Patient Preference and Adherence (Apr 2022)
Mediating Role of Depressive Symptoms on the Association Between Neighborhood Social Cohesion and Quality of Life in Individuals with Type 2 Diabetes Mellitus
Abstract
Liqun Wang,1 Ning Yan,2 Rongrong Guo,3 Lining Pu,1 Yuqi Dang,4 Ruiping Pan,5 Yang Niu3,6 1Department of Epidemiology and Statistics, School of Public Health and Management at Ningxia Medical University, Yinchuan, 750004, People’s Republic of China; 2Heart Centre & Department of Cardiovascular Diseases, General Hospital of Ningxia Medical University, Yinchuan, Ningxia, 750004, People’s Republic of China; 3School of traditional Chinese Medicine, Ningxia Medical University, Yinchuan, 750004, People’s Republic of China; 4Department of Endocrinology, Yinchuan Hospital of Traditional Chinese Medicine, Yinchuan, 750001, People’s Republic of China; 5Department of Chinese Medicine, The Second People’s Hospital of Shizuishan, Shizuishan, 753000, People’s Republic of China; 6Key Laboratory of the Ningxia Ethnomedicine Modernization, Ministry of Education, Ningxia Medical University, Yinchuan, 750004, People’s Republic of ChinaCorrespondence: Yang Niu, Key Laboratory of the Ningxia Ethnomedicine Modernization, Ministry of Education, Ningxia Medical University, Yinchuan, 750004, People’s Republic of China, Tel +8613909574577, Email [email protected]: Few studies have explored the association between neighborhood social cohesion (NSC), a type of social capital, and the quality of life of patients with type 2 diabetes mellitus (T2DM). In addition, the potential mechanism for this association remains unclear. The current study examined the mediation effect of depressive symptoms on the relationship between NSC and quality of life among diabetes patients in China.Patients and Methods: A cross-sectional study of 1747 T2DM patients was conducted. The specific quality of life (DSQL), Center for Epidemiological Survey Depression (CES-D), and social capital scales were administered using a face-to-face survey. Partial correlation analysis and a linear regression model were employed to explore the relationship between NSC, depressive symptoms, and quality of life. Bootstrap analysis using PROCESS was used to test the mediation model.Results: After controlling for covariates, NSC was negatively correlated with depressive symptoms (r=− 0.24, P< 0.01) and DSQL score (r=− 0.20, P< 0.01) while depressive symptoms were positively correlated with DSQL score (r=0.46, P< 0.01). Linear regression analysis also found that NSC was negatively associated with the DSQL score, while depressive symptoms were positively associated with the DSQL score. Depressive symptoms mediated the relationship between NSC and quality of life in T2DM patients (explaining 50.7% of the total variance).Conclusion: NSC was positively associated with improved quality of life among Chinese T2DM patients in this study, and depressive symptoms were likely to partially explain this relationship. These findings may be used to help maintain a good quality of life among at-risk individuals. Additional prospective studies are needed to confirm these findings.Keywords: neighborhood social cohesion, depressive symptoms, quality of life, mediating effect, T2DM patients
