The effect of social support, diabetes management self-efficacy, and diabetes distress on resilience among patients with type 2 diabetes: a moderated mediation analysis.

BACKGROUND: Diabetes can result in distress. Improving Resilience is important in managing these conditions. It is also important to consider the mediating role of diabetes management self-efficacy (DMSE) between diabetes distress (DD) and Resilience. Likewise, understanding how social support (SS) buffers the impact of diabetes distress on Resilience is equally important. METHODS: The present study used a cross-sectional design and included 403 participants diagnosed with type 2 diabetes (T2D). The study was conducted in the south of Iran. The participants were selected through convenience sampling from July 2022 to January 2023. Self-reported questionnaires, namely the Diabetes Distress Scale (DDS), Diabetes Management Self-Efficacy Scale (DMSE), Perceived Social Support Scale (PSSS), and Resilience Scale, were used for data collection in the present study. Structural equation modelling was used for moderated mediation analysis. RESULTS: The results of the Pearson correlation analysis were indicative of a significant negative correlation (p < 0.01) between diabetes distress and diabetes management self-efficacy (r = - 0.607), social support (r = - 0.417), and Resilience (r = - 0.552). The findings further revealed that diabetes management self-efficacy had fully mediated the correlation between diabetes distress and Resilience. Moreover, the results indicated that social support had a moderating role in the DD-resilience link. CONCLUSIONS: The present study's findings offer a new theoretical framework for T2DM that can benefit intervention designers. The results further suggest that promoting diabetes management self-efficacy can be an effective strategy to enhance Resilience and decrease diabetes distress. Also, nurses and other healthcare providers must pay close attention to support resources to improve the patients' Resilience and evaluate the distress associated with diabetes.

The effect of group reminiscence therapy on death anxiety and adaptation of the elderly to old age.

AIM: In the present study, we aimed to evaluate the effectiveness of group reminiscence on death anxiety and adaptation of the elderly to old age. METHODS: This is a clinical trial study. Using simple random sampling method, we divided 32 elderly people into the intervention (n = 16) and control (n = 16) groups. Reminiscence therapy was held in 12 sessions. The study instruments including demographic characteristics questionnaire, Mini Mental Status Examination, Templer Death Anxiety, and aging adjustment questionnaires were filled out by the samples in 3 steps before the intervention, after the last day of the intervention, and 30 days after the end of the interventional sessions. RESULTS: In the intervention group, the mean score of death anxiety and adjustment to old age before the intervention showed a statistically significant difference with the post-intervention stages (P < 0.05); however, in the control group, the mean scores of death anxiety and adjustment to old age in the 3 steps were not statistically significant (P > 0.05). Also, no statistically significant difference was found between the intervention and control groups before the intervention (P > 0.05), but there was a statistically significant relationship in the steps immediately after the last day of the intervention and 30 days after the end of the interventional sessions (P < 0.05). CONCLUSION: The findings of the present study indicate that reminiscence therapy is able to effectively reduce the anxiety of death in the elderly; also, reminiscence therapy can be used to improve the adaptation ability of the elderly to old age.