Abstract
AIM: To explore the parallel mediating effects of diabetes distress and self-efficacy on the relationship between family function and coping and adaptation ability in young and middle-aged patients with type 2 diabetes mellitus (T2DM). METHODS: From February to December 2023, a convenience sample of 236 young and middle-aged patients with T2DM was recruited from the endocrinology departments of two tertiary hospitals. Questionnaires were administered to collect sociodemographic and disease characteristics, the short version of the Coping and Adaptation Processing Scale (CAPS-SF-C), the Adaptation, Partnership, Growth, Affection, and Resolve (APGAR), the Diabetes Distress Scale (DDS), and the Self-Efficacy for Diabetes (SED). The SPSS 26.0 software was used for univariate analysis and Pearson correlation analysis. Model 4 of the SPSS macro program Process v3.4.1 was used to assess parallel mediation effects, with Bootstrap resampling set to 5,000 iterations. RESULTS: Pearson correlation analysis revealed that coping and adaptation ability was positively associated with family function (r=0.545, P < 0.01) and self-efficacy (r=0.578, P < 0.01) and negatively associated with diabetes distress (r=-0.508, P < 0.01). Additionally, diabetes distress and self-efficacy were found to play a parallel mediation between family function and coping and adaptation ability. The indirect effect of self-efficacy (0.081), and the indirect effect of diabetes distress (0.065) accounted for 19.06%, and 15.29% of the total effect (0.466). CONCLUSION: As the first study confirming dual-channel mediation in this population, we demonstrate that diabetes distress and self-efficacy functioned as parallel mediators in the relationship between family function and coping and adaptation ability. Healthcare professionals are encouraged to incorporate family-focused interventions into the management of T2DM. Reducing psychological stress and routinely monitoring self-efficacy levels are crucial for enhancing patients' coping and adaptation ability.