Psychosocial Factors Associated with Well-Being and HbA1c of People with Diabetes in Japan: A Structural Equation Model¹

The purpose of this study is to investigate psychosocial factors (independent and interdependent self-construal, emotional support) that may influence the health and well-being of people with diabetes in an interdependent culture. We conducted a cross-sectional survey on outpatients of type 1 and type 2 diabetes mellitus in Japan (N = 180, age 22-88 years, M = 62.48 years), to examine their independent and interdependent self-construal, perceived emotional support, and well-being (interdependent happiness). HbA1c data was obtained from their recent health record via their endocrinologists. Correlation analyses and structural equation modeling (SEM) were conducted to examine the relation between these variables. Patients' well-being correlated positively with age, independent self-construal, perceived emotional support, and negatively with HbA1c levels, but did not correlate with interdependent self-construal. SEM showed that, after controlling for age and gender, independence was related to perceived emotional support and well-being, which were in turn related to lower HbA1c levels. Our research suggests that, for people with diabetes in Japan, independence rather than interdependence is associated with their psychological well-being and health outcome.