领悟社会支持和应对方式在2型糖尿病患者心盛与益处发现中的链式中介作用

doi:10.16138/j.1673-6087.2026.03.05

内科理论与实践 ›› 2026, Vol. 21 ›› Issue (03): 232-239.doi: 10.16138/j.1673-6087.2026.03.05

领悟社会支持和应对方式在2型糖尿病患者心盛与益处发现中的链式中介作用

崔培荣(), 周莹霞(), 陆骆, 蔡筱丹, 史佳

上海交通大学医学院附属瑞金医院内分泌代谢科，上海　200025

收稿日期:2025-11-12 修回日期:2025-12-16 接受日期:2025-12-26 出版日期:2026-06-25 发布日期:2026-08-19
通讯作者: 周莹霞 E-mail：zyx20992@rjh.com.cn
作者简介:作者贡献/Authors’ Contributions崔培荣负责撰写初稿、数据收集、数据分析；周莹霞负责项目管理、审阅与编辑；陆骆负责数据收集；蔡筱丹负责审阅与编辑、研究实施；史佳负责项目管理。
基金资助:
上海交通大学医学院附属瑞金医院院级护理科研项目(RJKH(P)-2024-027);上海交通大学医学院附属瑞金医院青年培育计划项目(2024PY112)

Chain mediation roles of perceived social support and coping styles between flourishing and benefit finding in patients with type 2 diabetes mellitus

CUI Peirong(), ZHOU Yingxia(), LU Luo, CAI Xiaodan, SHI Jia

Department of Endocrinology and Metabolism, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China

Received:2025-11-12 Revised:2025-12-16 Accepted:2025-12-26 Online:2026-06-25 Published:2026-08-19

摘要/Abstract

摘要：

目的：基于三元交互理论，分析2型糖尿病患者心盛与益处发现的关联，以及领悟社会支持与应对方式在其中的链式中介作用，以期为改善患者益处发现水平提供依据。方法：采用便利抽样法，于2025年6月至10月选取上海市某三级甲等医院内分泌科门诊及住院2型糖尿病患者207例，采用一般资料问卷、心盛量表、领悟社会支持量表、应对方式量表及益处发现量表进行调查，采用SPSS 26.0和PROCESS 3.2进行单因素分析、相关性分析及链式中介效应检验。结果：共回收有效问卷207份，有效回收率100.00%。2型糖尿病患者益处发现、心盛、领悟社会支持、应对方式总分分别为（51.11±11.07）（45.80±7.70）（65.26±14.47）（0.00±1.40）分。不同学历、主要照顾者、婚姻状况、居住状态、糖化血红蛋白的2型糖尿病患者益处发现得分差异具有统计学意义(均P<0.05)。心盛、领悟社会支持、应对方式与益处发现呈正相关（r=0.517~0.672，P<0.01）。心盛水平对益处发现的总效应为0.744，直接效应为0.227，并通过“领悟社会支持→益处发现” “应对方式→益处发现”及“领悟社会支持→应对方式→益处发现”3条路径发挥间接作用，间接效应分别为0.022、0.090、0.206，总间接效应占总效应的69.5%。结论：2型糖尿病患者益处发现水平有待提高，医护人员应在了解其益处发现特征及影响因素后，基于三元交互理论采取干预措施，提升其益处发现水平。

关键词: 2型糖尿病, 心盛, 益处发现, 社会支持, 应对方式, 链式中介效应

Abstract:

Objective To examine the association between flourishing and benefit finding among patients with type 2 diabetes mellitus (T2DM) and the chain mediation roles of perceived social support and coping styles between them based on the triadic reciprocal determinism theory, so as to provide a reference for improving the benefit finding level of patients. Methods Using the convenience sampling method, 207 T2DM outpatients and inpatients were recruited from the department of endocrinology at a tertiary grade-A hospital in Shanghai from June 2025 to October 2025. The general information questionnaire, flourishing scale, multidimensional scale of perceived social support, coping style questionnaire, and benefit finding scale were used to conduct the survey. Univariate analysis, correlation analysis, and chain mediation effect testing were performed using SPSS 26.0 and PROCESS 3.2. Results A total of 207 valid questionnaires were collected, effective response rate 100.00%. The total scores of benefit finding, flourishing, perceived social support, and coping styles in T2DM patients were (51.11±11.07) (45.80±7.70) (65.26±14.47) and (0.00±1.40) points, respectively. There were statistically significant differences in benefit finding scores among T2DM patients with varied education levels, primary caregivers, marital status, living status, and glycated hemoglobin levels (all P<0.05). Flourishing, perceived social support, and coping styles were positively correlated with benefit finding (r=0.517~0.672, P<0.01). The total effect of flourishing on benefit finding was 0.744, with a direct effect of 0.227. The indirect effects were mediated through 3 pathways: “perceived social support → benefit finding” “coping styles → benefit finding” and “perceived social support → coping styles → benefit finding”, with indirect effects of 0.022, 0.090, and 0.206, respectively. The total indirect effect accounted for 69.5% of the total effect. Conclusions The benefit finding level of T2DM patients needs to be improved. Medical staff should implement intervention measures based on the triadic reciprocal determinism theory after understanding their characteristics and influencing factors of benefit finding, so as to enhance their benefit finding level.

