# Interaction of self-efficacy and sense of personal control on diabetes distress in older adults with type 2 diabetes: a cross-sectional study

**Authors:** Zhaoxia Tian, Xia Ren, Quanyi Wang, Wenke Guo, Hongmei Li, Linping Shang

PMC · DOI: 10.3389/fpubh.2026.1762971 · Frontiers in Public Health · 2026-02-04

## TL;DR

This study explores how self-efficacy and personal control affect diabetes distress in older adults with type 2 diabetes.

## Contribution

The study identifies new intervention strategies by examining the interplay between personal mastery and self-efficacy in alleviating diabetes distress.

## Key findings

- 59.06% of older adults with T2DM experienced distress.
- Low self-efficacy and personal mastery scores were significant risk factors for diabetes distress.
- The interplay between self-efficacy and personal control offers new intervention strategies for alleviating diabetes distress.

## Abstract

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.

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.

Findings revealed that 59.06% of older adults with T2DM experienced distress. Independent risk factors for DDS included disease duration ≥10 years (β = 1.181), living alone (β = 1.592), low educational attainment (β = −1.639), low household income (β = 1.432), PMS score <20 (β = 0.828), and GSES score <30 (β = 0.887). 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 (−0.081, −0.066, p < 0.005). Concurrently, the chained path was also significant (−0.020, −0.009, p < 0.05).

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.

## Linked entities

- **Diseases:** type 2 diabetes (MONDO:0005148)

## Full-text entities

- **Genes:** INS (insulin) [NCBI Gene 3630] {aka IDDM, IDDM1, IDDM2, ILPR, IRDN, MODY10}
- **Diseases:** DDS (MESH:D012128), metabolic disorder (MESH:D008659), neglect (MESH:D058069), language impairment (MESH:D007806), anxiety (MESH:D001007), malignancy (MESH:D009369), Diabetes (MESH:D003920), PMS (MESH:C538175), critical illness (MESH:D016638), disease (MESH:D004194), HL (MESH:C538324), chronic illness (MESH:D002908), cognitive dysfunction (MESH:D003072), depression (MESH:D003866), T2D (MESH:D003924), hypoglycemia (MESH:D007003)
- **Chemicals:** blood glucose (MESH:D001786), glucose (MESH:D005947), DD (-)
- **Species:** Homo sapiens (human, species) [taxon 9606]

## Full text

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## Figures

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## References

34 references — full list in the complete paper: https://tomesphere.com/paper/PMC12913128/full.md

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Source: https://tomesphere.com/paper/PMC12913128