Di Battista Ashley M, Hart Trevor A, Greco Laurie, Gloizer Jan
University of Melbourne, Department of Psychology, Melborne, Australia (Ms Di Battista)
Ryerson University, Toronto, Ontario, Canada (Dr Hart)
Diabetes Educ. 2009 May-Jun;35(3):465-75. doi: 10.1177/0145721709333492. Epub 2009 Mar 25.
The aim of this study was to examine the association between social anxiety and adherence to diabetes self-care and quality of life and to determine the effects of fear of hypoglycemia on these associations in adolescents with type 1 diabetes. It is hypothesized that (1) social anxiety will be negatively associated with adherence and quality of life and (2) that fear of hypoglycemia will mediate this relationship. It is also hypothesized that (3) girls will have higher social anxiety than boys.
Adolescents with type 1 diabetes were recruited during clinic visits at 2 international centers. Participants answered a survey containing questionnaires on social anxiety, behavioral adherence to the diabetes self-care regimen, quality of life, fear of hypoglycemia, and last hemoglobin A1C results.
Seventy-six adolescents (33 boys, 43 girls), mean age 15.9 (1.44) years, participated. Social anxiety levels are not statistically different between genders. In boys, social anxiety is associated with worse diet and insulin injection adherence; no associations are found in girls. Social anxiety is positively correlated with poor quality of life in both genders. Fear of hypoglycemia mediates the relationship between social anxiety and insulin adherence in boys.
Findings suggest that social anxiety, which is common in general populations of adolescents, may interfere with behavioral adherence and quality of life among adolescents with type 1 diabetes. Screening and treatment of social anxiety may result in better adherence and increased quality of life.
本研究旨在探讨社交焦虑与糖尿病自我管理依从性及生活质量之间的关联，并确定低血糖恐惧对1型糖尿病青少年这些关联的影响。研究假设如下：（1）社交焦虑与依从性及生活质量呈负相关；（2）低血糖恐惧将介导这种关系。还假设（3）女孩的社交焦虑水平高于男孩。
在2个国际中心的门诊就诊期间招募1型糖尿病青少年。参与者回答了一份调查问卷，其中包含有关社交焦虑、糖尿病自我管理方案的行为依从性、生活质量、低血糖恐惧以及最近血红蛋白A1C结果的问卷。
76名青少年（33名男孩，43名女孩）参与研究，平均年龄15.9（1.44）岁。男女之间的社交焦虑水平无统计学差异。在男孩中，社交焦虑与较差的饮食和胰岛素注射依从性相关；在女孩中未发现相关性。社交焦虑与男女两性的生活质量差呈正相关。低血糖恐惧介导了男孩社交焦虑与胰岛素依从性之间的关系。
研究结果表明，社交焦虑在青少年总体人群中很常见，可能会干扰1型糖尿病青少年的行为依从性和生活质量。筛查和治疗社交焦虑可能会带来更好的依从性并提高生活质量。
