Diabetes distress as mediators of loneliness and health promotion behaviour: a cross-sectional study.

OBJECTIVES: The purpose of this study was to explore whether diabetes distress mediated the relationship between loneliness and health promotion in older adults with diabetes. DESIGN: A cross-sectional study. SETTING: The study was conducted at three tertiary hospitals in Changsha, Hunan Province, China. PARTICIPANTS: The sample included 140 patients with diabetes (65 years and older, mean age 72.6 years, SD=4.6). METHODS: We employed path models to analyse data on diabetes distress, loneliness and health promotion behaviours. We collected diabetes distress, loneliness and health promotion behaviour with self-reported questionnaires including the Diabetes Distress Scale, the University of California at Los Angeles (UCLA) Loneliness Scale and the Elderly Health Promotion Scale from January 2022 to October 2022. Mediation analysis was performed by SPSS V.26.0's PROCESS macro. RESULT: The findings of this study indicated diabetes distress acted as a mediator between loneliness and health promotion behaviour. According to bootstrapping results, the total effect of loneliness on health promotion behaviour was significantly negative (ß=-0.312, p=0.006). Loneliness significantly and negatively correlated with diabetes distress (ß=-0.043, p<0.001), while diabetes distress significantly and negatively correlated with health promotion behaviours (ß=-2.724, p=0.008). Both the indirect effect and the direct effect of loneliness on health promotion behaviour were significant. CONCLUSION: Our study illustrated that loneliness was negatively associated with health promotion behaviours, and diabetes distress acted as a mediator in this relationship. It is suggested that healthcare providers should prioritise the identification and management of diabetes distress in older patients with diabetes who experience loneliness to improve health promotion behaviours and optimise disease management outcomes.

Analysis of the incidence of falls and related factors in elderly patients based on comprehensive geriatric assessment.

Objective: To investigate the incidence of falls in elderly aged 65 years and above among outpatients and inpatients, and to analyze its related factors and identify prevention strategies. Methods: A retrospective analysis was conducted on 451 patients aged 65 years and above who received comprehensive geriatric assessment in outpatients and inpatients from the Department of Geriatrics in the Second Xiangya Hospital from March 2021 to March 2022. According to whether there had been at least one fall in the past year, the patients were divided into a fall group and a non-fall group. Data were collected from the We-Chat applet of comprehensive geriatric assessment. A t test and chi-square test were performed to compare the difference between the two groups. Logistic regression analysis was then conducted to identify factors associated with falls. Results: (1) The incidence of falls among the outpatient and inpatient was 28.8%. (2) The rate of light, moderate, and heavy dependence on daily living ability and decreased mobile balance ability were higher in the fall group than those in the non-fall group. The average calf circumference in the fall group was significantly lower than that in the non-fall group. (3) The prevalence of diabetes and eye diseases in the fall group was significantly higher than that in the non-fall group. (4) The percentage of insomnia and suspicious insomnia cases in the fall group was higher than that in the non-fall group. The mean scores for dysphagia, frailty, and incontinence were higher and the mean malnutrition score was lower in the fall group than in the non-fall group. (5) Multiple logistic regression analysis showed that frailty, insomnia, and malnutrition were independent influencing factors of fall (OR = 1.955, 1.652, 10.719, P = 0.044, 0.041, 0.025, respectively). Conclusions: The incidence of falls among outpatients and inpatients aged 65 years and above is high. Frailty, insomnia, and malnutrition are the main factors influencing falls in these patients.