成人 2 型糖尿病伴初发并发症患者的家庭功能、血糖控制和生活质量评估。
Patient Assessment of Family Function, Glycemic Control and Quality of Life in Adult Patients With Type 2 Diabetes and Incipient Complications.
机构信息
Clinical Metabolic Physiology, Steno Diabetes Center Copenhagen, Copenhagen University Hospital, Gentofte Hospital, Hellerup, Denmark; University College Copenhagen, Institute of Nursing, University College, Copenhagen, Denmark.
Clinical Metabolic Physiology, Steno Diabetes Center Copenhagen, Copenhagen University Hospital, Gentofte Hospital, Hellerup, Denmark; University College Copenhagen, Institute of Nursing, University College, Copenhagen, Denmark.
出版信息
Can J Diabetes. 2019 Apr;43(3):193-200. doi: 10.1016/j.jcjd.2018.09.002. Epub 2018 Sep 17.
OBJECTIVES
Family affects the perception of diabetes self-management in patients with diabetes. Family-related questionnaires have been used to assess family function, but the Brief Family Assessment Measure (Brief FAM-III) has not been used previously in a diabetes population. We aimed to determine whether the family function is associated with glycated hemoglobin levels and quality of life as potential predictors of diabetes self-management.
METHODS
An exploratory study of patients with type 2 diabetes and incipient complications and their relatives using the Brief FAM-III, a self-report questionnaire comprising 3 scales assessing family function according to different perspectives: a general score, a dyadic relationship score and a self-rating score.
RESULTS
We included 127 patients: 72.4% males, mean age 65.23 (SD=10.26) years; glycated hemoglobin levels, 6.9% (SD=0.9%); diabetes duration, 9.1 (SD=0.6) years; and body mass index, 30.8 (SD=0.5) kg/m. Mean FAM-III scores for the 3 scales were 41.7 (SD=1.0), 41.5 (SD=0.9) and 38.5 (SD=1.1), respectively. Correlation coefficients were -0.06 (p=0.37), -0.09 (p=0.18) and -0.12 (p=0.06), showing no significant correlation between scales and glycated hemoglobin levels levels in the 3 perspectives before and after adjustment for confounders. Family function correlated with burden of diabetes at 0.14 (p=0.02), 0.24 (p=0.0003) and 0.16 (p=0.01), respectively, and mental health at -0.21 (p=0.0007), -0.23 (p=0.0005) and -0.25 (p<0.0001), respectively.
CONCLUSION
The results of our study suggest that in patients with type 2 diabetes, family function does not predict the level of glycemic control. However, we found an association among healthy family function, low burden of diabetes and strong mental health, issues that are important for the patients' quality of life, compliance with lifestyle factors and diabetes self-management.
目的
家庭会影响糖尿病患者对自我管理的认知。有一些与家庭相关的调查问卷被用来评估家庭功能，但《简明家庭评估量表》（Brief FAM-III）之前并未在糖尿病患者中使用过。我们旨在确定家庭功能是否与糖化血红蛋白水平和生活质量相关，因为它们可能是糖尿病自我管理的预测因素。
方法
对患有 2 型糖尿病和初发并发症的患者及其家属进行一项探索性研究，使用的是《简明家庭评估量表》（Brief FAM-III），这是一个自我报告问卷，包含 3 个根据不同视角评估家庭功能的量表：一般评分、对偶关系评分和自我评分。
结果
我们共纳入了 127 名患者：72.4%为男性，平均年龄 65.23（标准差=10.26）岁；糖化血红蛋白水平为 6.9%（标准差=0.9%）；糖尿病病程为 9.1（标准差=0.6）年；体重指数为 30.8（标准差=0.5）kg/m²。3 个量表的平均 FAM-III 评分分别为 41.7（标准差=1.0）、41.5（标准差=0.9）和 38.5（标准差=1.1）。在调整混杂因素后，3 个视角的量表评分与糖化血红蛋白水平之间的相关系数分别为-0.06（p=0.37）、-0.09（p=0.18）和-0.12（p=0.06），无显著相关性。家庭功能与糖尿病负担相关，相关系数分别为 0.14（p=0.02）、0.24（p=0.0003）和 0.16（p=0.01），与心理健康相关，相关系数分别为-0.21（p=0.0007）、-0.23（p=0.0005）和-0.25（p<0.0001）。
结论
本研究结果表明，在 2 型糖尿病患者中，家庭功能并不能预测血糖控制水平。然而，我们发现健康的家庭功能、较低的糖尿病负担和较强的心理健康之间存在关联，这些因素对患者的生活质量、对生活方式因素的依从性和糖尿病自我管理都很重要。
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