Abstract: Objective: The aim of this study is to investigate the mediating effect of self-efficacy between diabetes-related distress and self-management in empty-nest elderly patients with type 2 diabetes mellitus (T2DM).
Methods: A total of 347 empty-nest elderly patients with T2DM from Jiangsu Province Hospital of Chinese Medicine and Affiliated Hospital of Yangzhou University were investigated by a self-designed General Information Questionnaire, the Self-efficacy for diabetes, the Diabetes Distress Scale, and the summary of diabetes self-care activities. Diabetes-related distress and diabetes self-management were tested for correlation analysis with self-efficacy. Meditational analyses were conducted to test the hypothesized mediating effects of diabetes self-efficacy as an intervention variable between diabetes distress and self-management.
Results: About 68.59% of patients suffered from diabetes-related distress. The results of bivariate correlations revealed that self-efficacy was negatively correlated with diabetes-related distress (r =–0.627, P < 0.01) and positively correlated with self-management (r = 0.356, P < 0.01). The relationship effects of diabetes distress on self-management were fully mediated by self-efficacy.
Conclusions: Diabetes-related distress prevails in empty-nest elderly patients with T2DM. Self-efficacy plays a mediate role between diabetes-related distress and self-management. Psychological intervention is contributed to reducing diabetes-related distress.

Key words: Diabetes mellitus, empty nest elderly, mediating effect, self-efficacy