【摘要】 目的 分析社区2型糖尿病(T2DM)患者糖尿病痛苦(DD)和抑郁症状(DS)对自我效能的影响，并探讨DD在DS与自我效能间的中介效应。方法 采用便利抽样的方法对南京市648名社区T2DM患者进行问卷调查，问卷内容包括一般资料调查问卷、糖尿病痛苦量表、九条目患者健康问卷和糖尿病自我效能量表，采用多元线性回归模型分析自我效能的影响因素，使用中介效应分析探索DD的中介作用。结果 DD和DS的患病率分别为27.5%和40.4%,自我效能得分为3.82±0.60分。DD和DS显著正相关(r=0.56,P<0.01),并且均与自我效能呈负相关关系。DD (β=-0.34,P<0.01)和DS (β=-0.16,P<0.01)是自我效能的影响因素，DD在DS与自我效能间存在部分中介效应，Bootstrap 95%可信区间为-0.28～-0.16 (P<0.01)。结论 社区医疗工作者需要对T2DM患者的DD和DS进行早期筛查和治疗，这有助于提高患者管理疾病的自我效能。更多还原

【Abstract】 Objective To analyze the effects of diabetes distress(DD) and depressive symptoms(DS) on self-efficacy in community patients with type 2 diabetes mellitus(T2DM), and to explore the mediating effect of DD on DS and self-efficacy. Methods A total of 648 community patients with T2DM in Nanjing were selected by convenience sampling method and investigated with the general information questionnaire, Diabetes Distress Scale, 9-item Patient Health Questionnaire and Diabetes self-efficacy Scale. A multiple linear regression model was used to analyze the influencing factors of self-efficacy, and mediating effect analysis was used to explore the mediating role of DD.Results The prevalence of DD and DS was 27.5% and 40.4%, respectively, and the self-efficacy score was 3.82±0.60. DD and DS were significantly positively correlated(r=0.56, P<0.01), and both were negatively correlated with self-efficacy. DD(β=-0.34, P<0.01) and DS(β=-0.16, P<0.01) were the influencing factors of self-efficacy, and DD had a partial mediating effect between DS and self-efficacy, Bootstrap 95%confidence interval was-0.28--0.16(P<0.01). Conclusion Community health workers need to conduct early screening and treatment of DD and DS in T2DM patients, which can help improve patients’ self-efficacy inmanaging the disease.更多还原