Shin Jinah K, Poltavskiy Eduard, Kim Tae Nyun, Hasan Abdullah, Bang Heejung
Psychiatric Department at Elmhurst Hospital in New York 79-01, Broadway, Elmhurst, NY 11373, USA.
Graduate Group of Epidemiology, Department of Public Health Sciences, School of Medicine, University of California at Davis, Davis, CA, USA.
Prim Care Diabetes. 2017 Feb;11(1):63-70. doi: 10.1016/j.pcd.2016.07.007. Epub 2016 Aug 1.
To investigate patterns of and factors associated with help-seeking behaviors among individuals with diabetes mellitus (DM) and/or serious psychological distress (SPD).
The analysis was conducted with the California Health Interview Survey (CHIS) 2011-2012 of 40,803 adults. Logistic regression was used to examine the associations between the multiple facilitating/preventing factors and outcome, guided by the Andersen's Health Care Utilization Model.
The prevalence of DM and SPD were 10.9% and 3.4%, respectively, among participants in the survey. The participants with DM were more likely to experience SPD than those without DM (OR 1.46, 95% CI=1.11-1.91, p=0.006). Participants with combined DM and SPD, the most underserved, were less likely to perceive the need for mental health services and less likely to seek help, compared to those with only SPD. Need factors (SPD status and perceived need) were significantly associated with help-seeking behaviors for mental health, along with predisposing factors (age, gender, obesity, race, and employment), and enabling factors (insurance, English proficiency).
Perceptions about need for seeking help seem to play an important role in receiving mental health services in addition to other predisposing or enabling factors. Identification of these factors may improve clinical outcomes related to DM and SPD.
调查糖尿病(DM)患者和/或严重心理困扰(SPD)患者寻求帮助行为的模式及相关因素。
采用2011 - 2012年加利福尼亚健康访谈调查(CHIS)对40,803名成年人进行分析。以安德森医疗保健利用模型为指导,采用逻辑回归分析多种促进/阻碍因素与结果之间的关联。
调查参与者中,DM患病率为10.9%,SPD患病率为3.4%。与未患DM的参与者相比,患DM的参与者更易出现SPD(比值比1.46,95%置信区间=1.11 - 1.91,p = =0.006)。与仅患有SPD的参与者相比,患有DM和SPD的参与者(最缺乏服务的群体)更不易意识到对心理健康服务的需求,且寻求帮助的可能性更小。需求因素(SPD状态和感知需求)与心理健康方面的求助行为显著相关,同时还有易患因素(年龄、性别、肥胖、种族和就业情况)以及促成因素(保险、英语水平)。
除其他易患或促成因素外,对寻求帮助需求的认知似乎在获得心理健康服务方面起着重要作用。识别这些因素可能会改善与DM和SPD相关的临床结果。