{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T18:48:32Z","timestamp":1793386112293,"version":"4.5.0"},"reference-count":70,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,1,2]],"date-time":"2026-01-02T00:00:00Z","timestamp":1767312000000},"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. Psychol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Diabetes mellitus is highly prevalent in China, and individuals affected by this condition often experience stigma, which negatively impacts their psychological well-being and disease management. Empowerment interventions have the potential to reduce stigma by enhancing patients\u2019 knowledge and skills; however, the mechanisms underlying this effect are not yet fully understood. The present study aimed to examine the mediating role of self-management behaviors and the moderating effect of psychological resilience (PR) in this context.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>This study employed a cross-sectional design and included 329 individuals with diabetes, selected through a multistage stratified sampling method. Data collection instruments comprised the diabetes empowerment scale, the Connor-Davidson resilience scale, the stigma scale for chronic illness, and the diabetes management self-efficacy scale. Statistical analyses were performed using SPSS version 23.0, alongside the PROCESS macro, to investigate mediating and moderated mediation effects.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Empowerment (\n                      <jats:italic>r<\/jats:italic>\n                      = \u22120.451,\n                      <jats:italic>p<\/jats:italic>\n                      &amp;lt; 0.001), self-management (\n                      <jats:italic>r<\/jats:italic>\n                      = \u22120.397,\n                      <jats:italic>p<\/jats:italic>\n                      &amp;lt; 0.001), and PR (\n                      <jats:italic>r<\/jats:italic>\n                      = \u22120.325,\n                      <jats:italic>p<\/jats:italic>\n                      &amp;lt; 0.001) each demonstrated significant negative correlations with stigma. Furthermore, self-management was found to partially mediate the association between empowerment and stigma, accounting for 45.44% of the total effect [\n                      <jats:italic>\u03b2<\/jats:italic>\n                      = \u22120.169, 95% CI (\u22120.272, \u22120.088)]. PR significantly moderated the relationship between empowerment and self-management (\n                      <jats:italic>\u03b2<\/jats:italic>\n                      = 0.002,\n                      <jats:italic>p<\/jats:italic>\n                      &amp;lt; 0.001), as well as the direct relationship between empowerment and stigma (\n                      <jats:italic>\u03b2<\/jats:italic>\n                      = \u22120.012,\n                      <jats:italic>p<\/jats:italic>\n                      &amp;lt; 0.001). Simple slope analyses revealed that the positive influence of empowerment on self-management and the negative influence of empowerment on stigma were both more pronounced among individuals exhibiting higher levels of PR.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Our study demonstrates that empowerment has a direct impact on the stigma experienced by individuals with diabetes, as well as an indirect effect mediated by self-management, with PR acting as a moderating factor. These findings suggest that healthcare practitioners should prioritize the enhancement of empowerment-based education and implement tailored interventions that consider patients\u2019 varying levels of PR, in order to reduce stigma and promote better mental health outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpsyg.2025.1591565","type":"journal-article","created":{"date-parts":[[2026,1,2]],"date-time":"2026-01-02T06:28:55Z","timestamp":1767335335000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["The relationship between empowerment and stigma among the Chinese people with diabetes: the mediating role of self-management and the moderating role of psychological