{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T08:31:24Z","timestamp":1788165084307,"version":"build-2803163510"},"reference-count":39,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,5,12]],"date-time":"2026-05-12T00:00:00Z","timestamp":1778544000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"\n Background<\/jats:title>\n Quality of life (QoL) is a key prognostic indicator in type 2 diabetes mellitus (T2DM). The interplay between psychological and behavioral determinants remains underexplored.<\/jats:p>\n <\/jats:sec>\n \n Objectives<\/jats:title>\n To examine QoL and its associated factors in T2DM patients, and to test the mediating roles of personal mastery (PM) and health-promoting behaviors (HPB) between self-regulatory fatigue (SRF) and QoL.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n A cross-sectional study recruited 432 T2DM patients from three Chinese tertiary hospitals (July 2025\u2013February 2026). Data were collected using the Demographic Characteristics Questionnaire, Self-Regulatory Fatigue Scale, Personal Mastery Scale, Diabetes Health Promotion Scale, and Diabetes-Specific Quality of Life Scale. Pearson\u2019s correlation, multiple linear regression, and structural equation modeling were employed for data analysis. The mediating effects were tested using the bootstrap method.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n The total scores for SRF, PM, HPB, and QoL were 38.63 \u00b1 12.84, 26.12 \u00b1 7.62, 97.69 \u00b1 20.87, and 69.41 \u00b1 20.89, respectively. QoL correlated positively with SRF (\n r<\/jats:italic>\n = 0.581) and negatively with PM (\n r<\/jats:italic>\n = \u22120.557) and HPB (\n r<\/jats:italic>\n = \u22120.613, all\n p<\/jats:italic>\n &lt; 0.01). Ten independent predictors of QoL were identified (age, educational level, medical insurance payment method, smoking status, glycemic control status, number of comorbidities, self-care ability, SRF, PM, HPB;\n R<\/jats:italic>\n 2<\/jats:sup>\n = 0.418). SRF showed a total indirect effect on QoL via PM (28.7%) and HPB (44.6%), plus a chain mediation via PM\u2192HPB (11.3%).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n SRF is associated with lower QoL in T2DM patients, partly through reduced PM and HPB. Interventions targeting self-regulatory resources and PM may improve QoL. In parallel, strengthening personal mastery through empowerment-based education, goal setting, and individualized feedback can enhance patients\u2019 confidence in diabetes self-management, which may promote sustained engagement in healthy behaviors and ultimately improve QoL in this population.<\/jats:p>\n <\/jats:sec>","DOI":"10.3389\/fmed.2026.1835765","type":"journal-article","created":{"date-parts":[[2026,5,12]],"date-time":"2026-05-12T04:31:16Z","timestamp":1778560276000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Quality of life and self-regulatory fatigue in patients with type 2 diabetes mellitus: the mediating effects of personal mastery and health-promoting behaviors"],"prefix":"10.3389","volume":"13","author":[{"given":"Guiqiu","family":"Fang","sequence":"first","affiliation":[{"name":"Department of Nursing, Tianjin Fourth Central Hospital","place":["Tianjin, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Weidong","family":"Gong","sequence":"additional","affiliation":[{"name":"Gastrointestinal Surgery\/National Key Clinical Construction Specialist General Surgery, Affiliated Hengyang Hospital of Hunan Normal University and Hengyang Central Hospital, Hengyang","place":["Hunan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lihua","family":"Xia","sequence":"additional","affiliation":[{"name":"Gastrointestinal Surgery\/National Key Clinical Construction Specialist General Surgery, Affiliated Hengyang Hospital of Hunan Normal University and Hengyang Central Hospital, Hengyang","place":["Hunan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liping","family":"Li","sequence":"additional","affiliation":[{"name":"Gastrointestinal Surgery\/National Key Clinical Construction Specialist General Surgery, Affiliated Hengyang Hospital of Hunan Normal University and Hengyang Central Hospital, Hengyang","place":["Hunan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peng","family":"Sun","sequence":"additional","affiliation":[{"name":"Department of Deanery, Tianjin First Central Hospital","place":["Tianjin, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jie","family":"Song","sequence":"additional","affiliation":[{"name":"Department of Nursing, Tianjin Fourth Central Hospital","place":["Tianjin, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yufeng","family":"Cui","sequence":"additional","affiliation":[{"name":"Department of Nursing, Tianjin Fourth Central Hospital","place":["Tianjin, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaochun","family":"Tang","sequence":"additional","affiliation":[{"name":"Gastrointestinal Surgery\/National Key Clinical Construction Specialist General Surgery, Affiliated Hengyang Hospital of Hunan Normal University and Hengyang Central Hospital, Hengyang","place":["Hunan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Youxing","family":"Wu","sequence":"additional","affiliation":[{"name":"Gastrointestinal Surgery\/National Key Clinical Construction Specialist General Surgery, Affiliated Hengyang Hospital of Hunan Normal University and Hengyang Central Hospital, Hengyang","place":["Hunan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Panfeng","family":"Li","sequence":"additional","affiliation":[{"name":"Gastrointestinal Surgery\/National Key Clinical Construction Specialist General Surgery, Affiliated Hengyang Hospital of Hunan Normal University and Hengyang Central Hospital, Hengyang","place":["Hunan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoyan","family":"Zhang","sequence":"additional","affiliation":[{"name":"Gastrointestinal Surgery\/National Key Clinical Construction Specialist General Surgery, Affiliated Hengyang Hospital of Hunan Normal University and Hengyang Central Hospital, Hengyang","place":["Hunan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xing","family":"Ni","sequence":"additional","affiliation":[{"name":"Gastrointestinal Surgery\/National Key Clinical Construction Specialist General Surgery, Affiliated Hengyang Hospital of Hunan Normal University and Hengyang Central Hospital, Hengyang","place":["Hunan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Feng","family":"Lu","sequence":"additional","affiliation":[{"name":"Gastrointestinal Surgery\/National Key Clinical Construction Specialist General Surgery, Affiliated Hengyang Hospital of Hunan Normal University and Hengyang Central Hospital, Hengyang","place":["Hunan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiangyun","family":"Ru","sequence":"additional","affiliation":[{"name":"Gastrointestinal Surgery\/National Key Clinical Construction Specialist General Surgery, 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