Searle Aidan, Wetherell Mark A, Campbell Rona, Dayan Colin, Weinman John, Vedhara Kav
Department of Social Medicine, University of Bristol, Bristol, UK.
Int J Behav Med. 2008;15(3):173-9. doi: 10.1080/10705500802212940.
Previous research has examined patients' beliefs in diabetes and how these beliefs may affect patient outcomes. However, changes in symptoms and complications are a common feature of diabetes, and these can significantly alter the patient's "disease experience." However, no consideration has been given to how beliefs about diabetes vary according to the complications patients have.
The present study was designed to compare the beliefs of 22 patients with diabetic foot ulcers and 22 age-and gender-matched patients with diabetic retinopathy, and 22 age-and gender-matched controls with type 2 diabetes but without either complication.
Beliefs about diabetes were assessed with the Revised Illness Perception Questionnaire (IPQ-R; Moss-Morris et al., 2002).
Patients with foot ulcers held a greater belief in personal control of diabetes, but perceived treatment control was lower than that of diabetic controls without serious complications (p < .05). Patients with foot ulcers also demonstrated less illness coherence than patients with retinopathy and diabetic controls (p < .01) and also perceived their diabetes to be more cyclical in nature (p < .01).
Differences were found in diabetic patients' beliefs according to their complications. Future interventions should consider how the complications associated with diabetes may affect patients' beliefs and subsequent emotional and behavioral responses to the disease.
先前的研究探讨了患者对糖尿病的认知以及这些认知如何影响患者的治疗结果。然而，症状和并发症的变化是糖尿病的常见特征，这些变化会显著改变患者的“疾病体验”。然而，尚未考虑糖尿病认知如何因患者所患并发症的不同而有所差异。
本研究旨在比较22例糖尿病足溃疡患者、22例年龄和性别匹配的糖尿病视网膜病变患者以及22例年龄和性别匹配的2型糖尿病但无任何一种并发症的对照者的认知。
使用修订后的疾病认知问卷（IPQ-R；莫斯-莫里斯等人，2002年）评估对糖尿病的认知。
足溃疡患者对糖尿病的个人控制信念更强，但感知到的治疗控制低于无严重并发症的糖尿病对照者（p < 0.05）。足溃疡患者的疾病连贯性也低于视网膜病变患者和糖尿病对照者（p < 0.01），并且他们认为自己的糖尿病在本质上更具周期性（p < 0.01）。
根据并发症的不同，糖尿病患者的认知存在差异。未来的干预措施应考虑糖尿病相关并发症如何影响患者的认知以及随后对疾病的情绪和行为反应。
