Köbling Tamás, Váradi Zita, Katona Éva, Somodi Sándor, Kempler Péter, Páll Dénes, Zrínyi Miklós
Department of Medicine, University of Debrecen, Debrecen, Hungary.
Emergency Clinic, University of Debrecen, Debrecen, Hungary.
J Int Med Res. 2020 Jun;48(6):300060520931284. doi: 10.1177/0300060520931284.
To predict dietary self-efficacy behaviors in high glycosylated hemoglobin A1c (HbA1c) patients using type D personality (TDP) and other psychosocial measures.
A cross-sectional, predictive research design was implemented. Participants were type 2 diabetes mellitus patients diagnosed more than 2 years prior to the study. Data were collected for demographics, dietary self-efficacy and psychological measures. Spearman's rank-order correlation was used to test for relationships, the Mann-Whitney test was used to test for differences and multiple linear regression was used to examine predictors of dietary self-efficacy.
Lower dietary self-efficacy was strongly correlated with greater social isolation (r = 0.93) and moderately correlated with more mental health problems (r = 0.20) and higher TDP scores (r = 0.17). Higher HbA1c was inversely related to self-reported physical health (r = -0.19). Social and emotional isolation and time since diagnosis predicted dietary self-efficacy (greater isolation was associated with more dietary management difficulties).
Regression outcomes suggested that a 10% decrease in social isolation improves dietary self-efficacy by 30%, a significant boost to therapeutic adherence. We recommend assessment of social isolation to improve dietary self-efficacy and achieve better patient adherence to therapy.
使用D型人格（TDP）和其他心理社会测量方法预测糖化血红蛋白A1c（HbA1c）水平较高患者的饮食自我效能行为。
采用横断面预测性研究设计。参与者为在研究前2年以上被诊断为2型糖尿病的患者。收集了人口统计学、饮食自我效能和心理测量数据。使用Spearman等级相关检验关系，使用Mann-Whitney检验检验差异，并使用多元线性回归检验饮食自我效能的预测因素。
较低的饮食自我效能与更大的社会隔离密切相关（r = 0.93），与更多的心理健康问题中度相关（r = 0.20），与更高的TDP得分中度相关（r = 0.17）。较高的HbA1c与自我报告的身体健康呈负相关（r = -0.19）。社会和情感隔离以及诊断后的时间可预测饮食自我效能（更大的隔离与更多的饮食管理困难相关）。
回归结果表明，社会隔离减少10%可使饮食自我效能提高30%，这对治疗依从性有显著提升。我们建议评估社会隔离情况，以提高饮食自我效能并使患者更好地坚持治疗。
