Psychological Flexibility and Diabetes Self-Management: The Mediating Roles of Depressive Symptoms and Self-Efficacy

Abstract

Background:

Psychological flexibility is the concept and focus of Acceptance and Commitment Therapy. It has been demonstrated to benefit self-efficacy and depressive symptoms. However, its role in diabetes self-management (DSM) and the potential mechanisms remain unknown.

Purpose:

This study aimed to investigate the association between psychological flexibility and self-management and to explore the mediating effect of depressive symptoms and self-efficacy among people with diabetes in China.

Methods:

Using a cross-sectional study design, 249 people with type 2 diabetes in China were recruited from February 1, 2024, to April 30, 2024, and completed a structured online questionnaire.

Results:

Psychological flexibility and DSM showed a moderate correlation (r = 0.45, P < .001). Path analysis showed significant associations between the 3 subscales of psychological flexibility and depressive symptoms and self-efficacy. In addition, depressive symptoms partially mediated the relationship between the valued action subscale of psychological flexibility and DSM, while the mediation role of self-efficacy was not significant.

Conclusions:

The findings highlight the potential mechanisms of how higher levels of psychological flexibility may affect depressive symptoms reduction and self-management promotion. Acceptance and Commitment Therapy that particularly aims to enhance valued action may be effective for alleviating depressive symptoms and enhancing self-management.