Rubin Richard R, Peyrot Mark, Siminerio Linda M
Department of Medicine, The Johns Hopkins University, Baltimore, MD., USA.
Diabetes Care. 2006 Jun;29(6):1249-55. doi: 10.2337/dc05-2494.
The purpose of this study was to assess the relationship of patients' self-reported well-being, self-management, and diabetes control with factors related to the patient's health care.
This was a cross-sectional survey of national samples of patients with diabetes (n = 5,104) from the multinational study of Diabetes Attitudes, Wishes and Needs (DAWN). Patients from 13 countries in Asia, Australia, Europe, and North America reported their level of well-being, self-management, and diabetes control. Hierarchical multiple regression analysis (blocks are countries, respondent characteristics, and health care features) was used to examine predictors of diabetes-related distress and general well-being, adherence to lifestyle and medical treatment recommendations, and perceived diabetes control and hyperglycemic symptoms.
Country, respondent demographic and disease characteristics, and health care features were all associated with patient-reported outcomes. Better patient-provider collaboration was associated with more favorable ratings on all outcomes, and better access to the provider and availability of team care were associated with some positive outcomes. Country differences were only partly accounted for by patient and health care factors. Relationships between health care factors and outcomes varied across countries.
Patients' reports of well-being, self-management, and diabetes control were related to the countries in which they live, their demographic and disease characteristics, and features of their health care. Opportunities to enhance patient-provider collaboration, access to care, and availability of team care should be pursued.
本研究旨在评估患者自我报告的幸福感、自我管理能力以及糖尿病控制情况与患者医疗保健相关因素之间的关系。
这是一项对来自糖尿病态度、愿望与需求跨国研究（DAWN）的全国糖尿病患者样本（n = 5104）进行的横断面调查。来自亚洲、澳大利亚、欧洲和北美的13个国家的患者报告了他们的幸福感、自我管理能力和糖尿病控制水平。采用分层多元回归分析（分组为国家、受访者特征和医疗保健特征）来检验糖尿病相关困扰和总体幸福感、对生活方式和医疗治疗建议的依从性、以及感知到的糖尿病控制和高血糖症状的预测因素。
国家、受访者人口统计学和疾病特征以及医疗保健特征均与患者报告的结果相关。更好的医患合作与所有结果的更有利评分相关，更好的就医机会和团队护理的可及性与一些积极结果相关。国家差异仅部分由患者和医疗保健因素解释。医疗保健因素与结果之间的关系因国家而异。
患者对幸福感、自我管理能力和糖尿病控制的报告与他们所居住的国家、人口统计学和疾病特征以及医疗保健特征有关。应寻求加强医患合作、改善就医机会和提供团队护理的机会。
