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

Zheng Ting; Wang Huicai; Zakeer Kudelati; Ge Yongkang; Ayimire Alimu; Zhang Xiaotian; Qu Xingge; Li Tong

doi:10.1371/journal.pone.0317753

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

PLoS One. 2025 Jan 24;20(1):e0317753. doi: 10.1371/journal.pone.0317753. eCollection 2025.

Authors

Zheng Ting¹, Wang Huicai², Zakeer Kudelati³, Ge Yongkang⁴, Ayimire Alimu⁴, Zhang Xiaotian⁴, Qu Xingge⁴, Li Tong⁴

Affiliations

¹ Nursing School, Xinjiang Medical University, Urumqi, China.
² Department of Undergraduate Educational Management, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, China.
³ College of Health Management, Xinjiang Medical University, Urumqi, China.
⁴ The First Affiliated Hospital of Xinjiang Medical University, Urumqi, China.

Abstract

Objectives: Type 2 diabetes mellitus (T2DM) significantly deteriorates patients' quality of life (QOL). This study examined the dynamic interplay of factors that influence QOL in patients with T2DM, utilizing concepts from positive psychology and intrinsic mechanisms, to lay the groundwork for improving patient outcomes. Improving self-management behaviors is essential for effective disease management.

Methods: Using a cross-sectional design, this study incorporated 408 patients with T2DM from the endocrinology department of a public hospital in Urumqi, who were selected through convenience sampling from December 29, 2023 to June 30, 2024. Data collection tools included the General Data Questionnaire, Summary of Diabetes Self-Care Activities, Self-Efficacy for Diabetes Questionnaire, Connor-Davidson Resilience Scale, and Diabetes-Specific Quality of Life Scale. Structural equation modeling and Model 15 of Hayes' SPSS-Process program facilitated the moderated mediation analysis.

Results: The findings demonstrated that self-efficacy significantly enhanced the QOL (β = -0.8557, p < 0.01), with resilience serving as a partial mediator, accounting for 43.1% of this effect. Interactions between self-efficacy and self-management, and resilience and self-management, were also significant predictors of QOL (β = -0.0751, p < 0.01 and β = -0.0073, p < 0.05, respectively).

Conclusion: These findings introduce a novel theoretical framework for T2DM from the perspective of positive psychology, which will be beneficial for intervention development. This study underscores the importance of promoting diabetes self-management as an effective strategy to enhance QOL. Additionally, healthcare providers must focus on fostering patients' positive psychological traits and reliable self-management behaviors.

Copyright: © 2025 Ting et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

MeSH terms

Adult
Aged
Cross-Sectional Studies
Diabetes Mellitus, Type 2* / psychology
Diabetes Mellitus, Type 2* / therapy
Female
Humans
Male
Middle Aged
Psychology, Positive*
Quality of Life* / psychology
Resilience, Psychological*
Self Care / psychology
Self Efficacy*
Self-Management* / psychology
Surveys and Questionnaires

Grants and funding

The authors disclosed receipt of the following financial support for the research, authorship, and publication of this article: This work was supported by the National Undergraduate Innovation and Entrepreneurship Training Program for College students (S202310760036). There was no additional external funding received for this study.