Workplace culture of health and self-management behaviours among employees with type 2 diabetes: a cross-sectional moderated mediation study in urban China.
To examine (1) the mediating roles of self-efficacy and future-oriented time perspective (FTP) in the association between workplace culture of health (COH) and diabetes self-management and (2) the moderating effect of diabetes distress on the relationship between self-efficacy and FTP among employees with type 2 diabetes mellitus (T2DM).
A cross-sectional survey.
This study was conducted among employees with T2DM recruited from the Endocrinology Outpatient Departments at three tertiary hospitals in Taiyuan City, Shanxi Province, China, between March and October 2024.
The participants were 462 employees with T2DM who had been employed at their current organisations for at least 3 months following their T2DM diagnosis.
Data on demographics, diabetes-related and work-related factors, workplace COH, self-efficacy, time perspective, diabetes distress and self-management performance were collected via a survey. The moderated mediation effects were examined using Hayes's PROCESS macro.
Workplace COH was associated with diabetes self-management both directly (β=0.251, 95% CI 0.080 to 0.422, p<0.01) and indirectly (indirect effect=0.303, 95% CI 0.190 to 0.419). Two significant indirect pathways were identified: (1) workplace COH → self-efficacy → diabetes self-management (indirect effect=0.207, 95% CI 0.110 to 0.308); (2) workplace COH → self-efficacy → FTP → diabetes self-management (indirect effect=0.093, 95% CI 0.051 to 0.144). However, the indirect pathway: workplace COH → FTP → diabetes self-management was not significant (indirect effect=0.004, 95% CI -0.055 to 0.063). Additionally, a significant interaction (β=-0.356, 95% CI -0.566 to -0.146, p<0.01) indicated that diabetes distress moderated the relationship between self-efficacy and FTP.
This study demonstrated that workplace COH was associated with diabetes self-management both directly and indirectly, specifically through self-efficacy alone and serially through self-efficacy and FTP; it also confirmed that diabetes distress weakens the effect of self-efficacy on FTP, thereby providing a basis for developing interventions to improve self-management among employees with T2DM.
A cross-sectional survey.
This study was conducted among employees with T2DM recruited from the Endocrinology Outpatient Departments at three tertiary hospitals in Taiyuan City, Shanxi Province, China, between March and October 2024.
The participants were 462 employees with T2DM who had been employed at their current organisations for at least 3 months following their T2DM diagnosis.
Data on demographics, diabetes-related and work-related factors, workplace COH, self-efficacy, time perspective, diabetes distress and self-management performance were collected via a survey. The moderated mediation effects were examined using Hayes's PROCESS macro.
Workplace COH was associated with diabetes self-management both directly (β=0.251, 95% CI 0.080 to 0.422, p<0.01) and indirectly (indirect effect=0.303, 95% CI 0.190 to 0.419). Two significant indirect pathways were identified: (1) workplace COH → self-efficacy → diabetes self-management (indirect effect=0.207, 95% CI 0.110 to 0.308); (2) workplace COH → self-efficacy → FTP → diabetes self-management (indirect effect=0.093, 95% CI 0.051 to 0.144). However, the indirect pathway: workplace COH → FTP → diabetes self-management was not significant (indirect effect=0.004, 95% CI -0.055 to 0.063). Additionally, a significant interaction (β=-0.356, 95% CI -0.566 to -0.146, p<0.01) indicated that diabetes distress moderated the relationship between self-efficacy and FTP.
This study demonstrated that workplace COH was associated with diabetes self-management both directly and indirectly, specifically through self-efficacy alone and serially through self-efficacy and FTP; it also confirmed that diabetes distress weakens the effect of self-efficacy on FTP, thereby providing a basis for developing interventions to improve self-management among employees with T2DM.