The Mediating Effect of Acceptance Action in the Relationship between Diabetes Distress and Self-stigma among Old Adults with Diabetes in South Korea

다국어 초록 (Multilingual Abstract)

Purpose: This study investigated the mediating effects of acceptance action on the relationship between diabetes distress and self-stigma in older adults with diabetes. Methods: A descriptive research approach was adopted using 187 patients diagnosed with diabetes mellitus by an endocrinology doctor. The data were collected from 26 to 31 March, 2020 and were analyzed using descriptive statistics, t-test, one-way ANOVA, Pearson's correlation coefficient analysis, and hierarchical multiple regression. Results: The mean scores for diabetes distress, self-stigma, and acceptance action were 2.98±0.64, 2.54±0.74, and 4.16±0.35, respectively. Acceptance action partially mediated the relationship between diabetes distress and self-stigma (z=1.98, p=.024), with an explanatory power of 51.0%.
Conclusion: To reduce diabetes self-stigma among old adults in diabetes distress situations, it is necessary to improve their acceptance action and develop step-by-step differentiated acceptance action enhancement programs through multidisciplinary collaborations.

참고문헌 (Reference)

1 최수경 ; 김수현, "환자 활성화가 당뇨병 자가간호 행위 및 당뇨병 관련 스트레스에 미치는 영향" 한국성인간호학회 32 (32): 10-20, 2020

2 금혜선 ; 서순림 ; 한승우, "제2형 당뇨병 환자의 자기관리지식, 스트레스가 당뇨관리 자기효능감에 미치는 영향" 한국산학기술학회 21 (21): 498-508, 2020

3 송영신, "심리적 인슐린저항성 개념분석" 한국간호과학회 46 (46): 443-453, 2016

4 유다선 ; 손정락, "수용전념치료(ACT)가 제1형 당뇨 청소년의 당뇨 스트레스, 자기관리, 삶의 질 및 수용행동에 미치는 효과" 한국건강심리학회 19 (19): 637-654, 2014

5 성기월 ; 박미경 ; 남지란 ; 박지현 ; 강혜승, "당뇨병을 가지고 살아가는 취약계층 노인의 경험" 한국보건간호학회 31 (31): 149-161, 2017

6 Imani E, "The role of anxiety and depression on acceptance and action, considering emotional schemas in diabetics of Birjand(Iran)" 9 (9): 5551-5559, 2017

7 Baron RM, "The moderator-mediator variable distinction in social psychological research : conceptual, strategic, and statistical considerations" 51 (51): 1173-1182, 1986

8 서가원, "The Effects of Self-efficacy and Self-stigma on Self-care in People with Diabetes" 한국지역사회간호학회 32 (32): 86-94, 2021

9 Kuo CP, "Sleep quality and associated factors in adults with type 2 diabetes : a retrospective cohort study" 18 (18): 3025-, 2021

10 Seo K, "Self-stigma among Korean patients with diabetes : A concept analysis" 28 (28): 1794-1807, 2019

11 이명선 ; 고문희 ; 손행미, "Rearranging Everyday Lives among People with Type 2 Diabetes in Korea" 한국성인간호학회 26 (26): 703-711, 2014

12 Jeong M, "Predictors of health-related quality of life in Korean adults with diabetes mellitus" 17 (17): 9058-, 2020

13 Hayes SC, "Measuring experiential avoidance : a preliminary test of a working model" 54 (54): 553-578, 2004

14 Kim SK, "Management of type 2 diabetes mellitus in the elderly" 19 (19): 200-207, 2018

15 Kim SY, "Management of diabetes in the elderly" 23 (23): 128-132, 2022

16 Larsen PD, "Lubkin's chronic illness: impact and intervention" Jones & Barlett Learning 39-51, 2017

17 Patel A, "Intensive blood glucose control and vascular outcomes in patients with type 2 diabetes" 358 (358): 2560-2572, 2008

18 엄영실 ; 박화선 ; 김세현 ; 양선미 ; 남문석 ; 이형우 ; 이기영 ; 이시훈 ; 김연선 ; 박이병, "Evaluation of Stress in Korean Patients with Diabetes Mellitus Using the Problem Areas in Diabetes-Korea Questionnaire" 대한당뇨병학회 35 (35): 182-187, 2011

19 Maghsoudi Z, "Efficacy of acceptance and commitment therapy for emotional distress in the elderly with type 2 diabetes : a randomized controlled trial" 12 : 2137-2143, 2019

20 Gerstein HC, "Effects of intensive glucose lowering in type 2diabetes" 358 (358): 2545-2559, 2008

21 배재현 ; 한경도 ; 고승현 ; 양예슬 ; 최종한 ; 최경묵 ; 권혁상 ; 원규장, "Diabetes Fact Sheet in Korea 2021" 대한당뇨병학회 46 (46): 417-426, 2022

22 Seo K, "Development and validation of the self-stigma scale in people with diabetes" 8 (8): 1089-1097, 2021

23 Moon HM, "Development and validation of the program for facilitation of psychological acceptance based on acceptance &commitment therapy model" The Catholic University of Korea 2006

24 Polonsky WH, "Assessment of diabetes-related distress" 18 (18): 754-760, 1995

25 고승현 ; 허규연 ; 이상열 ; 김난희 ; 문민경 ; 박석오 ; 이병완 ; 김현진 ; 최경묵 ; 김진화, "Antihyperglycemic Agent Therapy for Adult Patients with Type 2 Diabetes Mellitus 2017: A Position Statement of the Korean Diabetes Association" 대한당뇨병학회 41 (41): 337-348, 2017

26 Jaworski M, "Adherence to dietary recommendations in diabetes mellitus : disease acceptance as a potential mediator" 12 : 163-174, 2018

27 Yoo B, "A review of qualitative research in Korea : The life experiences of diabetes patients" 18 (18): 270-274, 2017