The Moderating Role of Social Support in the Relationship Between Diabetes Distress and Psychological Well‐Being Among Older Adults With Type 2 Diabetes: A Cross‐Sectional Study Protocol

ABSTRACT Background and Aims Type 2 diabetes imposes a considerable psychological burden on older adults, including elevated diabetes distress and diminished psychological well‐being. Social support may buffer the harmful mental‐health effects of chronic disease‐related stress, yet whether it moderates the link between diabetes distress and psychological well‐being remains rarely examined among older Iranian adults with type 2 diabetes. This protocol aims to determine the moderating role of social support in that relationship in this population. Methods This descriptive‐analytic cross‐sectional protocol will recruit 300 adults aged 60 years or above with type 2 diabetes from the Bandar Abbas Diabetes Clinic through simple random sampling from the clinic electronic registry. Trained interviewers will administer a demographic and clinical form, the age‐adjusted Charlson Comorbidity Index, the PAID‐5 (diabetes distress), the MSSS‐5 (social support), and the WHO‐5 Well‐Being Index in person or by telephone using identical structured interviews. Hierarchical multiple regression will test the diabetes distress by social support interaction on WHO‐5 scores, in an unadjusted model and a model adjusted for a pre‐specified demographic and clinical covariate set, with heteroscedasticity‐robust standard errors, bootstrapped confidence intervals, and simple‐slopes and Johnson‐Neyman probing. Missing data will be handled with multiple imputation. Analyses will use IBM SPSS Statistics version 28 with two‐sided tests at α = 0.05. Results As a protocol, no empirical results are reported. The completed study will yield estimates of diabetes distress, social support, and psychological well‐being levels, their bivariate associations, and the moderation effect with appropriate uncertainty quantification. Conclusion The findings are expected to provide a scientific basis for nursing and psychosocial interventions that strengthen social support networks to protect the psychological well‐being of older adults with type 2 diabetes. Ethical approval has been obtained (IR.HUMS.REC.1405.013); written or audio‐recorded verbal informed consent will be obtained from all participants.