The mediating effect of loneliness and health promotion behaviors in older patients with type 2 diabetes: a cross-sectional study

Abstract Background Previous studies have explored the psychological factors that are proven to influence the behavior of patients with DM. However, the mediating effect of diabetes distress on loneliness to health promotion behavior has not been cleared. Methods We employed path models to analyze data on diabetes distress, loneliness, and health promotion behaviors. We used convenience sampling to sample 140 elderly diabetic patients from three tertiary A hospitals in Hunan Province. We collected demographic and disease characteristics, diabetes distress, loneliness, and health promotion behavior from January 2022 to October 2022. Moderated mediation analysis was performed by SPSS 26.0's PROCESS macro. Result According to bootstrapping results, the total effect of loneliness on health promotion behavior was significantly negative. Loneliness significantly and negatively correlated with diabetes stress, while diabetes distress significantly and negatively correlated with health promotion behaviors. Both the indirect effect and the direct effect of loneliness on health promotion behavior were significant Conclusion The association of diabetes distress plays a mediates role between loneliness and health promotion behavior. It is suggested that healthcare providers assessing and addressing diabetes distress need to increase attention to psychological distress, including loneliness, and then intervene to improve health promoting behaviors and disease management gains for older patients with type 2 diabetes.