Department of Human Ecology, University of Alberta, Edmonton, Alberta, Canada.
Br J Health Psychol. 2015 May;20(2):360-73. doi: 10.1111/bjhp.12105. Epub 2014 May 8.
The current study sought to explore the indirect association of spousal overprotection on patient dietary adherence through the mechanism of diabetes distress and whether the link between overprotection and diabetes distress was moderated by spouse active engagement.
Participants were 117 married couples in which one member had been diagnosed with type 2 diabetes and were recruited from a patient registry at a Midwestern (USA) medical centre. Data were gathered from spouses and patients through a self-report survey instrument. The research questions were answered with structural equation modelling using the latent moderated structural equations (LMS) approach and dyadic data analytic procedures.
Overprotection was associated with reduced dietary adherence indirectly via increased diabetes distress only at low levels of active engagement. The proposed model also proved superior when compared to two plausible alternatives.
These findings highlight the importance of understanding the nuanced associations among the different ways spouses cope with illness to achieve better diabetes outcomes and the mechanisms responsible for linking coping and dietary adherence. Statement of contribution What is already known on this subject? Spousal coping behaviour can influence dietary adherence among patients diagnosed with type 2 diabetes, positively and negatively. Spouses simultaneously engage in different ways of coping with partner illness, but little is known about the interactive nature of coping styles or possible mechanisms that might link coping with illness outcomes. What does this study add? Spousal overprotection is only associated with reduced patient dietary adherence when spouses are also engaging in low levels of active engagement. Diabetes distress is an important mechanism linking spousal coping with patient dietary adherence.
本研究旨在探讨配偶过度保护通过糖尿病困扰这一机制对患者饮食依从性的间接影响，以及过度保护与糖尿病困扰之间的联系是否受到配偶积极参与的调节。
参与者为来自美国中西部一家医疗中心患者登记处的 117 对已婚夫妇，其中一方被诊断患有 2 型糖尿病。数据通过自我报告调查工具从配偶和患者处收集。使用潜在调节结构方程（LMS）方法和对偶数据分析程序，通过结构方程模型回答研究问题。
仅在配偶积极参与程度较低的情况下，过度保护与糖尿病困扰的增加呈间接负相关，进而与饮食依从性的降低间接相关。与两种合理的替代方案相比，提出的模型也表现出优越性。
这些发现强调了理解配偶以不同方式应对疾病的细微关联对于实现更好的糖尿病结果的重要性，以及联系应对方式和饮食依从性的潜在机制。
研究贡献 关于这个主题，目前已经知道什么？ 配偶的应对行为会对被诊断患有 2 型糖尿病的患者的饮食依从性产生积极和消极的影响。配偶同时以不同的方式应对伴侣的疾病，但对于应对方式的相互作用性质或可能将应对与疾病结果联系起来的潜在机制知之甚少。 这项研究有什么新发现？ 只有当配偶也表现出低度积极参与时，配偶过度保护才与患者饮食依从性降低有关。糖尿病困扰是将配偶应对与患者饮食依从性联系起来的一个重要机制。
