Pijl Miranda, Henneman Lidewij, Claassen Liesbeth, Detmar Symone B, Nijpels Giel, Timmermans Danielle R M
Department of Public and Occupational Health, EMGO Institute, VU University Medical Center, Amsterdam, the Netherlands.
Prev Chronic Dis. 2009 Apr;6(2):A54. Epub 2009 Mar 16.
The aim of this study was to explore the perceptions of causes, risk, and control with regard to diabetes and the role of family history among people at increased risk for type 2 diabetes.
Semistructured interviews were conducted among people aged 57 to 72 years with (n = 9) and without (n = 12) a family history of diabetes.
Participants mentioned different causes for diabetes; these were often a combination of genetic and behavioral factors. Some participants with a family history expressed incoherent causal beliefs; their general ideas about the causes of diabetes did not explain why their relatives were affected. The role of genetics as a cause for diabetes was more pronounced when people perceived diabetes as "running in the family," and this finding did not necessarily relate to a high number of affected relatives. Although people with a family history were aware of the diabetes in their family, they did not always associate their family history with increased risk, nor did they worry about getting diabetes. The absence of diabetes in the family was often used as a reason to perceive a low risk. Participants who primarily perceived genetic predisposition as a cause felt less able to prevent getting diabetes.
Future diabetes prevention strategies would benefit from giving more attention to individual perceptions, especially in the context of family history, explaining the multifactorial character of diabetes, and highlighting effective ways to reduce the risk.
本研究的目的是探讨2型糖尿病风险增加人群对糖尿病病因、风险和控制的认知以及家族史的作用。
对年龄在57至72岁之间有(n = 9)和无(n = 12)糖尿病家族史的人群进行了半结构化访谈。
参与者提到了糖尿病的不同病因;这些病因通常是遗传因素和行为因素的结合。一些有家族史的参与者表达了前后矛盾的因果观念;他们对糖尿病病因的总体看法无法解释为什么他们的亲属会患病。当人们认为糖尿病是“家族遗传”时,遗传因素作为糖尿病病因的作用更为明显,而且这一发现不一定与大量患病亲属有关。虽然有家族史的人知道家族中的糖尿病情况,但他们并不总是将家族史与风险增加联系起来,也不担心患糖尿病。家族中没有糖尿病通常被用作认为风险较低的理由。主要将遗传易感性视为病因的参与者觉得预防患糖尿病的能力较差。
未来的糖尿病预防策略若能更多地关注个体认知,尤其是在家族史背景下,解释糖尿病的多因素特征,并强调降低风险的有效方法,将会从中受益。