School of Social Work, Arizona State University, Phoenix, AZ
Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA.
Diabetes Care. 2018 Jun;41(6):1149-1156. doi: 10.2337/dc17-2000. Epub 2018 Mar 27.
This study examined whether changes in depressive symptoms and social support prospectively predicted diabetes management among Hispanic patients with probable depression in patient-centered medical homes at safety-net clinics in East Los Angeles, CA.
Data were collected from 251 patients enrolled in a randomized clinical trial testing the effectiveness of a self-management intervention assisted by a promotora (Hispanic community health worker). Cross-lagged analyses examined associations between changes in depression symptoms and social support between baseline and 6-month follow-up and self-efficacy and adherence to diabetes management at the 6- and 12-month follow-ups.
Changes in depressive symptoms predicted self-efficacy and level of adherence at the 6- and 12-month follow-ups. Changes in total social support and emotional social support were correlated only with self-efficacy regarding diabetes management at 6-month follow-up.
Decline in depressive symptoms is a reliable predictor of improvement in self-efficacy and adherence to diabetes management. Further studies are recommended to study psychosocial mechanisms related to social relationships other than social support that affect diabetes management.
本研究旨在探讨在加利福尼亚州东洛杉矶的医疗保障诊所中，以患者为中心的医疗之家内，患有可能抑郁的西班牙裔患者的抑郁症状和社会支持的变化是否可以预测其糖尿病管理情况。
本研究的数据来自 251 名参与随机临床试验的患者，该试验测试了在 promotora（西班牙裔社区健康工作者）协助下进行自我管理干预的有效性。交叉滞后分析考察了基线和 6 个月随访之间抑郁症状和社会支持变化与 6 个月和 12 个月随访时自我效能和糖尿病管理依从性之间的关联。
抑郁症状的变化可预测 6 个月和 12 个月随访时的自我效能和依从性。总的社会支持和情感社会支持的变化仅与 6 个月随访时的糖尿病管理自我效能相关。
抑郁症状的减轻是自我效能和糖尿病管理依从性改善的可靠预测因素。建议进一步研究与社会关系相关的心理社会机制，这些机制除了社会支持外，还会影响糖尿病管理。
