Hernandez Rosalba, Ruggiero Laurie, Prohaska Thomas R, Chavez Noel, Boughton Seth W, Peacock Nadine, Zhao Weihan, Nouwen Arie
School of Social Work, University of Illinois at Urbana-Champaign, Urban, Illinois, USA (Dr Hernandez, Mr Boughton)
Institute for Health Research and Policy and Community Health Sciences, School of Public Health at University of Illinois at Chicago, Chicago, Illinois, USA (Dr Ruggiero, Dr Chavez, Dr Zhao)
Diabetes Educ. 2016 Aug;42(4):452-61. doi: 10.1177/0145721716654008. Epub 2016 Jun 19.
The purpose of this study is to examine the relationship between depressive symptoms and diabetes self-care in African American and Hispanic/Latino patients with type 2 diabetes and whether the association, if any, is mediated by diabetes-related self-efficacy.
The sample included self-report baseline data of African American and Hispanic/Latino patients with type 2 diabetes who were aged ≥18 years and enrolled in a diabetes self-management intervention study. Depressive symptoms were assessed with the 9-item Patient Health Questionnaire. The Summary of Diabetes Self-care Activities measured engagement in healthy eating, physical activity, blood glucose checking, foot care, and smoking. The Diabetes Empowerment Scale-Short Form assessed diabetes-related psychosocial self-efficacy. Indirect effects were examined with the Baron and Kenny regression technique and Sobel testing.
Sample characteristics (n = 250) were as follows: mean age of 53 years, 68% women, 54% African American, and 74% with income <$20 000. Depressive symptoms showed a significant inverse association with the self-care domains of general diet, specific diet, physical activity, and glucose monitoring in the African American group. In Hispanics/Latinos, depression was inversely associated with specific diet. Self-efficacy served a significant mediational role in the relation between depression and foot care among African Americans.
Self-efficacy mediated the relationship between depression and foot care in the African American group but was not found to be a mediator of any self-care areas within the Hispanic/Latino group. In clinical practice, alleviation of depressive symptoms may improve self-care behavior adherence. Diabetes education may consider inclusion of components to build self-efficacy related to diabetes self-care, especially among African American patients.
本研究旨在探讨非裔美国人和西班牙裔/拉丁裔2型糖尿病患者的抑郁症状与糖尿病自我管理之间的关系，以及这种关联（如果存在）是否由糖尿病相关的自我效能感介导。
样本包括年龄≥18岁且参加糖尿病自我管理干预研究的非裔美国人和西班牙裔/拉丁裔2型糖尿病患者的自我报告基线数据。使用9项患者健康问卷评估抑郁症状。糖尿病自我护理活动总结评估了在健康饮食、体育活动、血糖检查、足部护理和吸烟方面的参与情况。糖尿病赋权量表简版评估了与糖尿病相关的心理社会自我效能感。使用Baron和Kenny回归技术以及Sobel检验来检验间接效应。
样本特征（n = 250）如下：平均年龄53岁，68%为女性，54%为非裔美国人，74%的收入低于20000美元。在非裔美国人群体中，抑郁症状与总体饮食、特定饮食、体育活动和血糖监测的自我护理领域呈显著负相关。在西班牙裔/拉丁裔人群中，抑郁与特定饮食呈负相关。自我效能感在非裔美国人抑郁与足部护理的关系中起显著中介作用。
自我效能感介导了非裔美国人群体中抑郁与足部护理的关系，但在西班牙裔/拉丁裔群体的任何自我护理领域中均未发现其为中介因素。在临床实践中，减轻抑郁症状可能会改善自我护理行为依从性。糖尿病教育可考虑纳入增强与糖尿病自我护理相关的自我效能感的内容，尤其是在非裔美国患者中。
