1 Oklahoma State University, Stillwater, USA.
2 University of Minnesota Medical School, Duluth, , USA.
J Fam Nurs. 2018 Nov;24(4):621-639. doi: 10.1177/1074840718810550. Epub 2018 Nov 29.
American Indian (AI) communities experience a disproportionate rate of Type 2 diabetes (T2D) and cumulative exposure to stress. Although this link is well researched among various populations, it has not been examined among AI communities. Path analysis was used to examine a multiple-mediator model to explain how caregiver stress influences self-reported mental and physical health among 100 AI participants with T2D. Caregiver stress was negatively associated with physical and mental health. Physical health was positively associated with family/community connectedness and mental health was positively associated with both family support and connectedness. The relationship between caregiver stress and mental health was partially mediated by family/community connectedness; caregiver stress had no indirect effects on physical health via either hypothesized mediator. Findings demonstrate the importance of integrating individuals' connection to family and community and its influence on caregiver stress and mental health in intervention programs targeting diabetes management and care among AI communities.
美国印第安人（AI）社区经历着不成比例的 2 型糖尿病（T2D）和累积压力。尽管这种联系在各种人群中都有很好的研究，但在 AI 社区中尚未得到检验。路径分析用于检验一个多中介模型，以解释照顾者压力如何影响 100 名患有 T2D 的 AI 参与者自我报告的心理健康和身体健康。照顾者压力与身体健康和心理健康呈负相关。身体健康与家庭/社区联系呈正相关，心理健康与家庭支持和联系呈正相关。照顾者压力与心理健康之间的关系部分由家庭/社区联系介导；照顾者压力通过任何假设的中介都没有对身体健康产生间接影响。研究结果表明，在针对 AI 社区的糖尿病管理和护理的干预计划中，将个体与家庭和社区的联系及其对照顾者压力和心理健康的影响纳入其中非常重要。
