College of Nursing, Marquette University, Milwaukee, Wisconsin 53201-1881, USA.
Nurs Health Sci. 2010 Mar;12(1):94-104. doi: 10.1111/j.1442-2018.2009.00506.x.
Diabetes, with its consequences of premature death, complications, and economic costs, is a precursor to a public health crisis that is expected to worsen over the next several decades. The improvement of diabetes outcomes, specifically glycemic control as measured by glycosylated hemoglobin concentration (HbA1c), can impact this critical situation. A quantitative study was conducted that examined health literacy and patient trust as predictors of glycemic control. The related factors of demographics, socioeconomic status, diabetes knowledge, self-care activities, and depression were also considered. Implementing a cross-sectional, predictive design, a convenience sample of 102 patients with diabetes was recruited from two urban primary care clinics in the USA. A simultaneous multiple regression was conducted. The regression analysis was significant, with patient trust and depression accounting for 28.5% of the variance in HbA1c. There was a significant positive relationship between socioeconomic status and health literacy and between diabetes knowledge and health literacy. The results support promotion of the patient-provider relationship, depression screening among individuals with diabetes, and exploration of new strategies for diabetes education. Future research is needed to advance the framework, ascertain which factors engender patient trust, and determine the role of health literacy in glycemic control.
糖尿病会导致过早死亡、并发症和经济成本，是公共健康危机的前兆，预计在未来几十年内会恶化。改善糖尿病的结果，特别是糖化血红蛋白浓度（HbA1c）所衡量的血糖控制，可以影响这种关键情况。进行了一项定量研究，研究了健康素养和患者信任作为血糖控制的预测指标。还考虑了与人口统计学、社会经济地位、糖尿病知识、自我护理活动和抑郁相关的因素。采用横断面预测设计，从美国的两个城市初级保健诊所招募了 102 名糖尿病患者的便利样本。进行了同步多元回归。回归分析具有统计学意义，患者信任和抑郁占 HbA1c 方差的 28.5%。社会经济地位和健康素养之间以及糖尿病知识和健康素养之间呈显著正相关。结果支持促进医患关系，在糖尿病患者中进行抑郁筛查，并探索新的糖尿病教育策略。需要进一步研究来推进该框架，确定哪些因素会产生患者信任，并确定健康素养在血糖控制中的作用。
