关键词: 糖尿病视网膜病变, 社会隔离, 二元应对, 影响因素分析, 混合方法, 护理

Abstract:

Objective To investigate the status and influencing factors of social isolation in patients with diabetic retinopathy（DR）. Methods Explanatory sequential mixed methods research design. In the quantitative phase，284 dyads of patients with DR and their primary caregivers were conveniently recruited from the ophthalmology department of a tertiary hospital between April and October 2025. Data were collected using a general information questionnaire，the Lubben Social Network Scale-6，the Perceived Social Support Scale，the Diabetes Management Self-Efficacy Scale，the Zarit Burden Interview，and the Caregiver Preparedness Scale. Binary logistic regression and correlation analyses were performed. In the qualitative phase，12 dyads of patients with DR and their primary caregivers were purposively selected for semi-structured interviews. Thematic analysis was used for data analysis，and quantitative and qualitative findings were integrated. Results In this quantitative study, 266 valid questionnaires were collected. The prevalence of social isolation among patients with DR was 61.28%. Multivariate logistic regression showed that self-efficacy，social support，and caregiver burden were associated with social isolation in patients with DR（P<0.05），and the 3 variables were significantly correlated with each other（P<0.05）. 4 themes emerged from the qualitative analysis，further explaining the effects of self-perceived ability，social support，and caregiver burden on the formation of social isolation. Integrated findings suggested that social isolation in patients with DR may reflect a dyadic coupling mechanism characterized by “increased care dependence and impaired support carrying capacity.” Conclusion Social isolation is highly prevalent among patients with DR and is closely associated with self-efficacy，social support，and caregiver burden. Nursing interventions should adopt a patient-caregiver dyadic approach to promote early identification of social isolation and collaborative intervention.

Key words: Diabetic Retinopathy, Social Isolation, Dyadic Coping, Root Cause Analysis, Mixed Methods, Nursing Care