey, so on the first page of the questionnaire contains the informed consent form, and if the participant agrees to participate in the survey, the specific survey questions are answered.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
Data sharing statement: If necessary, the data can be made available to the public, and further enquiries can be directed to the corresponding author.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Jin-Hua Shen, Department of Nursing, Changde Hospital, Xiangya School of Medicine, Central South University (The First People’s Hospital of Changde City), No. 818 Renmin Road, Changde 415000, Hunan Province, China. 136112649@qq.com
Received: January 2, 2025
Revised: February 27, 2025
Accepted: March 14, 2025
Published online: May 19, 2025
Processing time: 120 Days and 6.2 Hours
Abstract
BACKGROUND

Diabetes is becoming increasingly common and has become an important global health issue. In addition to physical damage, diabetes often leads to psychological complications, such as depressive symptoms. Self-care is considered to be the cornerstone of type 2 diabetes mellitus (T2DM) management. This research evaluated depression and explored the associations between self-care activities, self-perceived burden, and depression among T2DM patients in China.

AIM

To investigate the self-care activities and the association between depression and self-perceived burden among Chinese inpatients with T2DM.

METHODS

A cross-sectional study was conducted in participants with T2DM. The data collected encompassed basic characteristics, diabetes self-care activities, depression levels, and self-perceived burdens. Bootstrapping was utilized to assess the mediating role of diabetes self-care activities.

RESULTS

There were 599 T2DM patients in the survey, and 71.8% had been diagnosed with the disease for 1–10 years. There were significant correlations between self-care activities, depression, and self-perceived burden. The significant coefficients for paths a (B = -0.281, P < 0.001) and b (B = -0.041, P < 0.05) suggested negative associations between self-perceived burden and self-care behavior and between self-care activities and depression. The indirect effect (path a × b) of self-perceived burden on depression through self-care behaviors was significant (B = 0.020, P < 0.05), with a 95% bias-corrected bootstrap confidence interval of 0.007–0.036.

CONCLUSION

The mediating model presented here highlights the role of self-care activities in exerting both direct and indirect effects on depression in participants with T2DM.

Keywords: Type 2 diabetes mellitus; Patient Health Questionnaire-9; Self-care; Self-perceived burden; Mediating role

Core Tip: The research evaluated depression status and explored the associations between self-care activities, self-perceived burden, and depression among type 2 diabetes mellitus (T2DM) patients in China. The findings indicated that self-care activities had a partial mediating effect between depression and self-perceived burden. The results emphasize the multifaceted role of self-care activities in patients with T2DM and its potential intervention significance.