{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T12:37:29Z","timestamp":1791463049007,"version":"4.3.4"},"reference-count":34,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,2,4]],"date-time":"2026-02-04T00:00:00Z","timestamp":1770163200000},"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. Public Health"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Diabetes distress (DD) constitutes a significant barrier to effective diabetes management, impacting self-care behaviors and complication incidence rates. It directly influences quality of life and healthcare resource utilization among gerontal patients. Research on alleviating DD offers a novel perspective for developing personalized self-management plans in clinical practice.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This cross-sectional study randomly selected 342 older adults with type 2 diabetes registered at community hospitals. Factors influencing disease distress were assessed using a demographic questionnaire, Diabetes Distress Scale (DDS), Personal Mastery Scale (PMS), General Self-Efficacy Scale (GSES), and Diabetes Self-Management Behavior Scale (DSMB-O). Structural equation modeling was employed for moderated mediation analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Findings revealed that 59.06% of older adults with T2DM experienced distress. Independent risk factors for DDS included disease duration \u226510\u202fyears (\n                      <jats:italic>\u03b2<\/jats:italic>\n                      \u202f=\u202f1.181), living alone (\n                      <jats:italic>\u03b2<\/jats:italic>\n                      \u202f=\u202f1.592), low educational attainment (\n                      <jats:italic>\u03b2<\/jats:italic>\n                      \u202f=\u202f\u22121.639), low household income (\n                      <jats:italic>\u03b2<\/jats:italic>\n                      \u202f=\u202f1.432), PMS score &amp;lt;20 (\n                      <jats:italic>\u03b2<\/jats:italic>\n                      \u202f=\u202f0.828), and GSES score &amp;lt;30 (\n                      <jats:italic>\u03b2<\/jats:italic>\n                      \u202f=\u202f0.887). Under the hypothetical model, the structural equation model revealed that the indirect path coefficients for self-efficacy and general sense of control via self-management on perceived illness distress were significant (\u22120.081, \u22120.066,\n                      <jats:italic>p<\/jats:italic>\n                      &amp;lt;\u202f0.005). Concurrently, the chained path was also significant (\u22120.020, \u22120.009,\n                      <jats:italic>p<\/jats:italic>\n                      &amp;lt;\u202f0.05).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Factors influencing disease distress in older adults with T2DM are diverse. The complex interplay between personal mastery and self-efficacy offers new intervention strategies for clinically alleviating diabetes distress.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpubh.2026.1762971","type":"journal-article","created":{"date-parts":[[2026,2,4]],"date-time":"2026-02-04T05:34:54Z","timestamp":1770183294000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Interaction of self-efficacy and sense of personal control on diabetes distress in older adults with type 2 diabetes: a cross-sectional study"],"prefix":"10.3389","volume":"14","author":[{"given":"Zhaoxia","family":"Tian","sequence":"first","affiliation":[{"name":"Department of Nursing, Fenyang College of Shanxi Medical University","place":["Fenyang, Shanxi Province, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xia","family":"Ren","sequence":"additional","affiliation":[{"name":"Department of Nursing, Lvliang Hospital of Traditional Chinese Medicine","place":["L\u00fcliang, Shanxi Province, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Quanyi","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Fenyang Hospital of Shanxi Province","place":["Fenyang, Shanxi Province, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wenke","family":"Guo","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Fenyang Hospital of Shanxi Province","place":["Fenyang, Shanxi Province, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hongmei","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Nursing, Fenyang College of Shanxi Medical University","place":["Fenyang, Shanxi Province, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Linping","family":"Shang","sequence":"additional","affiliation":[{"name":"Department of Nursing, The First Hospital of Shanxi Medical University","place":["Taiyuan, Shanxi Province, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,2,4]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"e63434","DOI":"10.2196\/63434","article-title":"Four new patient-reported outcome measures examining Health-seeking behavior in persons with type 2 diabetes mellitus (REDD-CAT): Instrument development study","volume":"9","author":"Mitchell","year":"2024","journal-title":"JMIR Diabetes"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"767","DOI":"10.1111\/dme.12245","article-title":"Diabetes attitudes, wishes and needs second study (DAWN2\u2122): Cross-national benchmarking of diabetes-related psychosocial outcomes for people with 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