Institute for Health Research, Kaiser Permanente Colorado, Denver, Colorado, USA.
Diabetes Care. 2010 Apr;33(4):751-3. doi: 10.2337/dc09-1746. Epub 2010 Feb 11.
To evaluate associations between psychosocial and social-environmental variables and diabetes self-management, and diabetes control.
Baseline data from a type 2 diabetes self-management randomized trial with 463 adults having elevated BMI (M = 34.8 kg/m(2)) were used to investigate relations among demographic, psychosocial, and social-environmental variables; dietary, exercise, and medication-taking behaviors; and biologic outcomes.
Self-efficacy, problem solving, and social-environmental support were independently associated with diet and exercise, increasing the variance accounted for by 23 and 19%, respectively. Only diet contributed to explained variance in BMI (beta = -0.17, P = 0.0003) and self-rated health status (beta = 0.25, P < 0.0001); and only medication-taking behaviors contributed to lipid ratio (total-to-HDL) (beta = -0.20, P = 0.0001) and A1C (beta = -0.21, P < 0.0001).
Interventions should focus on enhancing self-efficacy, problem solving, and social-environmental support to improve self-management of diabetes.
评估心理社会和社会环境变量与糖尿病自我管理和糖尿病控制之间的关系。
利用一项 2 型糖尿病自我管理随机试验的基线数据，该试验纳入了 463 名 BMI 升高（M=34.8kg/m(2)）的成年人，用于调查人口统计学、心理社会和社会环境变量；饮食、运动和服药行为；以及生物学结果之间的关系。
自我效能感、问题解决能力和社会环境支持与饮食和运动独立相关，分别增加了 23%和 19%的可解释方差。只有饮食对 BMI（β=-0.17，P=0.0003）和自我评估的健康状况（β=0.25，P<0.0001）有解释方差的贡献；只有服药行为对血脂比（总胆固醇/高密度脂蛋白）（β=-0.20，P=0.0001）和 A1C（β=-0.21，P<0.0001）有贡献。
干预措施应重点增强自我效能感、问题解决能力和社会环境支持，以改善糖尿病的自我管理。
