Wardian Jana, Sun Fei
Soc Work. 2015 Apr;60(2):175-82. doi: 10.1093/sw/swv001.
The purpose of this study is to understand changes in thinking in patients with diabetes and factors related to the health care providers and significant others that would mediate changes in thinking. Cross-sectional data were collected from three sites. Adults age 21 and older with type 2 diabetes were asked about their thinking regarding diabetes at diagnosis and the present time. In addition, respondents were asked questions about their perceptions of health care providers (that is, physicians, nurses, diabetes educators), significant others, and manage- ment of diabetes. Significant other blame and self-efficacy were found to be partial mediators in thinking about diabetes; the model explained 29 percent of the variance. Social workers are uniquely trained in the person-in-environment framework, which allows flexibility in creating interventions to provide patients with diabetes the support necessary to have a more positive orientation toward diabetes self-management, increase self-efficacy, and reduce feelings of blame from significant others. Improving the support of significant others and the patients' level of self-efficacy can provide mediation of negative thinking, which may result in an environment that supports improved diabetes self-management behaviors.
本研究的目的是了解糖尿病患者思维的变化以及与医疗保健提供者和重要他人相关的因素，这些因素将介导思维的变化。横断面数据是从三个地点收集的。年龄在21岁及以上的2型糖尿病成年人被问及他们在诊断时和目前对糖尿病的看法。此外，还询问了受访者对医疗保健提供者（即医生、护士、糖尿病教育者）、重要他人以及糖尿病管理的看法。研究发现，重要他人的责备和自我效能感是糖尿病思维的部分中介因素；该模型解释了29%的方差。社会工作者在人在环境框架方面接受过独特的培训，这使得在制定干预措施时具有灵活性，能够为糖尿病患者提供必要的支持，使其对糖尿病自我管理有更积极的态度，提高自我效能感，并减少来自重要他人的责备感。改善重要他人的支持和患者的自我效能感水平可以介导消极思维，这可能会营造一个支持改善糖尿病自我管理行为的环境。
