Shaw Benjamin A, Gallant Mary P, Riley-Jacome Mary, Spokane Linda S
Department of Health Policy, Management, and Behavior, School of Public Health, University at Albany, Rensselaer, NY 12144-3456, USA.
J Community Health. 2006 Oct;31(5):393-412. doi: 10.1007/s10900-006-9018-4.
The ability of adults with diabetes to manage their illness properly and prevent complications is, in part, a function of support provided by the people and institutions surrounding them. Using data from over 200 adults with diabetes in two medically underserved communities--one urban and one rural--this study examines the self-care specific support provided by four key sources: family and friends, community organizations, one's neighbors and neighborhood, and resources in the wider community. More specifically, this study aims to assess the support needs of adults with diabetes in these communities by estimating their rates of various self-care behaviors, the amount of support provided by key sources, and the associations between support from these sources and adherence to recommended diabetes self-care behaviors. Descriptive findings indicate that close to 40% of the sample failed to report at least moderate levels of adherence, and that physical activity in the rural community, and smoking in the urban community represent particular problem areas. Individuals from the urban sub-sample reported receiving more support from all of the sources assessed. Logistic regression models indicated that one's neighbors and neighborhood resources appear to have a broad influence on adherence to diabetes self-care behaviors. Support from family and friends, as well as from community organizations, also seems to be important. These results have implications for the design of interventions aimed at bolstering support for diabetes self-care, and point to the need for an enhanced focus on strengthening the social environmental resources of adults with diabetes.
患有糖尿病的成年人妥善管理自身疾病并预防并发症的能力，在一定程度上取决于其周围的人和机构所提供的支持。本研究利用来自两个医疗服务欠缺社区（一个城市社区和一个农村社区）的200多名成年糖尿病患者的数据，考察了四个关键来源提供的特定自我护理支持：家人和朋友、社区组织、邻居及邻里关系，以及更广泛社区中的资源。更具体地说，本研究旨在通过估计这些社区中成年糖尿病患者各种自我护理行为的发生率、关键来源提供的支持量，以及这些来源的支持与坚持推荐的糖尿病自我护理行为之间的关联，来评估他们的支持需求。描述性结果表明，近40%的样本未能报告至少中等程度的依从性，农村社区的体育活动和城市社区的吸烟是特别突出的问题领域。城市子样本中的个体报告称，从所有评估来源获得的支持更多。逻辑回归模型表明，邻居及邻里资源似乎对坚持糖尿病自我护理行为有广泛影响。来自家人和朋友以及社区组织的支持似乎也很重要。这些结果对旨在加强糖尿病自我护理支持的干预措施设计具有启示意义，并指出需要更加注重加强成年糖尿病患者的社会环境资源。
