Osborn Chandra Y, Mayberry Lindsay Satterwhite, Wagner Julie A, Welch Garry W
Vanderbilt University Medical Center, Nashville, TN, USA
Vanderbilt University Medical Center, Nashville, TN, USA.
West J Nurs Res. 2014 Oct;36(9):1091-110. doi: 10.1177/0193945914524639. Epub 2014 Feb 25.
Studies examining the impact of stressors on diabetes self-care have focused on a single stressor or have been largely qualitative. Therefore, we assessed the stressors experienced by a high-risk population with type 2 diabetes, and tested whether having more stressors was associated with less adherence to multiple self-care behaviors. Participants were recruited from a Federally Qualified Health Center and 192 completed a stressors checklist. Experiencing more stressors was associated with less adherence to diet recommendations and medications among participants who were trying to be adherent, but was not associated with adherence to other self-care behaviors. Because having more stressors was also associated with more depressive symptoms, we further adjusted for depressive symptoms. Stressors remained associated with less adherence to medications, but not to diet recommendations. For adults engaged in adherence, experiencing an accumulation of stressors presents barriers to adherence that are distinct from associated depressive symptoms.
研究应激源对糖尿病自我护理的影响时，要么聚焦于单一应激源，要么大多是定性研究。因此，我们评估了2型糖尿病高危人群所经历的应激源，并测试了应激源越多是否与多种自我护理行为的依从性越低相关。参与者从一家联邦合格健康中心招募，192人完成了应激源清单。在试图保持依从性的参与者中，经历更多应激源与饮食建议和药物治疗的依从性较低相关，但与其他自我护理行为的依从性无关。由于应激源越多也与更多抑郁症状相关，我们进一步对抑郁症状进行了调整。应激源仍然与药物治疗的依从性较低相关，但与饮食建议无关。对于努力保持依从性的成年人来说，经历应激源的累积会带来与相关抑郁症状不同的依从性障碍。
