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基于结构方程模型的2型糖尿病自我管理常识模型,用于理解依从性和生活质量

Common sense model of self-regulation for understanding adherence and quality of life in type 2 diabetes with structural equation modeling.

作者信息

Fall Estelle, Chakroun-Baggioni Nadia, Böhme Philip, Maqdasy Salwan, Izaute Marie, Tauveron Igor

机构信息

Université de Lorraine, APEMAC, F-57000 Metz, France.

Université Clermont Auvergne, CNRS, LAPSCO, F-63000 Clermont-Ferrand, France.

出版信息

Patient Educ Couns. 2021 Jan;104(1):171-178. doi: 10.1016/j.pec.2020.06.023. Epub 2020 Jun 27.

Abstract

OBJECTIVES

The objective of the present study was to test the Common Sense Model of self-regulation (CSM) for its relevance for improving adherence and quality of life in type 2 diabetes.

METHODS

A sample of 253 patients with type 2 diabetes was recruited. They completed questionnaires about their perceptions regarding diabetes, coping strategies, therapeutic adherence and quality of life. Their HbA1c levels were also collected. Structural equation modeling (SEM) was used to check the adequacy of our theoretical model (CSM) with the patient data.

RESULTS

The final model indicated that perceptions were directly and indirectly related to health outcomes through coping strategies and adequately matched the data (χ / df = 561/ 220 = 2.55; RMSEA = 0.08; PCFI = 0.66; PGFI = 0.70). Moreover, the model appeared to be identical for both types of treatment (oral and injectable).

CONCLUSIONS

Illness perceptions and coping strategies, or, more specifically, how patients accept disease and think they are able to manage it, significantly affect therapeutic adherence and quality of life in type 2 diabetes.

PRACTICE IMPLICATIONS

These results pave the way for developing psychological treatments aimed at improving patient acceptance and internal resources (e.g. use of autobiographical memory, Acceptance and Commitment Therapy).

摘要

目的

本研究的目的是检验自我调节常识模型(CSM)对于改善2型糖尿病患者的依从性和生活质量的相关性。

方法

招募了253名2型糖尿病患者。他们完成了关于其对糖尿病的认知、应对策略、治疗依从性和生活质量的问卷调查。还收集了他们的糖化血红蛋白水平。采用结构方程模型(SEM)来检验我们的理论模型(CSM)与患者数据的适配性。

结果

最终模型表明,认知通过应对策略与健康结果直接和间接相关,并且与数据充分匹配(χ²/ df = 561 / 220 = 2.55;RMSEA = 0.08;PCFI = 0.66;PGFI = 0.70)。此外,该模型在两种治疗类型(口服和注射)中似乎是相同的。

结论

疾病认知和应对策略,或者更具体地说,患者如何接受疾病以及认为自己能够应对疾病,会显著影响2型糖尿病患者的治疗依从性和生活质量。

实践意义

这些结果为开发旨在提高患者接受度和内在资源的心理治疗方法(例如使用自传体记忆、接受与承诺疗法)铺平了道路。

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