Steno Health Promotion Center, Steno Diabetes Center, Gentofte, Denmark.
Diabet Med. 2012 May;29(5):654-61. doi: 10.1111/j.1464-5491.2011.03485.x.
To investigate the relationship between structural and functional social support and patient activation, diabetes-related emotional distress, perceived diabetes care, self-management behaviour and HbA(1c) levels among patients with Type 2 diabetes.
Self-administered questionnaires were collected from 2572 patients with Type 2 diabetes. After adjusting for gender, age and education, Tobit and logistic regression models were used to examine associations between social network and patient activation, psychosocial problems, self-management behaviours and HbA(1c) levels.
Frequent contact with friends was associated with more positive scores for activation, fewer psychosocial problems, more positive assessment of care and health-promoting self-management behaviours such as frequent exercising and frequent foot examinations. Frequent contact with family was associated with more positive assessments of care. Living with a partner was associated with lower prevalence of smoking, a higher frequency of foot examinations and higher HbA(1c) levels. A poor functional social network, measured as perceived lack of help in the event of severe illness, was associated with low patient activation, greater emotional distress, negative assessment of care, less health-promoting eating habits and less frequent foot examinations.
Good social support is significantly associated with health-promoting behaviours and well-being among patients with Type 2 diabetes. However, HbA(1c) levels are higher for cohabitant persons, indicating barriers for social support. Intervention research is needed to investigate the causal relationship between social networks and health-promoting behaviours. This knowledge should be used in clinical practice when targeting and designing education, support and care for patients with Type 2 diabetes.
调查 2 型糖尿病患者结构性和功能性社会支持与患者激活、糖尿病相关情绪困扰、感知到的糖尿病护理、自我管理行为以及糖化血红蛋白（HbA1c）水平之间的关系。
从 2572 名 2 型糖尿病患者中收集了自我管理问卷。在调整了性别、年龄和教育程度后，使用 Tobit 和逻辑回归模型来检验社会网络与患者激活、心理社会问题、自我管理行为和 HbA1c 水平之间的关联。
与朋友频繁接触与更积极的激活评分、较少的心理社会问题、对护理的更积极评价以及更积极的促进健康的自我管理行为（如经常锻炼和经常检查足部）相关。与家人频繁接触与对护理的更积极评价相关。与伴侣一起生活与吸烟率较低、更频繁的足部检查和更高的 HbA1c 水平相关。功能不良的社会网络，表现为在发生严重疾病时感知到缺乏帮助，与患者激活度低、情绪困扰更大、对护理的负面评价、促进健康的饮食习惯较差以及足部检查频率较低相关。
良好的社会支持与 2 型糖尿病患者的促进健康行为和幸福感显著相关。然而，同居者的 HbA1c 水平较高，表明社会支持存在障碍。需要进行干预研究来调查社会网络与促进健康行为之间的因果关系。在针对 2 型糖尿病患者进行教育、支持和护理时，应该利用这些知识。
