The Mediating Role of Perceived Social Support in Family Cohesion and Disease Identity Among Chinese Adolescents and Young Adults with Type 1 Diabetes Mellitus: A Cross-Sectional Study

Objective: This study aimed to examine the association between family cohesion and disease identity in adolescents and young adults (AYAs) with type 1 diabetes mellitus (T1DM) and to test the mediating role of perceived social support in this relationship. Methods: From January 2025 to June 2025, a total of 222 AYA patients with T1DM were recruited from the Department of Endocrinology and Department of Pediatrics of four tertiary-level hospitals in Zhengzhou, Henan Province, China. The Disease Identity Questionnaire for AYA patients with T1DM, Family Cohesion Scale, and Perceived Social Support Scale were used. Results: Family cohesion was positively correlated with perceived social support and disease identity, and perceived social support was positively correlated with disease identity. Perceived social support played a partial mediating role in the association between family cohesion and disease identity (β = 0.391, p < 0.001), accounting for 63.6% of the total effect. Conclusions: Family cohesion is positively associated with perceived social support and disease identity in AYA patients with T1DM, with perceived social support playing a partial mediating role. This indicates that family cohesion shows both direct and indirect associations with patients’ disease identity. The study suggests that interventions aimed at enhancing family cohesion and perceived social support may inform strategies to improve patients’ disease identity, thereby potentially facilitating their psychosocial adaptation.