a Alice Ramez Chagoury School of Nursing, Lebanese American University , Byblos , Lebanon.
b Center for Health Disparities Research, Medical University of South Carolina , Charleston , SC , USA.
Ethn Health. 2019 Oct;24(7):767-778. doi: 10.1080/13557858.2017.1373075. Epub 2017 Sep 4.
Achieving and sustaining optimal glycemic control in type 2 diabetes (T2DM) is difficult because of socio-cultural and psychosocial factors including diabetes fatalism. Diabetes fatalism is 'a complex psychological cycle characterized by perceptions of despair, hopelessness, and powerlessness'. The purpose of this paper is to explore whether diabetes fatalism and other psychosocial and socio-cultural variables are correlates of glycemic control in Lebanese population with T2DM. A convenience sample of 280 adult participants with T2DM were recruited from a major hospital in greater Beirut-Lebanon area and from the community. Diabetes fatalism was assessed using the Arabic version of 12-item Diabetes Fatalism Scale. Multiple linear regression models were used to assess the relationship between HbA1c and psychosocial and socio-cultural characteristics including diabetes fatalism. Four models were run to examine the independent association between HbA1c and diabetes fatalism and to identify which of the 3 subscales (emotional distress, spiritual coping and perceived self-efficacy) were associated with HbA1c. The mean age of the participants was 58.24(SD = 13.48) and the majority were females (53.76%), while 32.73% of the sample had diabetes for more than 10 years. Fully adjusted multiple linear regression models showed that higher scores on diabetes fatalism and the emotional distress subscale ( = 0.018) were significantly associated with higher HbA1c values. In addition, having diabetes for more than 11 years ( = 0.05) and a higher number of diabetes complications ( < 0.001) were associated with higher HbA1c levels. However, advanced age ( = 0.055), female gender ( = 0.003), and diabetes education ( = 0.011) were significantly associated with lower HbA1c levels. This is the first study in the Arab region that identifies diabetes fatalism as an independent predictor of glycemic control among Lebanese. Future studies should further investigate this construct to guide interventions that can address it for better diabetes outcomes.
实现并维持 2 型糖尿病（T2DM）患者的最佳血糖控制非常困难，这是由于包括糖尿病宿命论在内的社会文化和心理社会因素所致。糖尿病宿命论是“一种复杂的心理循环，其特征是绝望、无助和无力感”。本文旨在探讨在黎巴嫩 T2DM 人群中，糖尿病宿命论和其他心理社会及社会文化变量是否与血糖控制相关。从贝鲁特-黎巴嫩地区的一家大医院和社区招募了 280 名成年 T2DM 患者作为便利样本。使用阿拉伯语版 12 项糖尿病宿命论量表评估糖尿病宿命论。采用多元线性回归模型评估 HbA1c 与心理社会和社会文化特征（包括糖尿病宿命论）之间的关系。共进行了 4 个模型的运行，以检验 HbA1c 与糖尿病宿命论之间的独立关联，并确定 3 个分量表（情绪困扰、精神应对和感知自我效能）中哪些与 HbA1c 相关。参与者的平均年龄为 58.24（SD=13.48），大多数为女性（53.76%），而 32.73%的样本患有糖尿病超过 10 年。完全调整后的多元线性回归模型显示，糖尿病宿命论得分较高和情绪困扰分量表得分较高（=0.018）与 HbA1c 值较高显著相关。此外，患有糖尿病超过 11 年（=0.05）和患有更多糖尿病并发症（<0.001）与较高的 HbA1c 水平相关。然而，年龄较大（=0.055）、女性（=0.003）和糖尿病教育（=0.011）与较低的 HbA1c 水平显著相关。这是在阿拉伯地区进行的第一项确定糖尿病宿命论是黎巴嫩人血糖控制的独立预测因素的研究。未来的研究应进一步探讨这一结构，以指导可以解决这一问题的干预措施，从而改善糖尿病结局。
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