Shao Yechang, Liang Lu, Shi Linjing, Wan Chengsong, Yu Shouyi
Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China.
School of Public Health, Southern Medical University, Guangzhou, China.
J Diabetes Res. 2017;2017:2804178. doi: 10.1155/2017/2804178. Epub 2017 May 25.
Ample evidence suggests that social support, self-efficacy, and adherence significantly, independently, and together affect glycemic control in patients with type 2 diabetes mellitus (T2DM), but the pathway from social support to glycemic control remains unclear. This study hypothesized that the effect of social support on glycemic control was mediated sequentially by self-efficacy and adherence. Patients with T2DM were recruited from two hospitals in Guangzhou, China, from January 1 to July 31, 2014, and their sociodemographic clinical data and their assessments on social support, self-efficacy, and adherence were obtained from medical records and self-completed questionnaires. Of the 532 patients who participated, 35% achieved glycemic control (i.e., HbA1c < 7%). Social support, self-efficacy, and adherence had significant correlations with each other and with glycemic control ( < 0.05). Regression analyses and structural equation modeling showed that better social support was associated to better patient self-efficacy, which, in turn, was associated with better medical adherence, which was associated with improved glycemic control, and the relationship between social support and glycemic control was sequentially and completely mediated by self-efficacy and adherence. The five goodness-of-fit indices confirmed that our data fitted the hypothesized pathway model strongly.
大量证据表明，社会支持、自我效能感和依从性分别显著地、独立地以及共同影响2型糖尿病（T2DM）患者的血糖控制，但社会支持与血糖控制之间的途径仍不明确。本研究假设社会支持对血糖控制的影响依次由自我效能感和依从性介导。2014年1月1日至7月31日，从中国广州的两家医院招募了T2DM患者，并从病历和自行填写的问卷中获取了他们的社会人口学临床数据以及他们对社会支持、自我效能感和依从性的评估。在参与的532名患者中，35%实现了血糖控制（即糖化血红蛋白<7%）。社会支持、自我效能感和依从性彼此之间以及与血糖控制均存在显著相关性（<0.05）。回归分析和结构方程模型表明，更好的社会支持与更好的患者自我效能感相关，而自我效能感又与更好的医疗依从性相关，医疗依从性又与改善的血糖控制相关，并且社会支持与血糖控制之间的关系依次并完全由自我效能感和依从性介导。五个拟合优度指标证实我们的数据与假设的途径模型高度拟合。
