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复原力在糖尿病患者心理调适和身体健康方面的作用。

The role of resilience on psychological adjustment and physical health in patients with diabetes.

作者信息

Yi Joyce P, Vitaliano Peter P, Smith Ronald E, Yi Jean C, Weinger Katie

机构信息

Department of Psychology, University of Washington, Seattle, WA, USA.

出版信息

Br J Health Psychol. 2008 May;13(Pt 2):311-25. doi: 10.1348/135910707X186994. Epub 2007 Mar 1.

Abstract

OBJECTIVE

This study used a longitudinal design to investigate the buffering role of resilience on worsening HbA(1c) and self-care behaviours in the face of rising diabetes-related distress.

METHOD

A total of 111 patients with diabetes completed surveys and had their glycosylated haemoglobin (HbA(1c)) assessed at baseline and at 1-year follow-up. Resilience was defined by a factor score of self-esteem, self-efficacy, self-mastery and optimism. Diabetes-related distress and self-care behaviours were also assessed.

RESULTS

Baseline resilience, diabetes-related distress and their interaction predicted physical health (HbA(1c)) at 1 year. Patients with low, moderate and high resilience were identified. Those with low or moderate resilience levels showed a strong association between rising distress and worsening HbA(1c) across time (r=.57, .56, respectively). However, those with high resilience scores did not show the same associations (r=.08). Low resilience was also associated with fewer self-care behaviours when faced with increasing distress (r=-.55). These correlation coefficients remained significant after controlling for starting-points.

CONCLUSION

In patients with diabetes, resilience resources predicted future HbA(1c) and buffered worsening HbA(1c) and self-care behaviours in the face of rising distress levels.

摘要

目的

本研究采用纵向设计,以调查面对日益增加的糖尿病相关困扰时,心理弹性对糖化血红蛋白(HbA1c)恶化及自我护理行为的缓冲作用。

方法

共有111名糖尿病患者完成了调查,并在基线和1年随访时接受糖化血红蛋白(HbA1c)评估。心理弹性由自尊、自我效能感、自我掌控和乐观的因子得分定义。还评估了糖尿病相关困扰和自我护理行为。

结果

基线心理弹性、糖尿病相关困扰及其交互作用可预测1年后的身体健康状况(HbA1c)。确定了低、中、高心理弹性的患者。低心理弹性或中等心理弹性水平的患者在随访期间,困扰增加与HbA1c恶化之间存在强关联(相关系数分别为0.57和0.56)。然而,高心理弹性得分的患者未表现出相同的关联(相关系数为0.08)。面对日益增加的困扰时,低心理弹性也与较少的自我护理行为相关(相关系数为 -0.55)。在控制起始点后,这些相关系数仍具有统计学意义。

结论

在糖尿病患者中,心理弹性资源可预测未来的HbA1c,并在面对日益增加的困扰时缓冲HbA1c恶化及自我护理行为。

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