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

Pan Tian; Chen Xiang; Wu Han; Zhao Yue; Zhang Lin

doi:10.16016/j.2097-0927.202607060

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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

Medical Psychology | 更新时间：2026-10-30

- 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
- Journal of Army Medical University Vol. 48, Issue 20, Pages: 2966-2974(2026)
- 作者机构：
  
  1.皖南医科大学：研究生学院，安徽芜湖
  2.皖南医科大学：护理学院内科教研室，安徽芜湖
- 作者简介：
  
  Zhang Lin， E-mail： yaoran2008@163.com
- 基金信息：
  
  the Project for Outstanding Young Talents from the Universities and Colleges of Anhui Province(gxyqZD2021118)
- DOI：10.16016/j.2097-0927.202607060
  CLC： R195.4;R395.1;R587.2
- Received：15 July 2026，
  
  Revised：2026-08-31，
  
  Accepted：02 September 2026，
  
  Published：30 October 2026
- 稿件说明：
移动端阅览
潘甜，陈想，吴涵，等.老年2型糖尿病患者并发症恐惧以远期健康风险泛化担忧为主：一项横断面研究［J］.陆军军医大学学报，2026，48（20）：2966-2974.DOI：10.16016/j.2097-0927.202607060.

Pan T，Chen X，Wu H，et al.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［J］.J Army Med Univ，2026，48（20）：2966-2974.DOI：10.16016/j.2097-0927.202607060.
潘甜，陈想，吴涵，等.老年2型糖尿病患者并发症恐惧以远期健康风险泛化担忧为主：一项横断面研究［J］.陆军军医大学学报，2026，48（20）：2966-2974.DOI：10.16016/j.2097-0927.202607060. DOI：

Pan T，Chen X，Wu H，et al.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［J］.J Army Med Univ，2026，48（20）：2966-2974.DOI：10.16016/j.2097-0927.202607060. DOI：

摘要

目的

并发症恐惧是老年2型糖尿病患者常见但易被忽视的心理问题，过度恐惧可致自我管理能力下降、血糖控制恶化。本研究基于压力与应对理论，探究老年2型糖尿病患者并发症恐惧现状并分析相关影响因素。

方法

本研究采用横断面研究设计，通过多阶段分层整群抽样法，选取2026年3—5月在皖南医科大学第一附属医院内分泌科和老年病科住院的255例老年2型糖尿病患者（≥60岁）为研究对象。使用一般资料调查表、并发症恐惧问卷（Fear of Complications Questionnaire， FCQ）、社会支持评定量表（Social Support Rating Scale， SSRS）、糖尿病管理自我效能量表（Diabetes Management Self-Efficacy Scale， DMSES）、糖尿病健康素养量表（Diabetes Health Literacy Scale， DHLS）进行调查。计算FCQ各维度得分，并以总分≥30分判定存在明显的并发症恐惧，统计其发生率。采用单因素分析、Spearman相关分析及多元线性回归分析影响因素。

结果

255例老年2型糖尿病患者FCQ总分为25.00（18.00，29.00）分，并发症恐惧发生率为23.5%。FCQ各维度得分：一般恐惧维度10.00（7.00，10.00）分，心血管并发症恐惧维度7.00 （5.00， 8.00）分，肾脏和眼及足部并发症恐惧维度均为4.00（3.00，6.00）分；其中一般恐惧维度得分最高，而具体并发症恐惧得分相对较低。单因素分析显示，老年2型糖尿病患者在年龄、性别、婚姻状况、职业、月收入、居住地、医疗费用支付方式、并发症数量、降糖方式及近6个月低血糖史方面，其FCQ得分差异均有统计学意义（

0.05）。Spearman相关分析显示，社会支持（

=-0.643）、自我效能（

=-0.593）和

健康素养（

=-0.644）均与FCQ得分呈显著负相关（

0.001）。多元线性回归分析显示，年龄（

=1.831，95%

：0.504~3.157）、并发症数量2种（

=2.157，95%

：0.607~3.707）和≥3种（

=5.356，95%

：3.295~7.416）、健康素养（

=-0.209，95%

：-0.299~-0.119）和社会支持（

=-0.203，95%

：-0.338~-0.069）是并发症恐惧的影响因素（

0.01）。

结论

老年2型糖尿病患者并发症恐惧以对远期健康风险的泛化担忧为主要特征，受压力源因素与应对资源因素共同影响。护理人员应重点关注高龄、并发症较多、健康素养不足及社会支持水平较低的老年患者，通过强化具体并发症认知教育填补患者认知盲区，并结合健康素养提升与社会支持强化。

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 elder

ly 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 (

0.05). Spearman correlation analysis indicated that social support (

=-0.643)

self-efficacy (

=-0.593)

and health literacy (

=-0.644) were significantly negatively correlated with FCQ scores (

0.001). Multiple linear regression analysis revealed that age (

=1.831

95%

: 0.504 to 3.157)

having 2 complications (

=2.157

95%

: 0.607 to 3.707) and ≥3 complications (

=5.356

95%

: 3.295 to 7.416)

health literacy (

=-0.209

95%

: -0.299 to -0.119)

and social support (

=-0.203

95%

: -0.338 to -0.069) were influencing factors for fear of complications (

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.

关键词

Keywords

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