Key words: type 2 diabetes mellitus, flourishing, benefit finding, social support, coping styles, chain mediation effect

中图分类号:

R587.1

崔培荣, 周莹霞, 陆骆, 蔡筱丹, 史佳. 领悟社会支持和应对方式在2型糖尿病患者心盛与益处发现中的链式中介作用[J]. 内科理论与实践, 2026, 21(03): 232-239.

CUI Peirong, ZHOU Yingxia, LU Luo, CAI Xiaodan, SHI Jia. Chain mediation roles of perceived social support and coping styles between flourishing and benefit finding in patients with type 2 diabetes mellitus[J]. Journal of Internal Medicine Concepts & Practice, 2026, 21(03): 232-239.

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项目	例数（%）	益处发现得分	F/t	P
年龄			2.742	0.067
≤44 岁	47（22.7）	48.12±12.74
45~59 岁	72（34.8）	52.94±10.70
≥60 岁	88（42.5）	51.20±10.17
性别			0.304	0.761
男性	116（56.0）	51.32±11.53
女性	91（44.0）	50.85±10.52
学历			2.829	0.026
初中及以下	36（17.4）	46.50±12.24
高中或中专	47（22.7）	50.34±8.46
大专	54（26.1）	51.56±10.47
本科	57（27.5）	53.14±12.55
硕士及以上	13（6.3）	55.92±7.86
主要照顾者			3.688	<0.001
其他	59（28.5）	55.47±11.14
本人	148（71.5）	49.37±10.59
婚姻状况			−2.416	0.017
未婚、离异、丧偶等	32（15.5）	46.81±9.68
已婚	175（84.5）	51.90±11.16
居住状态			−2.604	0.010
独居	23（11.1）	45.52±9.58
非独居	184（88.9）	51.81±11.07
医疗费用支付方式			0.758	0.449
城乡居民医保等	15（7.2）	53.20±11.11
城镇职工	192（92.8）	50.95±11.08
糖化血红蛋白			−3.307	0.001
≥7%	106（51.2）	48.69±10.44
< 7%	101（48.8）	53.65±11.20
并发症			−0.451	0.652
有	40（19.3）	49.76±10.92
无	167（80.7）	52.42±11.11

项目	$\bar{x}$	s
益处发现量表总分	51.11	11.07
心盛量表总分	45.80	7.70
MSPSS总分	65.26	14.47
家庭支持维度	22.75	4.48
朋友支持维度	21.34	4.12
其他支持维度	21.17	3.98
SCSQ总分	0.00	1.40
积极应对方式维度	34.33	7.47
消极应对方式维度	18.33	5.72

变量	益处发现总分	心盛量表总分	MSPSS总分	SCSQ总分
^1）：P<0.01。
益处发现总分	1.000	0.517^1）	0.636^1）	0.672^1）
心盛量表总分	−	1.000	0.587^1）	0.490^1）
MSPSS总分	−	−	1.000	0.669^1）
SCSQ总分	−	−	−	1.000

影响路径	效应值	SE	95% CI	相对效应值（%）
总效应	0.744	0.086	0.574~0.913	100.0
直接效应	0.227	0.087	0.056~0.397	30.5
间接效应	0.517	0.076	0.378~0.678	69.5
心盛→领悟社会支持→ 益处发现	0.022	0.067	0.088~0.354	29.8
心盛→应对方式→ 益处发现	0.090	0.045	0.012~0.185	12.1
心盛→领悟社会支持→ 应对方式→益处发现	0.206	0.053	0.115~0.323	27.7

领悟社会支持和应对方式在2型糖尿病患者心盛与益处发现中的链式中介作用

Chain mediation roles of perceived social support and coping styles between flourishing and benefit finding in patients with type 2 diabetes mellitus

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