Kim Chun-Ja, Schlenk Elizabeth A, Kim Dae Jung, Kim Moonsun, Erlen Judith A, Kim Se-Eun
Department of Adult Health Nursing, Ajou University College of Nursing, Suwon, Korea.
University of Pittsburgh School of Nursing, Pittsburgh, Pennsylvania, USA.
J Adv Nurs. 2015 Sep;71(9):2164-75. doi: 10.1111/jan.12682. Epub 2015 May 14.
To examine the mediating role of social support on the relationship of depressive symptoms to medication adherence and self-care activities in Korean adults.
Recent evidence suggests that higher levels of social support are associated with improved medication adherence and self-care activities; however, the role of social support on the relationship of depressive symptoms to medication adherence and self-care activities is less well understood.
A cross-sectional survey.
The data were collected from 311 Korean adults with type 2 diabetes who were taking hypoglycaemic agents in the period 2012-2013. Depressive symptoms, social support, medication adherence and self-care activities were assessed using structured questionnaires. Multiple regression analysis with adjustment for covariates and the Sobel test were used to examine the mediating effect of social support on the relationship of depressive symptoms to medication adherence and self-care activities.
There were statistically significant differences by subgroups with and without depressive symptoms in social support, medication adherence and self-care activities of diet, physical activity and stress management. The Sobel test confirmed that social support mediated the effect of depressive symptoms on medication adherence and self-care activities of diet, physical activity and stress management.
The evidence from this study suggests that social support-enhancing interventions that also manage depressive symptoms may be more timely and effective than interventions that target depressive symptoms alone in promoting adherence to medication adherence and self-care activities in this population.
探讨社会支持在韩国成年人抑郁症状与药物治疗依从性及自我护理活动关系中的中介作用。
近期证据表明，较高水平的社会支持与更好的药物治疗依从性及自我护理活动相关；然而，社会支持在抑郁症状与药物治疗依从性及自我护理活动关系中的作用尚不清楚。
横断面调查。
数据收集自2012 - 2013年期间311名正在服用降糖药的韩国2型糖尿病成年人。使用结构化问卷评估抑郁症状、社会支持、药物治疗依从性及自我护理活动。采用对协变量进行调整的多元回归分析和索贝尔检验，以检验社会支持在抑郁症状与药物治疗依从性及自我护理活动关系中的中介作用。
在社会支持、药物治疗依从性以及饮食、体育活动和压力管理的自我护理活动方面，有抑郁症状和无抑郁症状的亚组之间存在统计学上的显著差异。索贝尔检验证实，社会支持介导了抑郁症状对药物治疗依从性以及饮食、体育活动和压力管理的自我护理活动的影响。
本研究证据表明，在促进该人群的药物治疗依从性和自我护理活动方面，同时管理抑郁症状的增强社会支持干预措施可能比单独针对抑郁症状的干预措施更及时、有效。
