Tregea Hannah, Lee Christina, Browne Jessica L, Pouwer Frans, Speight Jane
a School of Psychology , The University of Queensland , St Lucia , Australia.
b The Australian Centre for Behavioural Research in Diabetes , Melbourne , Australia.
Psychol Health. 2016 May;31(5):592-604. doi: 10.1080/08870446.2015.1128543. Epub 2016 Jan 11.
Quality of health care (QoC) and self-efficacy may affect self-management of diabetes, but such effects are not well understood. We examined the indirect role of diabetes-specific self-efficacy (DSE) and generalised self-efficacy (GSE) in mediating the cross-sectional relationship between self-reported QoC and diabetes self-management.
Diabetes MILES-Australia was a national survey of 3,338 adults with diabetes. We analysed data from 1,624 respondents (age: M = 52.1, SD = 13.9) with type 1 (T1D; n = 680) or type 2 diabetes (T2D; n = 944), who responded to a version of the survey containing key measures.
self-reported healthy eating, physical activity, self-monitoring of blood glucose frequency, HbA1c, medication/insulin adherence.
We used Preacher and Hayes' bootstrapping method, controlling for age, gender and diabetes duration, to test mediation of DSE and GSE on the relationship of QoC with each self-management variable. We found statistically significant but trivial mediation effects of DSE and of GSE on most, but not all, variables (all effect sizes < .06).
Support for mediation was weak, suggesting that relationships amongst these variables are small and that future research might explore other aspects of self-management in diabetes.
医疗保健质量（QoC）和自我效能感可能会影响糖尿病的自我管理，但此类影响尚未得到充分理解。我们研究了糖尿病特异性自我效能感（DSE）和一般自我效能感（GSE）在介导自我报告的QoC与糖尿病自我管理之间的横断面关系中的间接作用。
澳大利亚糖尿病MILES研究是一项针对3338名成年糖尿病患者的全国性调查。我们分析了1624名受访者（年龄：M = 52.1，标准差 = 13.9）的数据，这些受访者患有1型糖尿病（T1D；n = 680）或2型糖尿病（T2D；n = 944），他们对包含关键测量指标的调查问卷版本做出了回应。
自我报告的健康饮食、身体活动、血糖自我监测频率、糖化血红蛋白（HbA1c）、药物/胰岛素依从性。
我们采用Preacher和Hayes的自抽样法，控制年龄、性别和糖尿病病程，以检验DSE和GSE对QoC与各自我管理变量之间关系的中介作用。我们发现，DSE和GSE对大多数（但并非全部）变量具有统计学上显著但微小的中介效应（所有效应量 < 0.06）。
对中介作用的支持较弱，这表明这些变量之间的关系较小，未来的研究可能会探索糖尿病自我管理的其他方面。
