Campbell Jennifer A, Walker Rebekah J, Smalls Brittany L, Egede Leonard E
Center for Patient Care and Outcomes Research (PCOR), Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, WI, 53226, USA.
Division of General Internal Medicine, Medical College of Wisconsin, Milwaukee, WI, USA.
BMC Endocr Disord. 2017 Jun 20;17(1):34. doi: 10.1186/s12902-017-0185-3.
To examine whether the social adaptability index (SAI) alone or components of the index provide a better explanatory model for self-care and diabetes outcomes.
Six hundred fifteen patients were recruited from two primary care settings. A series of multiple linear regression models were run to assess (1) associations between the SAI and diabetes self-care/outcomes, and (2) associations between individual SAI indicator variables and diabetes self-care/outcomes. Separate models were run for each self-care behavior and outcome. Two models were run for each dependent variable to compare associations with the SAI and components of the index.
The SAI has a significant association with the mental component of quality of life (0.23, p < 0.01). In adjusted analyses, the SAI score did not have a significant association with any of the self-care behaviors. Individual components from the index had significant associations between self-care and multiple SAI indicator variables. Significant associations also exist between outcomes and the individual SAI indicators for education and employment.
In this population, the SAI has low explanatory power and few significant associations with diabetes self-care/outcomes. While the use of a composite index to predict outcomes within a diabetes population would have high utility, particularly for clinical settings, this SAI lacks statistical and clinical significance in a representative diabetes population. Based on these results, the index does not provide a good model fit and masks the relationship of individual components to diabetes self-care and outcomes. These findings suggest that five items alone are not adequate to explain or predict outcomes for patients with type 2 diabetes.
探讨单独使用社会适应能力指数（SAI）或该指数的各个组成部分是否能为自我护理和糖尿病结局提供更好的解释模型。
从两个初级保健机构招募了615名患者。运行一系列多元线性回归模型以评估：（1）SAI与糖尿病自我护理/结局之间的关联，以及（2）各个SAI指标变量与糖尿病自我护理/结局之间的关联。针对每种自我护理行为和结局运行单独的模型。针对每个因变量运行两个模型，以比较与SAI及其指数组成部分的关联。
SAI与生活质量的心理成分有显著关联（0.23，p <0.01）。在调整分析中，SAI得分与任何自我护理行为均无显著关联。该指数中的各个组成部分在自我护理与多个SAI指标变量之间存在显著关联。结局与教育和就业的个体SAI指标之间也存在显著关联。
在该人群中，SAI的解释力较低，与糖尿病自我护理/结局的显著关联较少。虽然使用综合指数来预测糖尿病人群的结局会有很高的效用，特别是在临床环境中，但该SAI在具有代表性的糖尿病人群中缺乏统计学和临床意义。基于这些结果，该指数不能提供良好的模型拟合，并且掩盖了个体组成部分与糖尿病自我护理和结局之间的关系。这些发现表明，仅五项内容不足以解释或预测2型糖尿病患者的结局。
