Social Support and Self-Acceptance in Patients With Diabetic Retinopathy: The Mediating Role of Psychological Capital...

BACKGROUND Self-acceptance is fundamental to mental health in patients with chronic disease. Although associations between social support and self-acceptance are documented, the underlying mechanisms remain unclear. We examined whether psychological capital mediates the relationship between social support and self-acceptance in patients with diabetic retinopathy. MATERIAL AND METHODS A cross-sectional study using convenience sampling was conducted at a single tertiary center between June 2024 and February 2025, including 307 hospitalized patients with diabetic retinopathy. Data were collected using the interviewer-administered Positive Psychological Capital Questionnaire for Diabetic Retinopathy, Social Support Rating Scale, and Self-Acceptance Questionnaire. Inter-rater consistency was ensured through pre-study training sessions (intraclass correlation coefficient >0.90). Structural equation modeling with path analysis was used to examine direct and indirect effects. RESULTS Mean scores were 62.60 for psychological capital, 27.40 for social support, and 36.34 for self-acceptance. Correlation analysis revealed significant positive associations among all variables (P<0.01). Path analysis showed social support positively predicted psychological capital (ß=0.720, P<0.01) and self-acceptance (b=0.332, P<0.01). Psychological capital positively predicted self-acceptance (ß=0.494, P<0.01). Bootstrap analysis confirmed psychological capital partially mediated the social support-self-acceptance relationship (indirect effect=0.355, 95% CI: 0.195-0.560), accounting for 51.6% of the total statistical association. CONCLUSIONS Social support was positively associated with self-acceptance, with psychological capital partially mediating this relationship. Findings suggest potential value in interventions targeting social support enhancement and psychological capital development, although longitudinal studies are needed to establish temporal relationships. Findings may not generalize to outpatient or community-based populations.