Department of Dynamic and Clinical Psychology, Sapienza University of Rome, Rome, Italy.
Eur Rev Med Pharmacol Sci. 2019 Jan;23(2):749-754. doi: 10.26355/eurrev_201901_16889.
The aim of the present study was to assess the association among anxiety, depression, stress, social support and emotional abilities with adherence and healthcare spending in type 2 diabetic patients.
Sixty-four patients were enrolled and completed: Interpersonal Processes of Care (IPC), 20-item Toronto Alexithymia Scale (TAS-20), Rapid Stress Assessment Scale (RSAS), Morisky Medication Adherence Scale (MMAS-4), International Physical Activity Questionnaire (IPAQ)-Short Form and a socio-anamnestic questionnaire regarding also the healthcare spending.
Mathematical linear regressions models were performed showing the predictive effects of: anxiety and social support scores (RSAS) on adherence levels (respectively p =. 019; p =. 016); adherence levels on anxiolytic use (p =.04); aggressiveness scores (RSAS) on the number of general check-ups (p =.031); TAS-20 and physician-patient communication (IPC) on the number of hospitalization days (respectively p=.001; p=.008); physician patient decision making (IPC) scores on physical activity (IPAQ) levels (p=.025); physical activity (IPAQ) on the number of medical examinations (p=.039).
An association among psychosocial impairment, adherence and healthcare spending was found. Future studies should investigate the effect of a brief psychological intervention in increasing adherence levels and reducing the healthcare spending in this clinical population.
本研究旨在评估焦虑、抑郁、压力、社会支持和情绪能力与 2 型糖尿病患者的依从性和医疗保健支出之间的关系。
共纳入 64 例患者并完成了以下评估：人际护理过程量表（IPC）、20 项多伦多述情障碍量表（TAS-20）、快速压力评估量表（RSAS）、Morisky 药物依从性量表（MMAS-4）、国际体力活动问卷（IPAQ）-短表以及一份社会病史问卷，也包括医疗保健支出情况。
进行了数学线性回归模型分析，结果显示：焦虑和社会支持评分（RSAS）对依从水平具有预测作用（分别为 p =.019；p =.016）；依从水平对抗焦虑药物的使用具有预测作用（p =.04）；RSAS 的攻击性评分对一般检查次数具有预测作用（p =.031）；TAS-20 和医患沟通（IPC）对住院天数具有预测作用（分别为 p=.001；p=.008）；医患决策（IPC）评分对体力活动（IPAQ）水平具有预测作用（p=.025）；体力活动（IPAQ）对医疗检查次数具有预测作用（p =.039）。
发现了心理社会障碍、依从性和医疗保健支出之间的关联。未来的研究应该调查短期心理干预对增加依从性水平和降低该临床人群医疗保健支出的影响。
