{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,28]],"date-time":"2026-10-28T18:46:34Z","timestamp":1793213194033,"version":"4.5.0"},"reference-count":50,"publisher":"BMJ","issue":"10","license":[{"start":{"date-parts":[[2025,10,20]],"date-time":"2025-10-20T00:00:00Z","timestamp":1760918400000},"content-version":"unspecified","delay-in-days":19,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"the First China\u2019s Ministry of Education Project on Research, Reform and Practice of New Humanities","award":["2021020012"],"award-info":[{"award-number":["2021020012"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2025,10,2]]},"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To examine (1) the mediating roles of self-efficacy and future-oriented time perspective (FTP) in the association between workplace culture of health (COH) and diabetes self-management and (2) the moderating effect of diabetes distress on the relationship between self-efficacy and FTP among employees with type 2 diabetes mellitus (T2DM).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>A cross-sectional survey.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>This study was conducted among employees with T2DM recruited from the Endocrinology Outpatient Departments at three tertiary hospitals in Taiyuan City, Shanxi Province, China, between March and October 2024.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>The participants were 462 employees with T2DM who had been employed at their current organisations for at least 3 months following their T2DM diagnosis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Data on demographics, diabetes-related and work-related factors, workplace COH, self-efficacy, time perspective, diabetes distress and self-management performance were collected via a survey. The moderated mediation effects were examined using Hayes\u2019s PROCESS macro.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Workplace COH was associated with diabetes self-management both directly (\u03b2=0.251, 95%\u2009CI 0.080 to 0.422, p&lt;0.01) and indirectly (indirect effect=0.303, 95%\u2009CI 0.190 to 0.419). Two significant indirect pathways were identified: (1) workplace COH \u2192 self-efficacy \u2192 diabetes self-management (indirect effect=0.207, 95%\u2009CI 0.110 to 0.308); (2) workplace COH \u2192 self-efficacy \u2192 FTP \u2192 diabetes self-management (indirect effect=0.093, 95%\u2009CI 0.051 to 0.144). However, the indirect pathway: workplace COH \u2192 FTP \u2192 diabetes self-management was not significant (indirect effect=0.004, 95%\u2009CI \u22120.055 to 0.063). Additionally, a significant interaction (\u03b2=\u22120.356, 95%\u2009CI \u22120.566 to \u20130.146, p&lt;0.01) indicated that diabetes distress moderated the relationship between self-efficacy and FTP.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This study demonstrated that workplace COH was associated with diabetes self-management both directly and indirectly, specifically through self-efficacy alone and serially through self-efficacy and FTP; it also confirmed that diabetes distress weakens the effect of self-efficacy on FTP, thereby providing a basis for developing interventions to improve self-management among employees with T2DM.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2025-100263","type":"journal-article","created":{"date-parts":[[2025,10,21]],"date-time":"2025-10-21T08:00:38Z","timestamp":1761033638000},"page":"e100263","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":3,"title":["Workplace culture of health and self-management behaviours among employees with type 2 diabetes: a cross-sectional moderated mediation study in urban China"],"prefix":"10.1136","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-5092-5466","authenticated-orcid":false,"given":"Jin","family":"Li","sequence":"first","affiliation":[{"name":"School of Humanities and Social Sciences, Shanxi Medical University, Taiyuan, Shanxi, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-3848-6323","authenticated-orcid":false,"given":"Dan","family":"Luo","sequence":"additional","affiliation":[{"name":"School of Humanities and Social Sciences, Shanxi Medical University, Taiyuan, Shanxi, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nan","family":"Zhang","sequence":"additional","affiliation":[{"name":"School of Management, Shanxi Medical University, Taiyuan, Shanxi, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huaqing","family":"Guo","sequence":"additional","affiliation":[{"name":"School of Humanities and Social Sciences, Shanxi Medical University, Taiyuan, Shanxi, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-5369-0948","authenticated-orcid":false,"given":"Yan","family":"Shi","sequence":"additional","affiliation":[{"name":"School of Humanities and Social Sciences, Shanxi Medical University, Taiyuan, Shanxi, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhiguang","family":"Duan","sequence":"additional","affiliation":[{"name":"School of Humanities and Social Sciences, Shanxi Medical University, Taiyuan, Shanxi, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2025,10,20]]},"reference":[{"key":"2025120415072414000_15.10.e100263.1","unstructured":"International Diabetes Federation . 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