Guo Haijian, Wang Xuanxuan, Mao Tao, Li Xiaoning, Wu Ming, Chen Jiaying
School of Health Policy and Management, Nanjing Medical University, Nanjing, Jiangsu Province, China.
Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, Jiangsu Province, China.
PLoS One. 2018 Jan 25;13(1):e0190484. doi: 10.1371/journal.pone.0190484. eCollection 2018.
The deleterious effects of psychosocial outcomes on diabetic patients' health have not been fully investigated yet. This study was aimed to explore how psychosocial outcomes impacted on the health status of Chinese patients with type 2 diabetes.
A mix of stratified sampling and typical sampling were used to select diabetic patients in Jiangsu Province to conduct individual interviews. Health status was measured by EuroQol Visual Analogue Scale (VAS). Psychosocial outcomes were measured by instruments used in the Diabetes Attitudes, Wishes and Needs survey, including psychological well-being, diabetes distress, patient empowerment, self-management, and patient reported healthcare provision. Clinical characteristics measured included diabetes comorbidities, complications and treatment. OLS regression analyses were used to estimate how health status varied with different characteristics.
Altogether 1614 patients with type 2 diabetes aged 18-65 years from 6 districts/counties in Jiangsu Province were included in the study. With general characteristics and clinical factors controlled for, psychological well-being among all psychosocial outcomes had the most significant association with health status, with a difference of 9.2 in VAS scores between likely depression and good well-being. VAS scores were also significantly lower in patients with high diabetes distress and significantly higher in those more frequently conducting physical activities. Other psychosocial outcomes were not significantly associated with health status.
Likely depression and diabetes-related distress are negatively associated with health status while frequently conducting physical activities are positively associated with health status of type 2 diabetes patients aged 18-65 years from 6 districts/counties in Jiangsu Provinces. These findings underscore the necessity of undertaking routine assessment for depression and diabetes distress and prioritizing interventions on promoting regular physical activities in diabetic patients to improve health management and achieve better health outcomes.
心理社会因素对糖尿病患者健康的有害影响尚未得到充分研究。本研究旨在探讨心理社会因素如何影响中国2型糖尿病患者的健康状况。
采用分层抽样和典型抽样相结合的方法，选取江苏省的糖尿病患者进行个体访谈。健康状况采用欧洲五维度健康量表视觉模拟评分法（VAS）进行测量。心理社会因素采用糖尿病态度、愿望和需求调查问卷中的工具进行测量，包括心理健康、糖尿病困扰、患者赋权、自我管理以及患者报告的医疗服务提供情况。所测量的临床特征包括糖尿病合并症、并发症及治疗情况。采用普通最小二乘法回归分析来估计健康状况如何随不同特征而变化。
本研究共纳入了来自江苏省6个区/县的1614例年龄在18 - 65岁之间的2型糖尿病患者。在控制了一般特征和临床因素后，所有心理社会因素中，心理健康与健康状况的关联最为显著，可能存在抑郁与良好心理健康状态的VAS评分差异为9.2。糖尿病困扰程度高的患者VAS评分也显著较低，而体育活动频率较高的患者VAS评分显著较高。其他心理社会因素与健康状况无显著关联。
对于来自江苏省6个区/县的18 - 65岁2型糖尿病患者，可能存在的抑郁和糖尿病相关困扰与健康状况呈负相关，而经常进行体育活动与健康状况呈正相关。这些发现强调了对抑郁和糖尿病困扰进行常规评估的必要性，并优先对糖尿病患者促进规律体育活动进行干预，以改善健康管理并取得更好的健康结果。
