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

摘要：

目的 探讨糖尿病视网膜病变（diabetic retinopathy，DR）患者社会隔离现状及其影响因素。 方法 采用解释性顺序混合研究设计。量性研究中，便利选取2025年4—10月在河南省某三级甲等医院眼科就诊的284对DR患者及其主要照顾者作为调查对象，采用一般资料调查表、精简版社会网络量表、领悟社会支持量表、糖尿病患者自我效能量表、Zarit照顾者负担量表及照顾者准备度量表进行调查，并进行二元Logistic回归及相关性分析。质性研究中，采用目的抽样法，访谈12对DR患者及主要照顾者，采用主题分析法进行资料分析，并整合量性与质性结果。 结果 量性研究显示，有效回收问卷266份，DR患者社会隔离发生率为61.28%，多因素Logistic回归分析显示，自我效能、社会支持和照顾者负担为DR患者社会隔离的影响因素（P<0.05），三者之间均具有相关性（P<0.05）。质性研究提炼出4个主题，进一步解释了自身能力判断、社会支持和照顾者负担对社会隔离形成的影响。混合研究结果提示，DR患者社会隔离可能呈现“照护依赖-支持承接失衡”的二元机制。 结论 DR患者社会隔离发生率较高，其形成与患者自我效能、社会支持及照顾者负担密切相关。护理人员应从患者-照顾者二元视角出发，开展社会隔离早期识别和协同干预。

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