Department of Health Management and Policy, School of Public Health, University of Michigan, 109 South Observatory Street, SPH 2, Ann Arbor, MI 49109-2029, USA.
J Gerontol B Psychol Sci Soc Sci. 2010 May;65B(3):390-9. doi: 10.1093/geronb/gbp050. Epub 2009 Jun 18.
OBJECTIVES. Social support is generally conceptualized as health promoting; however, there is little consensus regarding the mechanisms through which support is protective. Illness support has been proposed to promote regimen adherence and subsequent prevention of health decline. We hypothesize that (a) support for regimen adherence is negatively associated with self-reported health decline among older diabetic adults and that (b) regimen adherence is negatively associated with health decline among older diabetic adults.
We used the Health and Retirement Study data on individuals over the age of 60 years with type 2 diabetes mellitus (n = 1,788), examining change in self-reported health status over a 2-year period using binomial and cumulative ordinal logistic regression models.
Diabetic support is not significantly associated with health decline, but it is strongly associated with adherence to health-promoting activities consisting of a diabetic regimen. Therefore, the extent to which one receives illness support for a given regimen component is highly positively associated with adhering to that component, although this adherence does not necessarily translate into protection against perceived decline in health.
Illness-related support appears to be a mechanism through which social support matters in the diabetic population. Although this relationship did not extend to prevention of health status decline among diabetics, the relationship between support and illness management is promising.
社会支持通常被认为具有促进健康的作用;然而,关于支持如何起到保护作用的机制,目前还没有达成共识。疾病支持被认为可以促进治疗方案的依从性,从而预防健康状况的恶化。我们假设:(a)支持治疗方案的依从性与老年糖尿病患者自我报告的健康状况恶化呈负相关;(b)治疗方案的依从性与老年糖尿病患者的健康状况恶化呈负相关。
我们使用了“健康与退休研究”中年龄在 60 岁以上且患有 2 型糖尿病的个体的数据(n=1788),使用二项式和累积有序逻辑回归模型,在两年的时间内检查自我报告的健康状况变化。
糖尿病相关支持与健康状况恶化没有显著关联,但与促进健康的活动(包括糖尿病治疗方案)的依从性密切相关。因此,对于给定的治疗方案组成部分,一个人获得疾病支持的程度与对该组成部分的依从性高度正相关,尽管这种依从性并不一定能预防健康感知下降。
与疾病相关的支持似乎是社会支持在糖尿病患者群体中起作用的一种机制。尽管这种关系并没有扩展到预防糖尿病患者健康状况恶化,但支持与疾病管理之间的关系很有前途。