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The chain mediating role of self-esteem and neurotic personality in anxiety and insomnia among patients with type 2 diabetes
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Wenxiu DING1, Ting LI2, Siying ZHANG1, Yani LI1, Zijian LI1, Yupei LIANG1, Siqi WANG1, Fei XIONG1
Chinese Nursing Research | 2026, 40(2) : 220 - 226
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Chinese Nursing Research | 2026, 40(2): 220-226
• Original Articles •
The chain mediating role of self-esteem and neurotic personality in anxiety and insomnia among patients with type 2 diabetes
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Wenxiu DING1, Ting LI2, Siying ZHANG1, Yani LI1, Zijian LI1, Yupei LIANG1, Siqi WANG1, Fei XIONG1
Affiliations
  • 1Xi'an Jiaotong University City College, Shaanxi 710018 China
  • 2Xijing Hospital, Air Force Medical University
Published: 2026-01-25 doi: 10.12102/j.issn.1009-6493.2026.02.007
Outline
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Objective

To explore the chain mediating role of self-esteem and neurotic personality in anxiety and insomnia among patients with type 2 diabetes(T2DM).

Methods

A total of 635 T2DM patients from six tertiary grade A hospitals in Xi'an City,Shaanxi Province were conveniently selected as the study subjects from June to December 2024.Surveys were conducted using the General Information Questionnaire,Self-Rating Anxiety Scale(SAS),Rosenberg Self-Esteem Scale(RSES),Eysenck Personality Questionnaire-Revised Short Scale for China(EPQ-RSC),and Athens Insomnia Scale(AIS).The SPSS Process macro was used to construct the chain mediation model.

Results

Anxiety was positively correlated with insomnia(r=0.321,P<0.05),self-esteem was negatively correlated with insomnia(r=-0.237,P<0.05),and neurotic personality was positively correlated with insomnia(r=0.371,P<0.05).The mediation analysis results showed that the total indirect effect of anxiety on insomnia was 0.046.Among this,the independent mediating effect of self-esteem accounted for 7.69% of the total effect.The independent mediating effect of neurotic personality accounted for 20.28% of the total effect.The chain mediating effect of self-esteem→neurotic personality accounted for 4.90% of the total effect.

Conclusions

Anxiety in T2DM patients can directly affect insomnia.It can also indirectly affect insomnia through the chain mediation path of self-esteem→neurotic personality.The study provide an important basis for developing targeted nursing interventions for insomnia in T2DM patients from psychological and personality perspectives.

type 2 diabetes  /  anxiety  /  insomnia  /  self-esteem  /  neurotic personality  /  chain mediation
丁文秀, 李婷, 张思颖, 李亚妮, 李梓健, 梁钰佩, 王思琪, 熊飞. 2型糖尿病病人自尊与神经质人格在焦虑与失眠中的链式中介作用. 护理研究, 2026 , 40 (2) : 220 -226 . DOI: 10.12102/j.issn.1009-6493.2026.02.007
Wenxiu DING, Ting LI, Siying ZHANG, Yani LI, Zijian LI, Yupei LIANG, Siqi WANG, Fei XIONG. The chain mediating role of self-esteem and neurotic personality in anxiety and insomnia among patients with type 2 diabetes[J]. Chinese Nursing Research, 2026 , 40 (2) : 220 -226 . DOI: 10.12102/j.issn.1009-6493.2026.02.007
Appendix
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Year 2026 volume 40 Issue 2
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Article Info
doi: 10.12102/j.issn.1009-6493.2026.02.007
  • Receive Date：2025-09-11
  • Online Date：2026-10-28
  • Published：2026-01-25
Article Data
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History
  • Received：2025-09-11
  • Revised：2025-12-24
Affiliations
    1Xi'an Jiaotong University City College, Shaanxi 710018 China
    2Xijing Hospital, Air Force Medical University

Corresponding:

LI Ting, E-mail:
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