目的 调查老年糖尿病(diabetes mellitus，DM)患者糖尿病心理痛苦(diabetes distress，DD)和跌倒恐惧(fear of falling，FOF)的现状，探究两者相关性，为制订相关干预措施提供理论依据。 方法 2022年3月至2023年1月，采用便利抽样法选取2所三级甲等医院门诊就诊的老年DM患者311例为研究对象，采用一般资料调查问卷、糖尿病痛苦量表（diabetes distress scale，DDS）和修订版跌倒效能量表(modified falls efficacy scale，MFES)对其调查。 结果 311例老年DM患者MFES总均分为 (7.81±1.10)分，FOF发生率为45.0%，DDS总均分(1.97±0.51)分，39.6%患者有中度以上DD。是否有近1年跌倒史、低血糖史、独居以及不同年龄、婚姻状况、受教育程度、人均月收入、慢性合并症数、慢性并发症数、糖尿病病程、血糖控制情况、糖尿病心理痛苦水平及身体/下肢功能水平的老年DM患者MFES评分差异均有统计学意义（均P＜0.05）；且DDS与MFES呈负相关(r=-0.604，P＜0.001)；年龄、受教育程度、近1年跌倒史、身体/下肢功能水平、DD是FOF的独立影响因素（均P＜0.001）。 结论 老年DM患者FOF和DD程度较为严重，两者相互影响。医护人员应重视老年DM患者的DD问题，尽早制订个体化的干预措施，提高跌倒效能，减轻FOF。

Objective To explore the status quo of diabetes distress (DD) and fear of falling (FOF) in elderly patients with diabetes mellitus (DM) ，to investigate the correlation between the DD and FOF，and to provide a theoretical basis for the development of relevant interventions. Methods From March 2022 to January 2023，311 outpatient elderly DM patients in 2 tertiary A hospitals were enrolled by the convenience sampling method as research objects，and were investigated using a general information questionnaire，diabetes distress scale (DDS) and modified falls efficacy scale (MFES). Results The total mean MFES score was (7.81±1.10).The incidence of FOF was 45.0%.The total mean DDS score was (1.97±0.51).For the DD level，39.6% of the patients were above the intermediate level.There were statistically significant differences in MFES scores among elderly DM patients with or without a history of falls in the past year，a history of hypoglycemia，living alone，different ages，marital status，education level，per capita monthly income，number of chronic complications，number of chronic complications，duration of diabetes，blood glucose control，level of diabetic psychological distress，and level of physical/lower limb function (all P＜0.05).DDS was negatively correlated with MFES (r=-0.604，P＜0.001).Age，education level，history of falls in the past year，physical/lower limb function level，and DD were independent influencing factors for FOF (all P＜0.001). Conclusion The degrees of FOF and DD are severe in elderly DM patients，and there is an interaction between FOF and DD.Medical staff should pay attention to the problem of DD in elderly DM patients and formulate individualized intervention measures as soon as possible to improve falls efficacy and reduce FOF.

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科技部重点研发计划项目（2020YFC2008802）；安徽省高校人文社会科学研究项目重大项目（SK2021ZD0030）；安徽医科大学研究生科研与实践创新项目（YJS20230066）