Impact of family function on social frailty in patients with diabetic retinopathy: the chain mediating role of positive coping and health literacy
10.3760/cma.j.cn115682-20241216-06895
- VernacularTitle:家庭功能对糖尿病视网膜病变患者社会衰弱的影响：积极应对和健康素养的链式中介作用
- Author:
Shan LI
1
;
Guanyi WANG
1
;
Xiaoxiao YANG
1
;
Lijuan ZHOU
1
Author Information
1. 首都医科大学附属北京同仁医院眼科中心，北京 100730
- Publication Type:Journal Article
- Keywords:
Diabetic retinopathy;
Family function;
Positive coping;
Health literacy;
Social frailty;
Mediation
- From:
Chinese Journal of Modern Nursing
2025;31(26):3585-3592
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the chain mediating role of positive coping and health literacy in the relationship between family function and social frailty in patients with diabetic retinopathy (DR) .Methods:A convenience sampling method was used to recruit 320 DR patients who visited the ophthalmology outpatient clinic of Beijing Tongren Hospital, Capital Medical University, from June 2023 to June 2024. Participants completed a general information questionnaire, Family Assessment Device (FAD), Simplified Coping Style Questionnaire (SCSQ), Health Literacy Management Scale (HeLMS), and Social Vulnerability Index (SVI). Spearman correlation analysis was used to examine the pairwise correlations between family function, positive coping, health literacy, and social frailty. The chain mediation model was tested using Model 6 of the PROCESS macro in SPSS 3.5. A total of 320 questionnaires were distributed, and 312 were collected. After excluding those with more than 10% missing items or regular response patterns, 302 valid questionnaires were analyzed, yielding a valid response rate of 94.38% (302/320) .Results:Among the 302 DR patients, the mean scores were as follows: FAD (154.26±9.79), positive coping (18.66±5.21), HeLMS (81.38±10.09), and SVI [13.50 (11.50, 16.00) ]. Univariate analysis revealed that age, gender, education level, employment status, and diabetes duration were significant influencing factors of social frailty ( P<0.05). Spearman correlation analysis showed that family function, positive coping, health literacy, and social frailty were all significantly correlated with each other ( P<0.01). Mediation analysis indicated that family function positively predicted the level of social frailty, with a direct effect value of 0.128, accounting for 65.64% of the total effect. Positive coping and health literacy played a mediating role through three pathways: family function→positive coping→social frailty (effect=0.037, 18.97% of the total effect) ; family function→health literacy→social frailty (effect=0.023, 11.80%) ; and family function→positive coping→health literacy→social frailty (effect=0.007, 3.59%). The total indirect effect was 0.067, accounting for 34.36% of the total effect. Conclusions:Family function affects the level of social frailty in DR patients both directly and indirectly through the mediating roles of positive coping and health literacy. Interventions targeting family function improvement, enhancement of positive coping strategies, and health literacy promotion may help reduce social frailty in this population.
