Department of Psychosomatic Medicine, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan.
Biopsychosoc Med. 2009 Mar 19;3:4. doi: 10.1186/1751-0759-3-4.
This cross-sectional and prospective study used a variety of psychological inventories to evaluate the relationship between psychosocial factors and the glycemic control of patients with type 2 diabetes.
Participants were 304 patients with type 2 diabetes who were treated as outpatients at diabetes clinics. All participants were assessed for HbA1c and completed the following self-report psychological inventories: 1) Diabetes Treatment Satisfaction Questionnaire (DTSQ), 2) Problem Areas in Diabetes Survey (PAID), 3) Well-being Questionnaire 12 (W-BQ12), 4) Self-Esteem Scale (SES), 5) Social Support Scale, and 6) Self-Efficacy Scale. HbA1c was again measured one year later. The relationships between the psychosocial variables obtained by analysis of the psychological inventories and baseline or one-year follow-up HbA1c were determined.
Baseline HbA1cwas significantly correlated with age, diet treatment regimen, number of microvascular complication of diabetes, and the total scores of DTSQ, W-BQ12, PAID, SES and the Self-Efficacy Scale. Hierarchical stepwise multiple regression revealed that significant predictors of baseline HbA1c were total DTSQ and PAID scores, along with age, diet treatment regimen, and number of microvascular complication of diabetes after adjustment for demographic, clinical and other psychosocial variables. Two hundred and ninety patients (95.4% of 304) were followed and assessed one year after baseline. Hierarchical stepwise multiple regression analysis showed the significant predictors of follow-up HbA1c to be total DTSQ and PAID scores, along with age and diet treatment regimen. However, the correlation between baseline and follow-up HbA1c was so high that the only other variable to retain significance was diet treatment regimen once baseline HbA1c was included in the regression of follow-up HbA1c.
The DTSQ and the PAID predicted both current and future HbA1c to a similar and significant degree in patients with type 2 diabetes.
本横断面前瞻性研究使用多种心理测评工具评估了 2 型糖尿病患者的社会心理因素与血糖控制之间的关系。
共纳入 304 例在糖尿病门诊接受治疗的 2 型糖尿病患者，对所有患者进行糖化血红蛋白（HbA1c）检测并完成以下自评心理测评量表：1）糖尿病治疗满意度问卷（DTSQ），2）糖尿病困扰量表（PAID），3）健康状况问卷 12 项（W-BQ12），4）自尊量表（SES），5）社会支持量表，6）自我效能感量表。1 年后再次检测 HbA1c。分析心理测评量表获得的社会心理变量与基线或 1 年后随访 HbA1c 的关系。
基线 HbA1c 与年龄、饮食治疗方案、糖尿病微血管并发症数量及 DTSQ、W-BQ12、PAID、SES 和自我效能感量表总分呈显著相关。分层逐步多元回归分析显示，调整人口统计学、临床和其他社会心理变量后，基线 HbA1c 的显著预测因子为 DTSQ 和 PAID 总分，以及年龄、饮食治疗方案和糖尿病微血管并发症数量。290 例患者（304 例患者的 95.4%）在基线后 1 年进行了随访和评估。分层逐步多元回归分析显示，随访 HbA1c 的显著预测因子为 DTSQ 和 PAID 总分，以及年龄和饮食治疗方案。然而，基线和随访 HbA1c 之间的相关性非常高，因此在将基线 HbA1c 纳入到随访 HbA1c 的回归分析中后，唯一保留意义的变量是饮食治疗方案。
DTSQ 和 PAID 可相似且显著地预测 2 型糖尿病患者当前和未来的 HbA1c。
