Trief P M, Aquilino C, Paradies K, Weinstock R S
Department of Psychiatry, State University of New York (SUNY) Health Science Center, Syracuse 13210, USA.
Diabetes Care. 1999 Apr;22(4):569-74. doi: 10.2337/diacare.22.4.569.
To evaluate quantitatively whether the work environments of adults with diabetes relate to the adequacy of metabolic control and/or to the individual's adaptation to diabetes and to explore qualitatively the interactions between an individual's life at work and ways of coping with diabetes.
A total of 129 insulin-requiring adults who were employed outside of the home were assessed on a single occasion. They completed two work system measures (The Work Environment Scale and The Work Apgar Scale) and two quality-of-life measures (The Diabetes Quality of Life Scale and The Appraisal of Diabetes Scale). Subjects also participated in a semi-structured interview concerning the interaction of work and diabetes. Glycemic control was assessed by using HbAlc results. Demographic data (age, sex, diabetes type, duration of diabetes, number of diabetes-related medical complications) were gathered from the charts.
Concerning glycemic control, neither of the work system measures was a significant predictor of HbAlc. Concerning psychosocial adaptation, supervisor support was found to be a significant predictor of positive appraisal and diabetes-related satisfaction. Involvement and coworker cohesion also predicted aspects of diabetes-related quality of life. Interview themes showed that for a minority (18%), diabetes affected choice of work and that for a majority (60%), diabetes affected relationships at work and raised financial/job concerns (49%). Most adjust their diet, blood glucose testing, and exercise regimen through work-related modifications.
For insulin-treated adults with diabetes, work system variables do not directly relate to glycemic control, but they do relate to psychosocial adaptation. Future work should examine further the specific aspects of the workplace that might affect adaptation, with the goal being to develop worksite interventions that target not only the employee with diabetes but also their supervisors and coworkers.
定量评估成年糖尿病患者的工作环境是否与代谢控制的充分性和/或个体对糖尿病的适应情况相关，并定性探索个体工作生活与应对糖尿病方式之间的相互作用。
对129名需使用胰岛素且外出工作的成年人进行了一次性评估。他们完成了两项工作系统测量（工作环境量表和工作阿普加量表）以及两项生活质量测量（糖尿病生活质量量表和糖尿病评估量表）。受试者还参与了关于工作与糖尿病相互作用的半结构化访谈。通过糖化血红蛋白（HbAlc）结果评估血糖控制情况。从病历中收集人口统计学数据（年龄、性别、糖尿病类型、糖尿病病程、糖尿病相关医疗并发症数量）。
关于血糖控制，两项工作系统测量均不是糖化血红蛋白的显著预测指标。关于心理社会适应，发现上级支持是积极评估和糖尿病相关满意度的显著预测指标。参与度和同事凝聚力也预测了糖尿病相关生活质量的某些方面。访谈主题显示，少数人（18%）表示糖尿病影响工作选择，多数人（60%）表示糖尿病影响工作中的人际关系并引发财务/工作担忧（49%）。大多数人通过与工作相关的调整来改变饮食、血糖检测和锻炼方案。
对于接受胰岛素治疗的成年糖尿病患者，工作系统变量与血糖控制无直接关联，但与心理社会适应相关。未来的研究应进一步考察工作场所可能影响适应的具体方面，目标是开发不仅针对糖尿病员工，还针对其上级和同事 的工作场所干预措施。
