A pathway study of factors influencing anxiety in patients with gestational diabetes mellitus

Abstract

Background: This study aims to assess anxiety severity among patients with and to elucidate the predominant psychological factors, informing the development of targeted anxiety management strategies. Methods: The cross-sectional study recruited 421 GDM patients via convenience sampling from Guangdong Province, China. Self-administered questionnaires, including the Pregnancy-related Anxiety Scale, Simplified Coping Style Questionnaire, Type D Personality Scale, Perceived Social Support Scale, and General Self-Efficacy Scale, were utilized to gather data. Data analysis was performed using Structural Equation Modeling (SEM) in AMOS 25.0 and SPSS 25.0. Results: Among patients with GDM, anxiety was significantly and positively associated with negative coping styles (β = 0.190, P < 0.01) and Type D personality (β = 0.167, P < 0.01), indicating their roles in exacerbating anxiety. In contrast, positive coping (β=-0.136, P < 0.01), perceived social support (β=-0.206, P < 0.01) and general self efficacy (β=-0.49, P < 0.01) had direct negative impacts on anxiety, suggesting their protective influence. Mediation analysis revealed that negative coping and Type D personality exerted significant mediating effects on anxiety, with the pathway from negative coping through Type D personality explaining 16% of the indirect effect (β = 2.302, 95% CI: 1.411 ~ 3.350) and the pathway from Type D personality through perceived social support explaining 32% of the indirect effect (β = 4.528, 95% CI: 3.231 ~ 5.913). Conclusion: The study identifies key psychological modifiers of anxiety in GDM, suggesting that targeted psychological support could mitigate anxiety and improve pregnancy outcomes.