resilience"],"prefix":"10.3389","volume":"16","author":[{"given":"Yujin","family":"Mei","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lin","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fuying","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yalin","family":"Shen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mingjia","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hui","family":"Guo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,1,2]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"20","DOI":"10.1186\/s12913-022-08959-3","article-title":"\"After all, we are all sick\": multi-stakeholder understanding of stigma associated with integrated management of HIV, diabetes and hypertension at selected government clinics in Uganda","volume":"23","author":"Akugizibwe","year":"2023","journal-title":"BMC Health Serv. Res."},{"key":"ref2","doi-asserted-by":"publisher","first-page":"110774","DOI":"10.1016\/j.diabres.2023.110774","article-title":"Type 2 diabetes stigma and its association with clinical, psychological, and behavioral outcomes: a systematic review and meta-analysis","volume":"202","author":"Akyirem","year":"2023","journal-title":"Diabetes Res. Clin. Pract."},{"key":"ref3","doi-asserted-by":"publisher","first-page":"S62","DOI":"10.2337\/dc14-S081","article-title":"Diagnosis and classification of diabetes mellitus","volume":"33","year":"2010","journal-title":"Diabetes Care"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"739","DOI":"10.2337\/diacare.23.6.739","article-title":"Diabetes empowerment scales (DES): a measure of psychosocial self-efficacy","volume":"23","author":"Anderson","year":"2000","journal-title":"Diabetes"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"311","DOI":"10.1007\/s13300-023-01528-9","article-title":"Impact of living with stigma in persons with type 1 diabetes: a patient\u2013physician perspective","volume":"15","author":"Ashraf","year":"2024","journal-title":"Diabetes Ther."},{"key":"ref6","doi-asserted-by":"publisher","first-page":"1175","DOI":"10.1037\/0003-066x.44.9.1175","article-title":"Human agency in social cognitive theory","volume":"44","author":"Bandura","year":"1989","journal-title":"Am. Psychol."},{"key":"ref7","doi-asserted-by":"publisher","first-page":"352","DOI":"10.1046\/j.1365-2648.1999.01077.x","article-title":"The psychometric properties of the diabetes management self-efficacy scale for patients with type 2 diabetes mellitus","volume":"30","author":"Bijl","year":"1999","journal-title":"J. Adv. Nurs."},{"key":"ref8","doi-asserted-by":"publisher","first-page":"1584","DOI":"10.1108\/IJPPM-04-2021-0197","article-title":"Organizational learning, resilience and psychological empowerment as antecedents of work engagement during COVID-19","volume":"72","author":"Blaique","year":"2023","journal-title":"Int. J. Prod. Perform. Manag."},{"key":"ref9","doi-asserted-by":"publisher","first-page":"197","DOI":"10.1111\/wvn.12295","article-title":"Longitudinal study of effectiveness of a patient-centered self-management empowerment intervention during Predischarge planning on stroke survivors","volume":"15","author":"Chen","year":"2018","journal-title":"Worldviews Evid.-Based Nurs."},{"key":"ref10","doi-asserted-by":"publisher","first-page":"1983","DOI":"10.3390\/healthcare10101983","article-title":"Influence of diabetes knowledge, self-stigma, and self-care behavior on quality of life in patients with diabetes","volume":"10","author":"Cho","year":"2022","journal-title":"Healthcare"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"76","DOI":"10.1002\/da.10113","article-title":"Development of a new resilience scale: the Connor-Davidson resilience scale (CD-RISC)","volume":"18","author":"Connor","year":"2003","journal-title":"Depress. Anxiety"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"101614","DOI":"10.1016\/j.eclinm.2022.101614","article-title":"The stigma associated with gestational diabetes mellitus: a scoping review","volume":"52","author":"Davidsen","year":"2022","journal-title":"EClinicalMedicine"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"484","DOI":"10.2337\/dc21-2396","article-title":"2022 National Standards for diabetes self-management education and support","volume":"45","author":"Davis","year":"2022","journal-title":"Diabetes Care"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"565","DOI":"10.1007\/s12529-020-09894-5","article-title":"A resilience intervention for adults with type 2 diabetes: proof-of-concept in community health centers","volume":"27","author":"Dubois","year":"2020","journal-title":"Int. J. Behav. Med."