在北加利福尼亚糖尿病研究（DISTANCE）中社会支持与生活方式对比医学糖尿病自我管理
Social support and lifestyle vs. medical diabetes self-management in the diabetes study of Northern California (DISTANCE).
作者信息
Rosland Ann Marie, Piette John D, Lyles Courtney R, Parker Melissa M, Moffet Howard H, Adler Nancy E, Schillinger Dean, Karter Andrew J
机构信息
VA Ann Arbor Center for Clinical Management Research, 2800 Plymouth Road, NCRC Building 16, 3rd Floor, Ann Arbor, MI, 48109, USA,
出版信息
Ann Behav Med. 2014 Dec;48(3):438-47. doi: 10.1007/s12160-014-9623-x.
BACKGROUND
In chronic illness self-care, social support may influence some health behaviors more than others.
PURPOSE
Examine social support's association with seven individual chronic illness self-management behaviors: two healthy "lifestyle" behaviors (physical activity, diet) and five more highly skilled and diabetes-specific (medical) behaviors (checking feet, oral medication adherence, insulin adherence, self-monitored blood glucose, primary care appointment attendance).
METHODS
Using cross-sectional administrative and survey data from 13,366 patients with type 2 diabetes, Poisson regression models estimated the adjusted relative risks (ARR) of practicing each behavior at higher vs lower levels of social support.
RESULTS
Higher emotional support and social network scores were significantly associated with increased ARR of both lifestyle behaviors. Both social support measures were also associated with increased ARR for checking feet. Neither measure was significantly associated with other medical behaviors.
CONCLUSIONS
Findings suggest that social support diminished in importance as self-care progresses from lifestyle to more skilled "medical" behaviors.
背景
在慢性病自我护理中，社会支持对某些健康行为的影响可能大于其他行为。
目的
研究社会支持与七种个体慢性病自我管理行为之间的关联：两种健康的“生活方式”行为（体育活动、饮食）以及五种技能要求更高且特定于糖尿病的（医疗）行为（检查足部、口服药物依从性、胰岛素依从性、自我监测血糖、按时就诊初级保健医生）。
方法
利用来自13366名2型糖尿病患者的横断面管理和调查数据，泊松回归模型估计了在社会支持水平较高与较低时实施每种行为的调整后相对风险（ARR）。
结果
较高的情感支持和社交网络得分与两种生活方式行为的ARR增加显著相关。两种社会支持指标也与检查足部的ARR增加相关。两种指标均与其他医疗行为无显著关联。
结论
研究结果表明，随着自我护理从生活方式行为发展到技能要求更高的“医疗”行为，社会支持的重要性逐渐降低。
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