Department of Preventive Medicine, Northwestern University Feinberg School of Medicine.
Institute for Health Research and Policy and Community Health Sciences, School of Public Health, University of Illinois.
Health Psychol. 2014 Jul;33(7):597-607. doi: 10.1037/hea0000043. Epub 2013 Dec 23.
This study aimed to examine diabetes self-care (DSC) patterns in low-income African American and Latino patients with Type 2 diabetes, and identify patient-related, biomedical/disease-related, and psychosocial correlates of DSC.
We performed cross-sectional analysis of survey data from African Americans and Latinos aged ≥18 years with Type 2 diabetes (n = 250) participating in a diabetes self-management intervention at 4 primary care clinics. The Summary of Diabetes Self-Care Activities captured the subcomponents of healthy eating, physical activity, blood sugar testing, foot care, and smoking. Correlates included patient-related attributes, biomedical/disease-related factors, and psychosocial constructs, with their multivariable influence assessed with a 3-step model building procedure using regression techniques.
Baseline characteristics were as follows: mean age of 53 years (SD = 12.4); 69% female; 53% African American; 74% with incomes below $20,000; and 60% with less than a high school education. DSC performance levels were highest for foot care (4.5/7 days) and lowest for physical activity (2.5/7 days). Across racial/ethnic subgroups, diabetes-related distress was the strongest correlate for DSC when measured as a composite score. Psychosocial factors accounted for 14% to 33% of variance in self-care areas for both racial/ethnic groups. Patient characteristics were more salient correlates in Hispanic/Latinos when examining the self-care subscales, particularly those requiring monetary resources.
Important information is provided on specific DSC patterns in a sample of ethnic/racial minorities with Type 2 diabetes. Significant correlates found may help with identification and intervention of patients who may benefit from strategies to increase self-care adherence.
本研究旨在调查低收入非裔美国人和拉丁裔 2 型糖尿病患者的糖尿病自我护理（DSC）模式，并确定与 DSC 相关的患者相关、生物医学/疾病相关和心理社会因素。
我们对 4 家初级保健诊所参与糖尿病自我管理干预的年龄≥18 岁的非裔美国人和拉丁裔 2 型糖尿病患者（n=250）的调查数据进行了横断面分析。糖尿病自我护理活动摘要记录了健康饮食、体力活动、血糖检测、足部护理和吸烟等亚组分。相关因素包括患者相关属性、生物医学/疾病相关因素和心理社会结构，使用回归技术的 3 步模型构建程序评估其多变量影响。
基线特征如下：平均年龄为 53 岁（标准差=12.4）；69%为女性；53%为非裔美国人；74%的收入低于 20000 美元；60%的受教育程度低于高中。DSC 表现水平最高的是足部护理（4.5/7 天），最低的是体力活动（2.5/7 天）。在不同种族/族裔亚组中，当以综合评分衡量时，糖尿病相关困扰是 DSC 的最强相关因素。心理社会因素占两组自我护理领域变异的 14%至 33%。在检查自我护理亚组时，患者特征在西班牙裔/拉丁裔中是更重要的相关因素，特别是那些需要货币资源的相关因素。
本研究为 2 型糖尿病少数民族样本中特定 DSC 模式提供了重要信息。发现的重要相关因素可能有助于识别和干预可能受益于增加自我护理依从性策略的患者。
