Social support as a mediator between depressive symptoms and self-care activities in adults patient with type 2 diabetes mellitus

Background: People with type 2 diabetes mellitus (DM) are at risk of experiencing depression, which in turn can affect their selfcare activities. Recent evidence has shown that social support is beneficial in reducing the risk of depression and positively affecting increases in self-care activities. However, the role of social support in the relationship between depressive symptoms and selfcare activities has not been studied. This study aims to determine the mediating effects of social support on the relationship between depressive symptoms and self-care activities of people with type 2 DM. Design and methods: A cross-sectional consecutive sampling approach was used with 94 respondents with type 2 diabetes in East Jakarta, Indonesia, who were undergoing diabetes treatments during May–June 2020. The instruments used were the Centre for Epidemiologic Studies-Depression Scale, Summary of Diabetes Self Care Activities and Duke-UNC Functional Social Support Questionnaire. All three questionnaires have been tested for validity and reliability. Data analysis was carried out using multiple linear regression, path analysis, and the Sobel test. Results: The results of multiple linear regression analysis on the variables age, sex, education level, socioeconomic status, duration of type 2 DM, and complications of type 2 DM showed that only complications of type 2 diabetes affected self-care activities (p=0.000; R(2)=0.515). The results of the path analysis and Sobel test showed that social support significantly mediated the effects of the relationship between depressive symptoms and selfcare activities (z=-0.162 > table 1.96; direct effect = -0.499; indirect effect = -0.0789; total effect = 40.3%). Conclusions: Screening for depressive symptoms and interventions involving social support are strongly suggested for patients with type 2 DM who are suspected of showing a decline in self-care activities.