},{"key":"ref15","doi-asserted-by":"publisher","first-page":"12","DOI":"10.1027\/1016-9040\/a000124","article-title":"Psychological resilience","volume":"18","author":"Fletcher","year":"2013","journal-title":"Eur. Psychol."},{"key":"ref16","doi-asserted-by":"publisher","first-page":"185","DOI":"10.5603\/DK.2016.0032","article-title":"Results of the second diabetes attitudes, wishes and needs (DAWN2) study: overview of the most important results from the polish perspective","volume":"5","author":"Foryciarz","year":"2016","journal-title":"Clinical Diabetology."},{"key":"ref17","doi-asserted-by":"publisher","first-page":"149","DOI":"10.1016\/j.jad.2013.10.041","article-title":"An examination of resilience cross-culturally in child and adolescent survivors of the 2008 China earthquake using the Connor-Davidson resilience scale (CD-RISC)","volume":"155","author":"Fu","year":"2014","journal-title":"J. Affect. Disord."},{"key":"ref18","doi-asserted-by":"publisher","first-page":"123","DOI":"10.2337\/diaclin.22.3.123","article-title":"Empowerment and self-management of diabetes","volume":"22","author":"Funnell","year":"2004","journal-title":"Clin. Diabetes"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"65","DOI":"10.55489\/ijmr.123202412","article-title":"A dual burden dilemma: navigating the global impact of communicable and non-communicable diseases and the way forward","volume":"12","author":"Goswami","year":"2024","journal-title":"Int. J. Med. Res."},{"key":"ref20","doi-asserted-by":"publisher","first-page":"2430","DOI":"10.1016\/S0140-6736(18)30314-3","article-title":"Trends in cause-specific mortality among adults with and without diagnosed diabetes in the USA: an epidemiological analysis of linked national survey and vital statistics data","volume":"391","author":"Gregg","year":"2018","journal-title":"Lancet"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"242","DOI":"10.1186\/s40359-023-01292-2","article-title":"The relationship between stigma and psychological distress among people with diabetes: a meta-analysis","volume":"11","author":"Guo","year":"2023","journal-title":"BMC Psychol."},{"key":"ref22","doi-asserted-by":"publisher","first-page":"1116","DOI":"10.1186\/s12913-022-08501-5","article-title":"All together now\u2013patient engagement, patient empowerment, and associated terms in personal healthcare","volume":"22","author":"Hickmann","year":"2022","journal-title":"BMC Health Serv. Res."},{"key":"ref23","doi-asserted-by":"publisher","first-page":"11","DOI":"10.1186\/1747-5341-5-11","article-title":"How clinicians make (or avoid) moral judgments of patients: implications of the evidence for relationships and research","volume":"5","author":"Hill","year":"2010","journal-title":"Philos. Ethics Humanit. Med."},{"key":"ref24","doi-asserted-by":"publisher","first-page":"259","DOI":"10.1111\/j.1442-2018.2010.00517.x","article-title":"Diabetes empowerment related to Pender\u2019s health promotion model: a meta-synthesis","volume":"12","author":"Ho","year":"2010","journal-title":"Nurs. Health Sci."},{"key":"ref25","doi-asserted-by":"publisher","first-page":"e2004","DOI":"10.1002\/hsr2.2004","article-title":"Diabetes mellitus, the fastest-growing global public health concern: early detection should be focused","volume":"7","author":"Hossain","year":"2024","journal-title":"Health Sci Rep."},{"key":"ref26","doi-asserted-by":"publisher","first-page":"e13398","DOI":"10.7717\/peerj.13398","article-title":"Psychometric properties of the general self-efficacy scale among Thais with type 2 diabetes: a multicenter study","volume":"10","author":"Hurst","year":"2022","journal-title":"PeerJ."},{"key":"ref27","doi-asserted-by":"publisher","first-page":"e003001","DOI":"10.1136\/bmjdrc-2022-003001","article-title":"Diabetes-related shame among people with type 2 diabetes: an internet-based cross-sectional study","volume":"10","author":"Inagaki","year":"2022","journal-title":"BMJ Open Diabetes Res. Care"},{"key":"ref28","doi-asserted-by":"publisher","first-page":"1362433","DOI":"10.3389\/fendo.2024.1362433","article-title":"Prevalence and co-prevalence of comorbidities among Chinese adult patients with type 2 diabetes mellitus: a cross-sectional, multicenter, retrospective, observational study based on 3B study database","volume":"15","author":"Ji","year":"2024","journal-title":"Front. Endocrinol."