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初级护理糖尿病患者生活质量的决定因素:对社会工作者的启示

Determinants of quality of life in primary care patients with diabetes: implications for social workers.

作者信息

Ayalon Liat, Gross Revital, Tabenkin Hava, Porath Avi, Heymann Anthony, Porter Boaz

机构信息

School of Social Work, Bar Ilan University, Israel.

出版信息

Health Soc Work. 2008 Aug;33(3):229-36. doi: 10.1093/hsw/33.3.229.

Abstract

Using a cross-sectional design of 400 primary care patients with diabetes, the authors evaluated demographics, health status, subjective health and mental health, health behaviors, health beliefs, knowledge of diabetes treatment, satisfaction with medical care, and quality of medical care as potential predictors of QoL and QoL in the hypothetical absence of diabetes. Those who reported difficulties meeting basic needs, diabetes-related complications, worse subjective health, and dissatisfaction with medical care were more likely to report worse QoL. Those who reported difficulties meeting basic needs, higher cholesterol level, and worse subjective health also were more likely to report better QoL in the hypothetical absence of diabetes. In addition, diabetes management played a major role in one's QoL in the hypothetical absence of diabetes: Engaging in stricter diabetes self-care and taking pharmaceutical treatment for managing diabetes were associated with better QoL in the hypothetical absence of diabetes. Providing psychosocial support geared toward diabetes self-management may improve patients' QoL. When doing so, social workers need to be aware of the potential trade-off between following medical recommendations that advocate for a strict lifestyle and patients' QoL.

摘要

作者采用横断面设计,对400名初级保健糖尿病患者进行研究,评估了人口统计学特征、健康状况、主观健康和心理健康、健康行为、健康信念、糖尿病治疗知识、医疗护理满意度以及医疗护理质量,将其作为生活质量(QoL)的潜在预测因素,以及假设无糖尿病情况下的生活质量。那些报告在满足基本需求方面存在困难、患有糖尿病相关并发症、主观健康状况较差以及对医疗护理不满意的患者,更有可能报告较差的生活质量。那些报告在满足基本需求方面存在困难、胆固醇水平较高以及主观健康状况较差的患者,在假设无糖尿病的情况下也更有可能报告较好的生活质量。此外,在假设无糖尿病的情况下,糖尿病管理对一个人的生活质量起着重要作用:在假设无糖尿病的情况下,进行更严格的糖尿病自我护理和接受药物治疗以控制糖尿病与较好的生活质量相关。提供针对糖尿病自我管理的心理社会支持可能会改善患者的生活质量。在这样做时,社会工作者需要意识到遵循倡导严格生活方式的医疗建议与患者生活质量之间可能存在的权衡。

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