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已发表论文
中青年糖尿病成人患者的自我表露和疾病进展恐惧：社会支持和疾病感知的链式中介作用
Authors Qin Y, Zhou L, Wang S, Wang L, Zhuang L, Zhou M
Received 27 November 2025
Accepted for publication 14 February 2026
Published 21 February 2026 Volume 2026:20 584707
DOI https://doi.org/10.2147/PPA.S584707
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 2
Editor who approved publication: Dr Johnny Chen
Yuehua Qin,* Lanlan Zhou,* Sujuan Wang, Li Wang, Lei Zhuang, Meijing Zhou
Department of Endocrinology, The First Affiliated Hospital with Nanjing Medical University, Nanjing, Jiangsu, People’s Republic of China
*These authors contributed equally to this work
Correspondence: Meijing Zhou, Department of Endocrinology, The First Affiliated Hospital with Nanjing Medical University, Nanjing, Jiangsu, People’s Republic of China, Email 18940860012@163.com
Background: Among younger and middle-aged adults with diabetes, fear of progression (Fop) is a prominent psychological burden that is associated with impaired self-management and poorer long-term treatment adherence. Although self-disclosure has shown benefits in alleviating Fop in other chronic conditions, its role in younger and middle-aged adults with diabetes, and the pathways through which it might relate to Fop remain unclear.
Purpose: To examine the effect of self-disclosure on FoP among younger and middle-aged adults with diabetes and to test the chain-mediating roles of social support and illness perception using a cross-sectional design.
Patients and Methods: A survey was conducted in a tertiary hospital in Nanjing, China, from March 2023 to August 2024. Standardized scales were used to assess self-disclosure, social support, illness perception, and FoP. A multiple mediation model was tested using the PROCESS macro for SPSS (v22.0).
Results: A total of 193 participants were included. Self-disclosure exhibited a substantial direct impact on FoP. It also exerted indirect effects through two pathways: (1) the independent mediation of illness perception and (2) the serial mediation of social support followed by illness perception.
Conclusion: Self-disclosure is a meaningful and modifiable psychosocial factor associated with reduced FoP among younger and middle-aged adults with diabetes. Interventions aimed at facilitating disclosure, enhancing supportive communication, and reshaping maladaptive illness perceptions may help reduce FoP and support long-term self-management and adherence.
Keywords: fear of progression, self-disclosure, social support, illness perception, diabetes
Department of Endocrinology, The First Affiliated Hospital with Nanjing Medical University, Nanjing, Jiangsu, People’s Republic of China
*These authors contributed equally to this work
Correspondence: Meijing Zhou, Department of Endocrinology, The First Affiliated Hospital with Nanjing Medical University, Nanjing, Jiangsu, People’s Republic of China, Email 18940860012@163.com
Background: Among younger and middle-aged adults with diabetes, fear of progression (Fop) is a prominent psychological burden that is associated with impaired self-management and poorer long-term treatment adherence. Although self-disclosure has shown benefits in alleviating Fop in other chronic conditions, its role in younger and middle-aged adults with diabetes, and the pathways through which it might relate to Fop remain unclear.
Purpose: To examine the effect of self-disclosure on FoP among younger and middle-aged adults with diabetes and to test the chain-mediating roles of social support and illness perception using a cross-sectional design.
Patients and Methods: A survey was conducted in a tertiary hospital in Nanjing, China, from March 2023 to August 2024. Standardized scales were used to assess self-disclosure, social support, illness perception, and FoP. A multiple mediation model was tested using the PROCESS macro for SPSS (v22.0).
Results: A total of 193 participants were included. Self-disclosure exhibited a substantial direct impact on FoP. It also exerted indirect effects through two pathways: (1) the independent mediation of illness perception and (2) the serial mediation of social support followed by illness perception.
Conclusion: Self-disclosure is a meaningful and modifiable psychosocial factor associated with reduced FoP among younger and middle-aged adults with diabetes. Interventions aimed at facilitating disclosure, enhancing supportive communication, and reshaping maladaptive illness perceptions may help reduce FoP and support long-term self-management and adherence.
Keywords: fear of progression, self-disclosure, social support, illness perception, diabetes