},{"key":"ref29","doi-asserted-by":"publisher","first-page":"69","DOI":"10.1080\/09669582.2019.1675673","article-title":"Knowledge, empowerment, and action: testing the empowerment theory in a tourism context","volume":"28","author":"Joo","year":"2020","journal-title":"J. Sustain. Tour."},{"key":"ref30","doi-asserted-by":"publisher","first-page":"e062971","DOI":"10.1136\/bmjopen-2022-062971","article-title":"Protocol for a feasibility study and process evaluation of a psychosocially modelled diabetes education programme for young people with type 1 diabetes: the youth empowerment skills (YES) programme","volume":"12","author":"Kariyawasam","year":"2022","journal-title":"BMJ Open"},{"key":"ref31","doi-asserted-by":"publisher","first-page":"242","DOI":"10.1177\/17579139221136725","article-title":"Perceived stigma among diabetic patients and their caregivers: a review","volume":"144","author":"Kaur","year":"2024","journal-title":"Perspect. Public Health"},{"key":"ref32","volume-title":"Kendall\u2019s advanced theory of statistics","author":"Kendall","year":"2004"},{"key":"ref33","doi-asserted-by":"publisher","first-page":"58","DOI":"10.1016\/j.eurpsy.2014.06.002","article-title":"Self-stigma as a mediator between social capital and empowerment among people with major depressive disorder in Europe: the ASPEN study","volume":"30","author":"Lanfredi","year":"2015","journal-title":"Eur. Psychiatry"},{"key":"ref34","volume-title":"Stress, appraisal, and coping","author":"Lazarus","year":"1984"},{"key":"ref35","doi-asserted-by":"publisher","first-page":"104340","DOI":"10.1016\/j.jesp.2022.104340","article-title":"Concealment stigma: the social costs of concealing","volume":"101","author":"Le Forestier","year":"2022","journal-title":"J. Exp. Soc. Psychol."},{"key":"ref36","doi-asserted-by":"publisher","first-page":"e34242","DOI":"10.1097\/MD.0000000000034242","article-title":"The status of stigma in patients with type 2 diabetes mellitus and its association with medication adherence and quality of life in China: a cross-sectional study","volume":"102","author":"Li","year":"2023","journal-title":"Medicine"},{"key":"ref37","doi-asserted-by":"publisher","first-page":"e15424","DOI":"10.1111\/dme.15424","article-title":"\"I feel like I'm being talked to like an equal\": diabetes language matters to adults with diabetes, a mixed-methods study","volume":"41","author":"Litterbach","year":"2024","journal-title":"Diabet. Med."},{"key":"ref38","doi-asserted-by":"publisher","first-page":"1451","DOI":"10.1080\/17441692.2021.1934061","article-title":"A scoping review of the integration of empowerment-based perspectives in quantitative intersectional stigma research","volume":"17","author":"Logie","year":"2022","journal-title":"Glob. Public Health"},{"key":"ref39","doi-asserted-by":"publisher","first-page":"312","DOI":"10.1080\/10749357.2019.1592306","article-title":"Reliability and validity of a Chinese version of the stigma scale for chronic illness (SSCI) in patients with stroke","volume":"26","author":"Lu","year":"2019","journal-title":"Top. Stroke Rehabil."},{"key":"ref40","doi-asserted-by":"publisher","first-page":"4","DOI":"10.1111\/hex.13374","article-title":"Towards conceptual convergence: a systematic review of psychological resilience in family caregivers of persons living with chronic neurological conditions","volume":"25","author":"McKenna","year":"2022","journal-title":"Health Expect."},{"key":"ref41","doi-asserted-by":"publisher","first-page":"1124570","DOI":"10.3389\/fpubh.2023.1124570","article-title":"The relationship between psychological resilience and depression among the diabetes patients under the background of \u201cdynamic zero COVID-19\u201d: the mediating role of stigma and the moderating role of medication burden","volume":"11","author":"Mei","year":"2023","journal-title":"Front. Public Health"},{"key":"ref42","doi-asserted-by":"publisher","first-page":"205","DOI":"10.1080\/10803548.2024.2424078","article-title":"The impact of leadership on workplace safety climate and employees' wellbeing with particular focus on transformational leadership","volume":"31","author":"Moda","year":"2025","journal-title":"Int. J. Occup. Saf. Ergon."