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患者与医疗服务提供者对糖尿病及其对自我管理影响的认知:非裔美国患者与白人患者的比较

Patient-provider perceptions of diabetes and its impact on self-management: a comparison of African-American and White patients.

作者信息

Tang T S, Stansfield R B, Oh M, Anderson R M, Fitzgerald J T

机构信息

University of Michigan Department of Medical Education, University of Michigan Medical School, Ann Arbor, MI, USA.

出版信息

Diabet Med. 2008 Mar;25(3):341-8. doi: 10.1111/j.1464-5491.2007.02371.x.

Abstract

AIMS

To compare patient-provider differences in diabetes-related perceptions between African-American and White patients and to examine its association with self-care behaviours.

METHODS

One hundred and thirty patient-provider pairs were recruited from the greater Detroit area. Patients and providers completed a survey assessing perceptions about diabetes-related concepts and demographic background. The Diabetes Semantic Differential Scale was used to measure diabetes-related perceptions. Patients also reported the frequency of performing self-care behaviours, including following a healthy eating plan, engaging in physical activity, blood glucose monitoring, and taking medication and/or insulin.

RESULTS

There were a greater number of patient-provider differences in diabetes-related perceptions for the African-American patients (nine of 18 concepts) compared with the White patients (four of 18 concepts). Stepwise regression analyses found patients' semantic differential scores to be significantly associated with five self-care behaviours for African-American patients and two self-care behaviours for White patients. Providers' semantic differential scores emerged as predictors of self-care behaviours for African-American patients, but not for White patients.

CONCLUSIONS

Our findings suggest that compared with White patients, African-Americans differ in a greater number of diabetes-related perceptions than their providers. Patients' and providers' perceptions of diabetes care concepts have a significant impact on a greater number of self-care behaviours for African-American patients than White patients.

摘要

目的

比较非裔美国患者与白人患者在糖尿病相关认知方面的医患差异,并研究其与自我护理行为的关联。

方法

从底特律大都会地区招募了130对医患。患者和医护人员完成了一项调查,评估对糖尿病相关概念和人口统计学背景的认知。糖尿病语义差异量表用于测量糖尿病相关认知。患者还报告了进行自我护理行为的频率,包括遵循健康饮食计划、进行体育活动、监测血糖以及服药和/或注射胰岛素。

结果

与白人患者(18个概念中的4个)相比,非裔美国患者在糖尿病相关认知方面存在更多的医患差异(18个概念中的9个)。逐步回归分析发现,患者的语义差异得分与非裔美国患者的五种自我护理行为以及白人患者的两种自我护理行为显著相关。医护人员的语义差异得分成为非裔美国患者自我护理行为的预测因素,但对白种人患者则不然。

结论

我们的研究结果表明,与白人患者相比,非裔美国人在更多糖尿病相关认知方面与医护人员存在差异。与白人患者相比,患者和医护人员对糖尿病护理概念的认知对非裔美国患者的更多自我护理行为有显著影响。

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