Fear of complications in elderly patients with type 2 diabetes mellitus is dominated by generalized worry about long-term health risks: a cross-sectional study
- 1Graduate School， Wannan Medical University， Wuhu， Anhui， China
- 2Department of Internal Medicine Nursing， School of Nursing， Wannan Medical University， Wuhu， Anhui， China
Abstract
Objective Fear of complications is a common but easily neglected psychological issue in elderly patients with type 2 diabetes mellitus (T2DM), and excessive fear may impair self-management and glycemic control. Based on the stress and coping theory, this study aims to investigate the current status of fear of complications in elderly T2DM patients and analyze its influencing factors. Methods A cross-sectional study was conducted on 255 hospitalized elderly T2DM patients (≥60 years old) by multi-stage stratified cluster sampling from Department of Endocrinology and Department of Geriatrics of the First Affiliated Hospital of Wannan Medical University between March and May 2026. A general information questionnaire, Fear of Complications Questionnaire (FCQ), Social Support Rating Scale (SSRS), Diabetes Management Self-Efficacy Scale (DMSES), and Diabetes Health Literacy Scale (DHLS) were used for investigation. The scores of each FCQ dimension were calculated, and a total score ≥30 was defined as significant fear of complications; the incidence was then calculated. Univariate analysis, Spearman correlation analysis, and multiple linear regression analysis were employed to identify influencing factors. Results The total FCQ score of the 255 elderly T2DM patients was 25.00 (18.00, 29.00), and the incidence of fear of complications was 23.5%. The scores of each dimension of FCQ were as follows: general fear 10.00 (7.00, 10.00), fear of cardiovascular complications 7.00 (5.00, 8.00), and both renal and ocular-foot complications fear 4.00 (3.00, 6.00). Among them, the general fear dimension had the highest score, while the scores of specific complication fears were relatively low. Univariate analysis showed that there were statistically significant differences in FCQ scores among elderly T2DM patients in terms of age, gender, marital status, occupation, monthly income, residence, medical expense payment method, number of complications, glucose-lowering regimen, and history of hypoglycemia in the past 6 months (P<0.05). Spearman correlation analysis indicated that social support (r=-0.643), self-efficacy (r=-0.593), and health literacy (r=-0.644) were significantly negatively correlated with FCQ scores (P<0.001). Multiple linear regression analysis revealed that age (B=1.831, 95%CI: 0.504 to 3.157), having 2 complications (B=2.157, 95%CI: 0.607 to 3.707) and ≥3 complications (B=5.356, 95%CI: 3.295 to 7.416), health literacy (B=-0.209, 95%CI: -0.299 to -0.119), and social support (B=-0.203, 95%CI: -0.338 to -0.069) were influencing factors for fear of complications (P<0.01). Conclusion Fear of complications in elderly T2DM patients is characterized by generalized worry about long-term health risks, and is jointly influenced by both stressor factors and coping resource factors. Nursing staff should focus on these patients with advanced age, multiple complications, insufficient health literacy, and low levels of social support. Targeted interventions should include education on specific complications to fill patients’ cognitive gaps, combined with improvement of health literacy and strengthening of social support.
Related
- Association of Serum Magnesium Concentration With Microvascular Complications Among Patients Diagnosed With Type 2 Diabetes Mellitus: An Observational Cross-Sectional Analysis.
- Incidence of diabetes remission and association with microvascular and macrovascular complications in patients with newly diagnosed type 2 diabetes mellitus: a retrospective cohort study using real-world data in Thailand.
- Microvascular and Macrovascular Complications and Their Associated Risk Factors Among Patients with Type 2 Diabetes in Saudi Arabia: A Systematic Review and Meta-Analysis
- Cross-Sectional Association of Lipoprotein(a) Levels With Vascular Complications and Related Parameters in a Japanese Type 2 Diabetes Cohort
- Latent Profiles of Fear of Complications and Associated Factors Among Older Inpatients with Type 2 Diabetes: A Cross-Sectional Study.
BibTeX
@article{tian2026fear,
title = {{Fear of complications in elderly patients with type 2 diabetes mellitus is dominated by generalized worry about long-term health risks: a cross-sectional study}},
author = {Pan Tian and Zhang Lin},
journal = {陆军军医大学学报},
year = {2026},
month = oct,
doi = {10.16016/j.2097-0927.202607060},
url = {https://doi.org/10.16016/j.2097-0927.202607060},
note = {CC BY},
}
RIS
TY - JOUR
TI - Fear of complications in elderly patients with type 2 diabetes mellitus is dominated by generalized worry about long-term health risks: a cross-sectional study
AU - Pan Tian
AU - Zhang Lin
PY - 2026
DA - 2026/10/30
JO - 陆军军医大学学报
DO - 10.16016/j.2097-0927.202607060
UR - https://doi.org/10.16016/j.2097-0927.202607060
AB - Objective Fear of complications is a common but easily neglected psychological issue in elderly patients with type 2 diabetes mellitus (T2DM), and excessive fear may impair self-management and glycemic control. Based on the stress and coping theory, this study aims to investigate the current status of fear of complications in elderly T2DM patients and analyze its influencing factors. Methods A cross-sectional study was conducted on 255 hospitalized elderly T2DM patients (≥60 years old) by multi-stage stratified cluster sampling from Department of Endocrinology and Department of Geriatrics of the First Affiliated Hospital of Wannan Medical University between March and May 2026. A general information questionnaire, Fear of Complications Questionnaire (FCQ), Social Support Rating Scale (SSRS), Diabetes Management Self-Efficacy Scale (DMSES), and Diabetes Health Literacy Scale (DHLS) were used for investigation. The scores of each FCQ dimension were calculated, and a total score ≥30 was defined as significant fear of complications; the incidence was then calculated. Univariate analysis, Spearman correlation analysis, and multiple linear regression analysis were employed to identify influencing factors. Results The total FCQ score of the 255 elderly T2DM patients was 25.00 (18.00, 29.00), and the incidence of fear of complications was 23.5%. The scores of each dimension of FCQ were as follows: general fear 10.00 (7.00, 10.00), fear of cardiovascular complications 7.00 (5.00, 8.00), and both renal and ocular-foot complications fear 4.00 (3.00, 6.00). Among them, the general fear dimension had the highest score, while the scores of specific complication fears were relatively low. Univariate analysis showed that there were statistically significant differences in FCQ scores among elderly T2DM patients in terms of age, gender, marital status, occupation, monthly income, residence, medical expense payment method, number of complications, glucose-lowering regimen, and history of hypoglycemia in the past 6 months (P<0.05). Spearman correlation analysis indicated that social support (r=-0.643), self-efficacy (r=-0.593), and health literacy (r=-0.644) were significantly negatively correlated with FCQ scores (P<0.001). Multiple linear regression analysis revealed that age (B=1.831, 95%CI: 0.504 to 3.157), having 2 complications (B=2.157, 95%CI: 0.607 to 3.707) and ≥3 complications (B=5.356, 95%CI: 3.295 to 7.416), health literacy (B=-0.209, 95%CI: -0.299 to -0.119), and social support (B=-0.203, 95%CI: -0.338 to -0.069) were influencing factors for fear of complications (P<0.01). Conclusion Fear of complications in elderly T2DM patients is characterized by generalized worry about long-term health risks, and is jointly influenced by both stressor factors and coping resource factors. Nursing staff should focus on these patients with advanced age, multiple complications, insufficient health literacy, and low levels of social support. Targeted interventions should include education on specific complications to fill patients’ cognitive gaps, combined with improvement of health literacy and strengthening of social support.
SN - 2097-0927
ER -