},{"key":"ref43","doi-asserted-by":"publisher","first-page":"e0186458","DOI":"10.1371\/journal.pone.0186458","article-title":"Is patient empowerment the key to promote adherence? A systematic review of the relationship between self-efficacy, health locus of control and medication adherence","volume":"12","author":"N\u00e1fr\u00e1di","year":"2017","journal-title":"PLoS One"},{"key":"ref44","doi-asserted-by":"publisher","first-page":"1048","DOI":"10.1111\/1753-0407.13454","article-title":"Patient experiences of continuous glucose monitoring and sensor-augmented insulin pump therapy for diabetes: a systematic review of qualitative studies","volume":"15","author":"Natale","year":"2023","journal-title":"J. Diabetes"},{"key":"ref45","doi-asserted-by":"publisher","first-page":"9142949","DOI":"10.1155\/jdr\/9142949","article-title":"Associations between self-stigma and health promotion behaviors in overweight\/obese patients with type 2 diabetes: a cross-sectional study","volume":"2025","author":"Niu","year":"2025","journal-title":"J. Diabetes Res."},{"key":"ref46","doi-asserted-by":"publisher","first-page":"1358","DOI":"10.1080\/13557858.2021.1881764","article-title":"Exploring the impact of cultural beliefs in the self-management of type 2 diabetes among black sub-Saharan Africans in the UK\u2013a qualitative study informed by the PEN-3 cultural model","volume":"27","author":"Omodara","year":"2022","journal-title":"Ethn. Health"},{"key":"ref47","doi-asserted-by":"publisher","first-page":"680","DOI":"10.1177\/10901981221098373","article-title":"Perspectives of persons with type 2 diabetes toward diabetes self-management: a qualitative study","volume":"49","author":"Othman","year":"2022","journal-title":"Health Educ. Behav."},{"key":"ref48","doi-asserted-by":"publisher","first-page":"2434","DOI":"10.1108\/JKM-09-2022-0747","article-title":"Exploring empowerment as an enabler of effective knowledge management","volume":"27","author":"Ozpamuk","year":"2023","journal-title":"J. Knowl. Manag."},{"key":"ref49","doi-asserted-by":"publisher","first-page":"1157","DOI":"10.15537\/smj.2022.43.10.20220344","article-title":"Self-esteem mediates the relationship perceived stigma with self-efficacy for diabetes management in individuals with type 2 diabetes mellitus","volume":"43","author":"Ozturk","year":"2022","journal-title":"Saudi Med. J."},{"key":"ref50","doi-asserted-by":"publisher","first-page":"1012","DOI":"10.1080\/08870446.2023.2290170","article-title":"Patient-driven decisions and perceptions of the \u2018safest possible choice\u2019: insights from patient-provider conversations about how some breast cancer patients choose contralateral prophylactic mastectomy","volume":"40","author":"Padamsee","year":"2023","journal-title":"Psychol. Health"},{"key":"ref51","doi-asserted-by":"publisher","first-page":"2213","DOI":"10.1111\/hex.13398","article-title":"How might diabetes organisations address diabetes-related stigma? Findings from a deliberative democratic case study","volume":"25","author":"Pillen","year":"2022","journal-title":"Health Expect."},{"key":"ref52","doi-asserted-by":"publisher","first-page":"108387","DOI":"10.1016\/j.diabres.2020.108387","article-title":"Weight stigma and diabetes stigma in U.S. adults with type 2 diabetes: associations with diabetes self-care behaviors and perceptions of health care","volume":"168","author":"Puhl","year":"2020","journal-title":"Diabetes Res. Clin. Pract."},{"key":"ref53","doi-asserted-by":"publisher","first-page":"6657","DOI":"10.3390\/ijerph17186657","article-title":"Non-communicable diseases-related stigma: a mixed-methods systematic review","volume":"17","author":"Rai","year":"2020","journal-title":"Int. J. Environ. Res. Public Health"},{"key":"ref54","doi-asserted-by":"publisher","first-page":"585","DOI":"10.1007\/s11136-009-9475-1","article-title":"Measuring stigma across neurological conditions: the development of the stigma scale for chronic illness (SSCI)","volume":"18","author":"Rao","year":"2009","journal-title":"Qual. Life Res."