Folkhälsan Institute of Genetics, Folkhälsan Research Center, Biomedicum Helsinki, Finland.
Health Qual Life Outcomes. 2010 Nov 29;8:142. doi: 10.1186/1477-7525-8-142.
Sense of coherence (SOC) has been associated with various self-care behaviours in the general population. As the management of type 1 diabetes heavily relies on self-management, the SOC concept could also prove important in this population. This paper is a report of a study conducted among patients with type 1 diabetes to assess the associations between SOC and glycaemic control, microvascular complications, and patients' conceptions of their disease.
Altogether 1,264 adult patients (45% men, age range 18-82 years) with type 1 diabetes participated in this cross-sectional study. SOC was evaluated using a 13-item SOC questionnaire. Standardized assays were used to determine HbA1c. Nephropathy status was based on albumin excretion rate and retinal laser-treatment was used as an indication of severe retinopathy. Patients' subjective conceptions of diabetes were studied using a questionnaire.
Higher SOC scores, reflecting stronger SOC, were associated with lower HbA1c values. Strong SOC was independently associated with reaching the HbA1c level <7.5%. Adjusting for diabetes duration, age at onset, socioeconomic status and HbA1c, weak SOC was associated with the presence of nephropathy among men, but not women. No associations were observed between SOC and severe retinopathy. Four dimensions describing patients' conceptions of HbA1c, complications, diabetes control and hypoglycaemia were formed from the diabetes questionnaire. Weak SOC was independently associated with worse subjective conceptions in the dimensions of HbA1c and hypoglycaemia. Furthermore among men, an association between weak SOC and the complications factor was observed.
Interventions to improve patients' SOC, if available, could improve patients' metabolic control and therefore also reduce the incidence of diabetic complications.
社会适应能力（SOC）与普通人群的各种自我保健行为有关。由于 1 型糖尿病的管理主要依赖于自我管理，因此 SOC 概念在该人群中也可能很重要。本文报告了一项针对 1 型糖尿病患者的研究，该研究旨在评估 SOC 与血糖控制、微血管并发症以及患者对疾病的认识之间的关系。
共有 1264 名成年 1 型糖尿病患者（45%为男性，年龄 18-82 岁）参加了这项横断面研究。采用 13 项 SOC 问卷评估 SOC。采用标准化检测方法测定 HbA1c。肾病状态基于白蛋白排泄率，视网膜激光治疗用于严重视网膜病变的指标。使用问卷研究患者对糖尿病的主观认识。
SOC 评分较高，反映 SOC 较强，与 HbA1c 值较低相关。在调整了糖尿病病程、发病年龄、社会经济地位和 HbA1c 后，较弱的 SOC 与男性而非女性的肾病有关。SOC 与严重视网膜病变之间没有关联。从糖尿病问卷中形成了四个描述患者对 HbA1c、并发症、糖尿病控制和低血糖主观认识的维度。较弱的 SOC 与 HbA1c 和低血糖维度的主观认识较差独立相关。此外，在男性中，较弱的 SOC 与并发症因素之间存在关联。
如果有改善患者 SOC 的干预措施，可能会改善患者的代谢控制，从而降低糖尿病并发症的发生率。
