Cooke Debbie, Bond Rod, Lawton Julia, Rankin David, Heller Simon, Clark Marie, Speight Jane
School of Health Sciences, University of Surrey, Guildford, Surrey, GU2 7XH, UK.
School of Psychology, University of Sussex, Brighton, UK.
J Behav Med. 2015 Oct;38(5):817-29. doi: 10.1007/s10865-015-9649-y. Epub 2015 Jun 14.
Few studies have identified determinants of glycemic control (HbA1c) and diabetes-specific quality of life (DSQoL) in adults with type 1 diabetes. To identify factors predicting outcomes following structured diabetes education. 262 participants completed biomedical and questionnaire assessments before, and throughout 1 year of follow-up. The proportion of variance explained ranged from 28 to 62 % (DSQoLS) and 14-20 % (HbA1c). When change in psychosocial variables were examined, reduced hypoglycemia fear, lower 'perceived diabetes seriousness', greater self-efficacy and well-being predicted QoL improvements from baseline to 3-months. Increased frequency of blood glucose testing predicted improvements in HbA1c from baseline to 6-months. Greater benefits may be achieved if programs focus explicitly on psychosocial factors. Self-care behaviours did not predict HbA1c suggesting existing assessment tools need refinement. Evaluation of treatment mechanisms in self-management programs is recommended.
很少有研究确定1型糖尿病成年患者血糖控制（糖化血红蛋白）和糖尿病特异性生活质量（DSQoL）的决定因素。为了确定结构化糖尿病教育后预测结果的因素，262名参与者在1年随访期间及之前完成了生物医学和问卷调查评估。解释的方差比例范围为28%至62%（DSQoLS）和14%至20%（糖化血红蛋白）。当检查心理社会变量的变化时，低血糖恐惧降低、“感知糖尿病严重性”降低、自我效能感和幸福感增强可预测从基线到3个月时生活质量的改善。血糖检测频率增加可预测从基线到6个月时糖化血红蛋白的改善。如果项目明确关注心理社会因素，可能会取得更大的益处。自我护理行为无法预测糖化血红蛋白，这表明现有的评估工具需要改进。建议对自我管理项目中的治疗机制进行评估。
