Relationship Between Ego Depletion and Health Promotion Behaviors in Older Adults with Diabetes: A Cross-sectional Study in Shanghai, China

Overview

Journal Glob Health Med

Specialty Public Health

Date 2025 Mar 3

PMID 40026856

Authors

Zhongying Guo

Li Chen

Jiaojiao Bai

Rui Chen

Yanyuan Zhu

Jingyi Zhu

Affiliations

Soon will be listed here.

Abstract

In recent years, the prevalence of diabetes in the elderly has risen sharply, and diabetes and its related complications seriously affect the physical and mental health of patients. Health promotion behaviors are extremely important in preventing the onset and development of diabetes. Ego depletion is a common negative psychological experience among most patients with chronic disease, which affects their performance of health-promoting behaviors. However, the relationship between ego depletion and health-promoting behaviors in elderly patients with diabetes is unclear. We assessed the relationship between ego depletion and health-promoting behaviors in older people with diabetes, and the factors influencing health-promoting behaviors. The 751 participants had an ego depletion score of 44.55 ± 6.62 and a health-promoting behavior score of 77.61 ± 18.72, with a significant negative correlation between ego depletion and health-promoting behavior ( = -0.320, < 0.001). The level of health promotion behaviors was higher in patients with a high school level of education and above ( < 0.001), living with a spouse and children ( = 0.010) and having received diabetes-related health education ( < 0.001), and the cognitive ( < 0.001), emotional ( < 0.001) and behavioral control dimensions of ego depletion ( = 0.016) were significant predictors of health promotion behaviors. Nursing staff should provide personalized care for patients with a low level education, who are living alone, and who have not received health education to prevent or respond to patient ego depletion and to improve patients' health promotion behaviors.

References

Khuwaja A, Khawaja S, Motwani K, Khoja A, Azam I, Fatmi Z . Preventable lifestyle risk factors for non-communicable diseases in the Pakistan Adolescents Schools Study 1 (PASS-1). J Prev Med Public Health. 2011; 44(5):210-7. PMC: 3249258. DOI: 10.3961/jpmph.2011.44.5.210. View

Bezo B, Huang Y, Lin C . Factors influencing self-management behaviours among patients with type 2 diabetes mellitus in the Solomon Islands. J Clin Nurs. 2019; 29(5-6):852-862. DOI: 10.1111/jocn.15139. View

Baumeister R, Bratslavsky E, Muraven M, Tice D . Ego depletion: is the active self a limited resource?. J Pers Soc Psychol. 1998; 74(5):1252-65. DOI: 10.1037//0022-3514.74.5.1252. View

Li X, Gao Q, Sun L, Gao W . Effect of self-control on health promotion behavior in patients with coronary heart disease: mediating effect of ego-depletion. Psychol Health Med. 2021; 27(6):1268-1276. DOI: 10.1080/13548506.2020.1867316. View

Li Y, Teng D, Shi X, Qin G, Qin Y, Quan H . Prevalence of diabetes recorded in mainland China using 2018 diagnostic criteria from the American Diabetes Association: national cross sectional study. BMJ. 2020; 369:m997. PMC: 7186854. DOI: 10.1136/bmj.m997. View

Balakumar P, Maung-U K, Jagadeesh G . Prevalence and prevention of cardiovascular disease and diabetes mellitus. Pharmacol Res. 2016; 113(Pt A):600-609. DOI: 10.1016/j.phrs.2016.09.040. View

Solberg Nes L, Ehlers S, Patten C, Gastineau D . Self-regulatory fatigue, quality of life, health behaviors, and coping in patients with hematologic malignancies. Ann Behav Med. 2014; 48(3):411-23. PMC: 4599876. DOI: 10.1007/s12160-014-9621-z. View

. Introduction: Standards of Medical Care in Diabetes-2022. Diabetes Care. 2021; 45(Suppl 1):S1-S2. DOI: 10.2337/dc22-Sint. View

Gao Y, Shan Y, Jiang T, Cai L, Zhang F, Jiang X . Dietary Adherence, Self-Regulatory Fatigue and Trait Self-Control Among Chinese Patients with Peritoneal Dialysis: A Cross-Sectional Study. Patient Prefer Adherence. 2021; 15:443-451. PMC: 7920602. DOI: 10.2147/PPA.S298231. View

10.

Sun H, Saeedi P, Karuranga S, Pinkepank M, Ogurtsova K, Duncan B . IDF Diabetes Atlas: Global, regional and country-level diabetes prevalence estimates for 2021 and projections for 2045. Diabetes Res Clin Pract. 2021; 183:109119. PMC: 11057359. DOI: 10.1016/j.diabres.2021.109119. View

11.

Chen C, Peng Y, Weng H, Fan J, Guo S, Yen H . Development and preliminary testing of a brief screening measure of healthy lifestyle for diabetes patients. Int J Nurs Stud. 2012; 50(1):90-9. DOI: 10.1016/j.ijnurstu.2012.09.001. View

12.

Cho D, Park C . Barriers to physical activity and healthy diet among breast cancer survivors: A multilevel perspective. Eur J Cancer Care (Engl). 2017; 27(1). PMC: 5786487. DOI: 10.1111/ecc.12772. View

13.

Solberg Nes L, Ehlers S, Whipple M, Vincent A . Self-regulatory fatigue in chronic multisymptom illnesses: scale development, fatigue, and self-control. J Pain Res. 2013; 6:181-8. PMC: 3596127. DOI: 10.2147/JPR.S40014. View

14.

Blonde L, Umpierrez G, Reddy S, McGill J, Berga S, Bush M . American Association of Clinical Endocrinology Clinical Practice Guideline: Developing a Diabetes Mellitus Comprehensive Care Plan-2022 Update. Endocr Pract. 2022; 28(10):923-1049. PMC: 10200071. DOI: 10.1016/j.eprac.2022.08.002. View

15.

Luo X, Liu T, Yuan X, Ge S, Yang J, Li C . Factors Influencing Self-Management in Chinese Adults with Type 2 Diabetes: A Systematic Review and Meta-Analysis. Int J Environ Res Public Health. 2015; 12(9):11304-27. PMC: 4586677. DOI: 10.3390/ijerph120911304. View

16.

Nerat T, Locatelli I, Kos M . Type 2 diabetes: cost-effectiveness of medication adherence and lifestyle interventions. Patient Prefer Adherence. 2016; 10:2039-2049. PMC: 5055046. DOI: 10.2147/PPA.S114602. View

17.

Baumeister R, Gailliot M, DeWall C, Oaten M . Self-regulation and personality: how interventions increase regulatory success, and how depletion moderates the effects of traits on behavior. J Pers. 2006; 74(6):1773-801. DOI: 10.1111/j.1467-6494.2006.00428.x. View

18.

Mogre V, Abanga Z, Tzelepis F, Johnson N, Paul C . Adherence to and factors associated with self-care behaviours in type 2 diabetes patients in Ghana. BMC Endocr Disord. 2017; 17(1):20. PMC: 5366118. DOI: 10.1186/s12902-017-0169-3. View

19.

Zhang M, Guo L, Namassevayam G, Wei M, Xie Y, Guo Y . Factors associated with health behaviours among stroke survivors: A mixed-methods study using COM-B model. J Clin Nurs. 2024; 33(6):2138-2152. DOI: 10.1111/jocn.17103. View

20.

Solberg Nes L, Carlson C, Crofford L, de Leeuw R, Segerstrom S . Self-regulatory deficits in fibromyalgia and temporomandibular disorders. Pain. 2010; 151(1):37-44. DOI: 10.1016/j.pain.2010.05.009. View