Chlebowy Diane Orr, Garvin Bonnie J
The University of Kentucky College of Nursing, Lexington (Dr Chlebowy)
The Ohio State University College of Nursing, Columbus (Dr Garvin)
Diabetes Educ. 2006 Sep-Oct;32(5):777-86. doi: 10.1177/0145721706291760.
The purpose of this study was to examine the relationships of psychosocial variables (social support, self-efficacy, and outcome expectations) to diabetes self-care behaviors and glycemic control in Caucasian and African American adults with type 2 diabetes.
Study participants were scheduled for outpatient visits at 1 of 3 clinical sites in the southeastern United States. All 91 participants completed 4 self-report measures: Social Support Questionnaire (SSQ), Self-efficacy Questionnaire (SEQ), Outcome Expectancy Questionnaire (OEQ), and The Diabetes Activities Questionnaire (TDAQ) at the time of the clinic visit. Long-term glycemic control was assessed by glycosylated hemoglobin analyses at the time of the clinic visit. Pearson product-moment correlations were used to determine whether significant relationships existed between scores on the SSQ, SEQ, OEQ, and TDAQ and glycosylated hemoglobin values. Two-sample t tests were used to detect differences in scores on the self-report measures and glycosylated hemoglobin values between the 2 racial groups.
In all participants, no significant relationships were found between (1) social support and self-care behaviors and (2) self-efficacy and self-care behaviors. Self-care behaviors were significantly, positively correlated with outcome expectancy scores for the total group and for African Americans. No significant relationships were found between (1) social support and glycemic control, (2) self-efficacy and glycemic control, and (3) outcome expectations and glycemic control. African Americans reported less social support satisfaction than Caucasians did.
Psychosocial variables investigated in this study were not related to health outcomes of type 2 diabetes. Caucasians and African Americans were similar in these variables. It is important to investigate the relationships between other variables (eg, age, duration of diabetes, education) and self-care behaviors and glycemic control. Although African Americans experience higher rates of diabetes-related complications than Caucasians do, this may possibly be due to other factors (eg, heredity, financial barriers, inadequate health care). Additional investigations to study the relationships of these variables to diabetes control are warranted.
本研究旨在探讨心理社会变量(社会支持、自我效能感和结果期望)与患有2型糖尿病的白种人和非裔美国成年人的糖尿病自我护理行为及血糖控制之间的关系。
研究参与者被安排在美国东南部3个临床地点之一进行门诊就诊。所有91名参与者在门诊就诊时完成了4项自我报告测量:社会支持问卷(SSQ)、自我效能感问卷(SEQ)、结果期望问卷(OEQ)和糖尿病活动问卷(TDAQ)。通过门诊就诊时的糖化血红蛋白分析评估长期血糖控制情况。使用Pearson积差相关分析来确定SSQ、SEQ、OEQ和TDAQ的得分与糖化血红蛋白值之间是否存在显著关系。使用两样本t检验来检测两个种族群体在自我报告测量得分和糖化血红蛋白值方面的差异。
在所有参与者中,未发现(1)社会支持与自我护理行为之间以及(2)自我效能感与自我护理行为之间存在显著关系。自我护理行为与总群体以及非裔美国人的结果期望得分显著正相关。未发现(1)社会支持与血糖控制之间、(2)自我效能感与血糖控制之间以及(3)结果期望与血糖控制之间存在显著关系。非裔美国人报告的社会支持满意度低于白种人。
本研究中调查的心理社会变量与2型糖尿病的健康结果无关。白种人和非裔美国人在这些变量方面相似。研究其他变量(如年龄、糖尿病病程、教育程度)与自我护理行为及血糖控制之间的关系很重要。尽管非裔美国人比白种人经历更高的糖尿病相关并发症发生率,但这可能是由于其他因素(如遗传、经济障碍、医疗保健不足)。有必要进行进一步研究以探讨这些变量与糖尿病控制之间的关系。