Self-care activities mediate self-perceived burden and depression in Chinese patients with type 2 diabetes

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.

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

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.

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.

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.