Miles Shannon R, Khambaty Tasneem, Petersen Nancy J, Naik Aanand D, Cully Jeffrey A
Health Service Research and Development Center of Innovation on Disability and Rehabilitation Research (CINDRR), James A. Haley Veterans' Hospital, 3000 Bruce (B) Downs Boulevard (116A), Tampa, FL, 33612, USA.
Department of Psychiatry & Behavioral Neurosciences, Morsani College of Medicine, University of South Florida, Tampa, FL, 33620, USA.
J Clin Psychol Med Settings. 2018 Mar;25(1):55-65. doi: 10.1007/s10880-017-9527-6.
Many patients with diabetes have poorly controlled blood sugar levels and remain at risk for serious diabetes complications, despite access to effective diabetes treatments and services. Using the transactional model of stress and coping framework, the study investigated the contributions of affect (Positive and Negative Affect Schedule) and coping (maladaptive and adaptive coping from the Brief Cope) on diabetes self-management behaviors, namely diet and exercise. One hundred seventy-eight rural adults with uncontrolled diabetes and moderate depressive symptoms completed the measures. Multiple regression analyses demonstrated that positive affect and negative affect were significantly associated with diet and exercise, even after adjusting for diabetes severity, illness intrusiveness, and diabetes knowledge. However, two path analyses clarified that adaptive coping mediated the relationships between affect (positive and negative) and self-management behaviors (diet and exercise). Comprehensive diabetes treatments that include self-management support can assist patients in recognition and use of adaptive emotion-focused coping skills.
许多糖尿病患者尽管能够获得有效的糖尿病治疗和服务，但其血糖水平仍控制不佳，面临严重糖尿病并发症的风险。该研究采用压力与应对框架的交互模型，调查了情感（正负性情绪量表）和应对方式（简易应对方式问卷中的适应不良和适应性应对）对糖尿病自我管理行为（即饮食和运动）的影响。178名患有未控制糖尿病和中度抑郁症状的农村成年人完成了相关测量。多元回归分析表明，即使在调整了糖尿病严重程度、疾病侵扰性和糖尿病知识之后，积极情感和消极情感仍与饮食和运动显著相关。然而，两项路径分析表明，适应性应对在情感（积极和消极）与自我管理行为（饮食和运动）之间起中介作用。包括自我管理支持在内的综合糖尿病治疗可以帮助患者认识并运用适应性的情绪聚焦应对技巧。