},{"key":"ref55","doi-asserted-by":"publisher","first-page":"308","DOI":"10.1016\/j.jcjd.2023.04.009","article-title":"Diabetes and mental health","volume":"47","author":"Robinson","year":"2023","journal-title":"Can. J. Diabetes"},{"key":"ref56","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1007\/s40271-012-0001-0","article-title":"Social stigma in diabetes: a framework to understand a growing problem for an increasing epidemic","volume":"6","author":"Schabert","year":"2013","journal-title":"Patient"},{"key":"ref57","doi-asserted-by":"publisher","first-page":"175","DOI":"10.1177\/0002716203260099","article-title":"Positive stigma: examining resilience and empowerment in overcoming stigm","volume":"591","author":"Shih","year":"2004","journal-title":"Ann. Am. Acad. Polit. Soc. Sci."},{"key":"ref58","doi-asserted-by":"publisher","first-page":"61","DOI":"10.1016\/S2213-8587(23)00347-9","article-title":"Bringing an end to diabetes stigma and discrimination: an international consensus statement on evidence and recommendations","volume":"12","author":"Speight","year":"2024","journal-title":"Lancet Diabetes Endocrinol."},{"key":"ref59","doi-asserted-by":"publisher","first-page":"e0317753","DOI":"10.1371\/journal.pone.0317753","article-title":"Exploring the dynamics of self-efficacy, resilience, and self-management on quality of life in type 2 diabetes patients: a moderated mediation approach from a positive psychology perspective","volume":"20","author":"Ting","year":"2025","journal-title":"PLoS One"},{"key":"ref60","doi-asserted-by":"publisher","first-page":"451","DOI":"10.1177\/0017896920983837","article-title":"The empowerment ladder: understanding transition across leadership stages in individuals with type 1 diabetes and other noncommunicable diseases","volume":"80","author":"Ugliara","year":"2021","journal-title":"Health Educ. J."},{"key":"ref61","doi-asserted-by":"publisher","first-page":"2247","DOI":"10.3390\/ijerph18052247","article-title":"Enablers of patient knowledge empowerment for self-management of chronic disease: an integrative review","volume":"18","author":"Vainauskien\u0117","year":"2021","journal-title":"Int. J. Environ. Res. Public Health"},{"key":"ref62","doi-asserted-by":"publisher","first-page":"1360","DOI":"10.3390\/ijerph19031360","article-title":"The promise of digital self-management: a reflection about the effects of patient-targeted e-health tools on self-management and wellbeing","volume":"19","author":"van Olmen","year":"2022","journal-title":"Int. J. Environ. Res. Public Health"},{"key":"ref63","doi-asserted-by":"publisher","first-page":"e52464","DOI":"10.2196\/52464","article-title":"Efficacy of a WeChat-based multimodal digital transformation management model in new-onset mild to moderate hypertension: randomized clinical trial","volume":"25","author":"Wang","year":"2023","journal-title":"J. Med. Internet Res."},{"key":"ref64","doi-asserted-by":"publisher","first-page":"312","DOI":"10.1097\/JCN.0000000000001098","article-title":"Network analysis of dyadic burdens, psychological disorders, psychological resilience, and illness- or caregiving-related beliefs in patients with chronic heart failure and their caregivers","volume":"40","author":"Wang","year":"2024","journal-title":"J. Cardiovasc. Nurs."},{"key":"ref65","doi-asserted-by":"publisher","first-page":"117","DOI":"10.1186\/s12888-022-03740-6","article-title":"Social support and depressive symptoms: exploring stigma and self-efficacy in a moderated mediation model","volume":"22","author":"Wang","year":"2022","journal-title":"BMC Psychiatry"},{"key":"ref66","doi-asserted-by":"publisher","first-page":"1055","DOI":"10.1111\/jan.15077","article-title":"Patient empowerment and self-management behaviour of chronic disease patients: a moderated mediation model of self-efficacy and health locus of control","volume":"78","author":"Wang","year":"2022","journal-title":"J. Adv. Nurs."},{"key":"ref67","doi-asserted-by":"publisher","first-page":"774","DOI":"10.1186\/s12913-025-12953-w","article-title":"Patients and healthcare providers needs and challenges in diabetes self-management and support in Ethiopian primary healthcare context","volume":"25","author":"Yimer","year":"2025","journal-title":"BMC Health Serv. 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