The Department of Medicine and the Center for Health Disparities Research, Medical University of South Carolina, Charleston (Dr Egede)
Center for Disease Prevention and Health Interventions for Diverse Populations, Ralph H. Johnson VA Medical Center, Charleston, South Carolina (Dr Egede)
Diabetes Educ. 2010 Mar-Apr;36(2):276-83. doi: 10.1177/0145721710361389. Epub 2010 Feb 23.
The mechanism by which depression influences health outcomes in persons with diabetes is uncertain. The purpose of this study was to test whether depression is related to self-care behavior via social motivation and indirectly related to glycemic control via self-care behavior.
Patients with diabetes were recruited from an outpatient clinic. Information gathered pertained to demographics, depression, and diabetes knowledge (information); diabetes fatalism (personal motivation); social support (social motivation); and diabetes self-care (behavior). Hemoglobin A1C values were extracted from the patient medical record. Structural equation models tested the predicted pathways.
Higher levels of depressive symptoms were significantly related to having less social support and decreased performance of diabetes self-care behavior. In addition, when depressive symptoms were included in the model, fatalistic attitudes were no longer associated with behavioral performance.
Among adults with diabetes, depression impedes the adoption of effective self-management behaviors (including physical activity, appropriate dietary behavior, foot care, and appropriate self-monitoring of blood glucose behavior) through a decrease in social motivation.
抑郁影响糖尿病患者健康结果的机制尚不清楚。本研究旨在检验抑郁是否通过社会动机与自我护理行为相关，以及是否通过自我护理行为与血糖控制间接相关。
从门诊诊所招募糖尿病患者。收集的信息包括人口统计学、抑郁和糖尿病知识（信息）；糖尿病宿命论（个人动机）；社会支持（社会动机）；以及糖尿病自我护理（行为）。从患者的病历中提取血红蛋白 A1C 值。结构方程模型检验了预测途径。
较高水平的抑郁症状与社交支持减少和糖尿病自我护理行为表现下降显著相关。此外，当将抑郁症状纳入模型时，宿命论态度与行为表现不再相关。
在患有糖尿病的成年人中，抑郁通过降低社会动机，阻碍了有效的自我管理行为（包括体育锻炼、适当的饮食行为、足部护理和适当的自我监测血糖行为）的采用。
