Abstract:

Objective To examine the status of intrinsic capacity and self-management behaviors in older adults with diabetes and multimorbidity，to explore the relationship between intrinsic capacity and self-management behaviors and their internal mechanisms，and to provide a reference for developing precise interventions targeting intrinsic capacity and self-management behaviors for older adults with diabetes and multimorbidity. Methods A convenience sampling method was used to select 425 older patients with diabetes and comorbidities from 2 tertiary hospitals and 1 community health service center in Tianjin from November 2025 to January 2026. Data was collected using a general information questionnaire，an intrinsic capacity assessment tool，and the Diabetes Self-Management Behavior Scale. Hierarchical regression analysis was performed to examine the influence of intrinsic capacity on self-management behaviors. Network analysis was conducted using R version 4.5.2 to construct a network model，identify core nodes，and evaluate the stability of the network structure. Results A total of 407 valid questionnaires were recovered，with an effective response rate of 95.76%. The mean intrinsic capacity score of older adults with diabetes and multimorbidity was（3.19±1.65） points，and the mean self-management behavior score was（34.11±12.58） points. Hierarchical linear regression analysis showed that intrinsic capacity independently explained 34.2% of the total variance in self-management behaviors in elderly patients with diabetes multimorbidity. Network analysis revealed that the strongest positive correlation was between motor function and exercise behavior（r=0.486），while the strongest negative correlation was between psychological function and medication adherence behavior（r=-0.209）. Motor function had the highest strength centrality in the network（strength centrality=1.328）. Conclusion Both intrinsic capacity and self-management behaviors in older adults with diabetes and multimorbidity are at a low-to-moderate level. Intrinsic capacity and self-management behaviors are interrelated. Motor function is a key node for interventions targeting both intrinsic capacity and self-management behaviors. It is recommended that nursing professionals prioritize intervention strategies designed to improve motor function，thereby enhancing the overall quality of life in older adults with diabetes and multimorbidity.

Key words: Older Adults with Diabetes and Multimorbidity, Intrinsic Capacity, Self-Management Behavior, Network Analysis, Nursing Care

摘要：

目的 调查老年糖尿病共病患者内在能力和自我管理行为现状，探讨内在能力与自我管理行为的关系及其内部关联机制，为制订针对老年糖尿病共病患者内在能力和自我管理行为的精准干预措施提供参考。方法 采用便利抽样法，于2025年11月—2026年1月选取天津市2所三级甲等医院及1所社区卫生服务中心的425例老年糖尿病共病患者作为调查对象，采用一般资料调查表、内在能力评估工具、糖尿病自我管理行为量表等工具进行调查，通过分层回归分析探究内在能力对老年糖尿病共病患者自我管理行为的影响，应用R 4.5.2软件构建二者的网络模型，识别核心节点，并评估网络结构稳定性。结果 回收有效问卷407份，问卷有效回收率为95.76%。老年糖尿病共病患者内在能力得分为（3.19±1.65）分，自我管理行为得分为（34.11±12.58）分。分层回归分析结果显示，内在能力可独立解释老年糖尿病共病患者自我管理行为总变异的34.2%。网络分析显示，运动功能和运动行为的正相关性最强（r=0.486），心理功能和用药行为的负相关性最强（r=-0.209）。运动功能在网络中的强度中心性最高（强度中心性=1.328）。结论 老年糖尿病共病患者内在能力和自我管理行为总体处于中低水平，内在能力与自我管理行为相互关联，运动功能是内在能力和自我管理行为干预的关键节点，建议护士优先针对运动功能设计干预策略，改善老年糖尿病共病患者的整体生活质量。

关键词: 老年糖尿病共病, 内在能力, 自我管理行为, 网络分析, 护理