与2型糖尿病相关的心理社会困扰、临床变量及自我管理活动：加纳的一项研究
Psychosocial distress, clinical variables and self-management activities associated with type 2 diabetes: a study in Ghana.
作者信息
Amankwah-Poku Margaret, Amoah Albert G B, Sefa-Dedeh Araba, Akpalu Josephine
机构信息
Department of Psychology, School of Social Sciences, College of Humanities, University of Ghana, P.O. Box L 84, Legon, Accra, Ghana.
Department of Medicine and Therapeutics, University of Ghana Medical School, College of Health Sciences, University of Ghana, Legon, Accra, Ghana.
出版信息
Clin Diabetes Endocrinol. 2020 Jul 14;6:14. doi: 10.1186/s40842-020-00102-7. eCollection 2020.
AIM
Psychosocial distress can act as a barrier to diabetes self-care management and thus compromise diabetes control. Yet in Ghana, healthcare centres mainly focus on the medical aspect of diabetes to the neglect of psychosocial care. This study determined the relationship amongst psychosocial distress, clinical variables, and self-management activities associated with type 2 diabetes management.
METHOD
Questionnaires were administered to 162 patients from four hospitals in Accra, Ghana, to assess psychosocial distress (e.g. diabetes distress), clinical variables (e.g. glycaemic control), and self- management activities (e.g. medication intake) related to diabetes. In assessing diabetes distress, the use of the PAID allowed evaluation of broader range of emotional concerns (diabetes-related emotional distress), while the DDS allowed evaluation of factors more closely related to diabetes self-management (diabetes distress).
RESULTS
Diabetes-related emotional distress, diabetes distress and depressive symptoms were reciprocally positively correlated, while non-supportive family behaviour correlated negatively with these psychological variables. Diabetes-related emotional distress correlated positively with systolic and diastolic blood pressure, and correlated negatively with exercise regimen. On the other hand, diabetes distress correlated negatively with dietary and exercise regimen and correlated positively with glycaemic levels, while depressive symptoms correlated positively with glycaemic levels, diabetes complication and systolic blood pressure. Contrary to the literature, non-supportive family behaviour correlated positively with diet, exercise and medication regimen.
CONCLUSION
The positive association of psychological variables with glycaemic levels and blood pressure levels, and the positive association of non-supportive family behaviour with self-management activities suggests the need for psychosocial care to be incorporate in the management of type 2 diabetes in Ghana. Patients can be screened for diabetes-related distress and symptoms of depression and provided psychosocial care where necessary.
目的
心理社会困扰可能成为糖尿病自我管理的障碍，从而影响糖尿病的控制。然而在加纳，医疗中心主要关注糖尿病的医学方面，而忽视了心理社会护理。本研究确定了心理社会困扰、临床变量以及与2型糖尿病管理相关的自我管理活动之间的关系。
方法
对来自加纳阿克拉四家医院的162名患者进行问卷调查，以评估与糖尿病相关的心理社会困扰（如糖尿病困扰）、临床变量（如血糖控制）和自我管理活动（如药物摄入）。在评估糖尿病困扰时，使用糖尿病痛苦评估量表（PAID）可以评估更广泛的情绪问题（与糖尿病相关的情绪困扰），而糖尿病困扰量表（DDS）可以评估与糖尿病自我管理更密切相关的因素（糖尿病困扰）。
结果
与糖尿病相关的情绪困扰、糖尿病困扰和抑郁症状呈相互正相关，而不支持的家庭行为与这些心理变量呈负相关。与糖尿病相关的情绪困扰与收缩压和舒张压呈正相关，与运动方案呈负相关。另一方面，糖尿病困扰与饮食和运动方案呈负相关，与血糖水平呈正相关，而抑郁症状与血糖水平、糖尿病并发症和收缩压呈正相关。与文献相反，不支持的家庭行为与饮食、运动和药物治疗方案呈正相关。
结论
心理变量与血糖水平和血压水平的正相关，以及不支持的家庭行为与自我管理活动的正相关，表明在加纳2型糖尿病的管理中需要纳入心理社会护理。可以对患者进行与糖尿病相关的困扰和抑郁症状筛查，并在必要时提供心理社会护理。
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