Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, NY, USA.
Departments of Medicine (Endocrinology) and Epidemiology & Population Health, Albert Einstein College of Medicine, Bronx, NY, USA.
Diabet Med. 2021 May;38(5):e14383. doi: 10.1111/dme.14383. Epub 2020 Nov 2.
Self-rated health, a measure of self-reported general health, is a robust predictor of morbidity and mortality in various populations, including persons with diabetes. This study examines correlates of self-rated health in adults with diabetic peripheral neuropathy (DPN).
Participants recruited from the UK and USA (n = 295; mean (± sd) age: 61.5 ± 10.7 years; 69% male; 71% type 2 diabetes) rated their health at baseline and 18 months. DPN severity was assessed using the neuropathy disability score and the vibration perception threshold. Validated self-report measures assessed neuroticism, DPN-symptoms of pain, unsteadiness and reduced sensation in feet, DPN-related limitations in daily activities, DPN-specific emotional distress and symptoms of depression.
In the fully adjusted baseline model, younger age, presence of cardiovascular disease and higher depression symptom scores showed likely clinically meaningful independent associations with worse health ratings. Being at the UK study site and presence of nephropathy indicated potentially meaningful independent associations with lower baseline health ratings. These predictors were largely consistent in their association with health ratings at 18 months.
Results identify independent correlates of health ratings among adults with DPN. Future research should investigate the clinical implications of associations and examine changes in these variables over time and potential effects on changes in health perceptions. If these associations reflect causal pathways, our results may guide interventions to target issues that are likely to have an impact on subjectively experienced health as an important patient-reported outcome in DPN care.
自评健康是一种自我报告的总体健康状况的衡量标准,它是各种人群(包括患有糖尿病的人群)发病率和死亡率的强有力预测指标。本研究探讨了患有糖尿病周围神经病变(DPN)的成年人自评健康的相关因素。
本研究从英国和美国招募了参与者(n=295;平均(±标准差)年龄:61.5±10.7 岁;69%为男性;71%为 2 型糖尿病),他们在基线和 18 个月时对自己的健康状况进行了评分。DPN 严重程度使用神经病变残疾评分和振动感觉阈值进行评估。经过验证的自我报告测量方法评估了神经质、DPN 疼痛症状、不稳和脚部感觉减退、DPN 相关的日常活动受限、DPN 特异性情绪困扰和抑郁症状。
在完全调整的基线模型中,年龄较小、患有心血管疾病和较高的抑郁症状评分与较差的健康评分有明显的临床意义的独立关联。在英国研究地点和肾病的存在与较低的基线健康评分有潜在的有意义的独立关联。这些预测因素在与 18 个月时的健康评分的关联中基本一致。
结果确定了 DPN 成年人健康评分的独立相关因素。未来的研究应该调查这些关联的临床意义,并研究这些变量随时间的变化以及对健康感知变化的潜在影响。如果这些关联反映了因果途径,我们的结果可能指导针对可能对主观体验健康产生影响的问题的干预措施,这是 DPN 护理中重要的患者报告结局之一。