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2型糖尿病诊断对心理健康、生活质量和社会交往的影响:一项纵向研究

Impact of a type 2 diabetes diagnosis on mental health, quality of life, and social contacts: a longitudinal study.

作者信息

Feng Xiaoqi, Astell-Burt Thomas

机构信息

Population Wellbeing and Environment Research Lab (PowerLab), School of Health and Society, Faculty of Social Sciences, University of Wollongong, Wollongong, New South Wales, Australia; Early Start Research Institute, Faculty of Social Sciences, University of Wollongong, Wollongong, New South Wales, Australia; Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, New South Wales, Australia.

出版信息

BMJ Open Diabetes Res Care. 2017 Feb 16;5(1):e000198. doi: 10.1136/bmjdrc-2016-000198. eCollection 2017.

Abstract

AIMS

The aim was to examine whether a type 2 diabetes mellitus (T2DM) diagnosis increases the odds of psychological distress, a worsening in overall quality of life, and a potential reduction in social contacts.

METHOD

Longitudinal data were obtained from the 45 and Up Study (baseline 2006-2008; 3.4±0.95 years follow-up time). Fixed effects logistic and negative binomial regression models were fitted on a complete case on outcome sample that did not report T2DM at baseline (N=26 344), adjusted for time-varying confounders. The key exposure was doctor-diagnosed T2DM at follow-up. Outcome variables examined included the Kessler Psychological Distress Scale, self-rated quality of life, and four indicators of social contacts.

RESULTS

A modest increase in the odds of psychological distress associated with T2DM diagnosis (OR=1.30) was not statistically significant (95% CI 0.75 to 2.25). A T2DM diagnosis was associated with a fivefold increase in the odds of a participant reporting that their quality of life had become significantly poorer (OR 5.49, 95% CI 1.26 to 23.88). T2DM diagnosis was also associated with a reduction in times spent with friends and family (RR 0.88, 95% CI 0.82 to 0.95), contacts by telephone (RR 0.95, 95% CI 0.87 to 1.02), attendance at social clubs or religious groups (RR 0.82, 95% CI 0.73 to 0.91), and the number of people nearby but outside the home that participants felt they could rely on (RR 0.92, 95% CI 0.86 to 0.98).

CONCLUSIONS

A T2DM diagnosis can have important impacts on quality of life and on social contacts, which may have negative impacts on mental health and T2DM management in the longer term.

摘要

目的

本研究旨在探讨2型糖尿病(T2DM)诊断是否会增加心理困扰的几率、导致总体生活质量恶化以及可能减少社交联系。

方法

纵向数据取自45岁及以上研究(基线时间为2006 - 2008年;随访时间为3.4±0.95年)。对基线时未报告T2DM的完整病例结局样本(N = 26344)拟合固定效应逻辑回归和负二项回归模型,并对随时间变化的混杂因素进行调整。关键暴露因素为随访时医生诊断的T2DM。所检查的结局变量包括凯斯勒心理困扰量表、自评生活质量以及四个社交联系指标。

结果

与T2DM诊断相关的心理困扰几率适度增加(OR = 1.30),但无统计学意义(95%CI 0.75至2.25)。T2DM诊断与参与者报告其生活质量显著变差的几率增加五倍相关(OR 5.49,95%CI 1.26至23.88)。T2DM诊断还与与朋友和家人相处时间减少(RR 0.88,95%CI 0.82至0.95)、电话联系减少(RR 0.95,95%CI 0.87至1.02)、参加社交俱乐部或宗教团体减少(RR 0.82,95%CI 0.73至0.91)以及参与者感觉可以依靠的家附近但不在家的人数减少(RR 0.92,95%CI 0.86至0.98)相关。

结论

T2DM诊断可能对生活质量和社交联系产生重要影响,从长远来看,这可能对心理健康和T2DM管理产生负面影响。

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