Chain mediating effect of rational medication self-efficacy and medication self-management between medication literacy and frailty in elderly patients with type 2 diabetes mellitus

WANG Yanxing; LI Wanling; ZHU Wenjuan; AN Yuan; ZHANG Kaihui; HE Xingyue

doi:10.16460/j.issn2097-6569.2025.11.013

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Journal of Nursing ›› 2025, Vol. 32 ›› Issue (11) : 13-19. DOI: 10.16460/j.issn2097-6569.2025.11.013

Chain mediating effect of rational medication self-efficacy and medication self-management between medication literacy and frailty in elderly patients with type 2 diabetes mellitus

WANG Yanxing¹, LI Wanling², ZHU Wenjuan², AN Yuan¹, ZHANG Kaihui¹, HE Xingyue¹

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Abstract

Objective To explore the multiple mediating roles of rational medication self-efficacy and medication self-management in the effects of medication literacy on frailty in elderly patients with type 2 diabetes mellitus. Methods Three hundred and thirty elderly patients with type 2 diabetes mellitus who were hospitalized in the endocrinology department of a tertiary grade-A hospital in Shanxi Province from August to November 2024 were conveniently selected as study subjects. General Information Questionnaire, Medication Literacy Questionnaire, Self-efficacy for Appropriate Medication Use Scale, Medication Self-Management Behavior Scale for the Elderly with Chronic Diseases, and Tilburg Frailty Indicator were used to conduct the investigation, and the chain mediation model was constructed and tested. Results The scores of medication literacy, rational medication self-efficacy, medication self-management, and frailty in elderly patients with type 2 diabetes mellitus were 5.00(4.00, 6.00), 30.02±2.69, 74.17±8.06, and 4.00(3.00, 6.00) respectively. Frailty was negatively associated with medication literacy, rational medication self-efficacy, and medication self-management in elderly patients with type 2 diabetes mellitus (all P<0.001). The indirect effect of medication literacy on frailty was established, with a total indirect effect of -0.125; the specific mediating effect of rational medication self-efficacy accounted for 45.6% of the total indirect effect, and that of medication self-management accounted for 40.0% of the total indirect effect. The chain-mediated effects of rational medication self-efficacy and medication self-management between medication literacy and frailty in elderly patients with type 2 diabetes mellitus accounted for 14.4% of the total indirect effects. Conclusion The chain mediating effect of rational medication self-efficacy and medication self-management between medication literacy and frailty in elderly patients with type 2 diabetes mellitus is established. It is recommended that healthcare professionals take measures to improve medication literacy in elderly patients with type 2 diabetes mellitus, and enhance their rational medication self-efficacy and medication self-management, thereby improving their frailty.

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aged / type 2 diabetes mellitus / medication literacy / frailty / self-efficacy / self-management

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WANG Yanxing, LI Wanling, ZHU Wenjuan, AN Yuan, ZHANG Kaihui, HE Xingyue. Chain mediating effect of rational medication self-efficacy and medication self-management between medication literacy and frailty in elderly patients with type 2 diabetes mellitus[J]. Journal of Nursing. 2025, 32(11): 13-19 https://doi.org/10.16460/j.issn2097-6569.2025.11.013

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