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2 型糖尿病患者的社会支持与糖尿病相关困扰之间的关联。

Associations Between Social Support and Diabetes-Related Distress in People With Type 2 Diabetes Mellitus.

出版信息

J Am Osteopath Assoc. 2020 Nov 1;120(11):721-731. doi: 10.7556/jaoa.2020.145.

Abstract

CONTEXT

Diabetes is a complex, chronic condition and managing it can have psychosocial implications for patients, including an impact on relationships with their loved ones and physical wellness. The necessary modifications to daily behaviors can be very overwhelming, thus leading to diabetes-related distress.

OBJECTIVE

To investigate the association between diabetes-related distress and perceived social support among people with type 2 diabetes.

METHODS

This cross-sectional study surveyed a population with a lower socioeconomic status (Medi-Cal recipients, which are only given to low-income individuals) in Solano County, California. Patients who had type 2 diabetes mellitus, who were between 40 and 80 years old, and who had a medical appointment in the clinic(s) at least once between December 2015 and December 2016 were included. Patients who could not understand or speak English and patients whose primary care clinicians declined their participation in the study were excluded from the study. Each study participant was recruited at the end of their medical appointment, and the survey instrument in paper form was administered. The Problem Areas in Diabetes (PAID) scale, which indicates diabetes-related distress, and Multidimensional Scale of Perceived Social Support (MSPSS) with 3 subscales (family, friends, and significant others) were used in this study. Multiple linear regression models were used to analyze the associations between PAID and MSPSS surveys.

RESULTS

For the 101 participants included in our study, multiple linear regression models showed statistically significant association between total MSPSS scores and total PAID scores (β = -.318; 95% CI, .577, -.0581; P=.017) as well as between MSPSS family subscale scores and total PAID scores (β= -.761; 95% CI, -1.35, -.168; P=.012). Among the 3 MSPSS subscales, higher perceived support from family members was found to be significantly associated with lower total PAID scores (β= -.761; 95% CI, -1.35, -.168; P=.012).

CONCLUSION

Our findings suggest that a higher level of perceived social support experienced was associated with lower diabetes-related distress among patients with type 2 diabetes. Osteopathic physicians have a central role in providing comprehensive, patient-centered, holistic care, and the attention to social support in chronic disease management can help remove barriers in providing optimal care.

摘要

背景

糖尿病是一种复杂的慢性疾病,会对患者的心理社会产生影响,包括对与亲人的关系和身体健康的影响。日常行为的必要改变可能会让人不堪重负,从而导致与糖尿病相关的痛苦。

目的

调查 2 型糖尿病患者的糖尿病相关痛苦与感知社会支持之间的关系。

方法

本横断面研究调查了加利福尼亚州索拉诺县社会经济地位较低的人群(Medi-Cal 受助人,仅提供给低收入个人)。纳入标准为:患有 2 型糖尿病、年龄在 40 至 80 岁之间、2015 年 12 月至 2016 年 12 月期间至少在诊所就诊过一次的患者。不理解或不会说英语的患者以及其初级保健临床医生拒绝参与研究的患者被排除在研究之外。每位研究参与者在就诊结束时被招募,然后以纸质形式发放调查工具。该研究使用了糖尿病相关痛苦指标(Problem Areas in Diabetes,PAID)量表和包含 3 个分量表(家庭、朋友和重要他人)的多维感知社会支持量表(Multidimensional Scale of Perceived Social Support,MSPSS)。采用多元线性回归模型分析 PAID 和 MSPSS 调查之间的关联。

结果

在纳入的 101 名参与者中,多元线性回归模型显示,总 MSPSS 评分与总 PAID 评分之间存在统计学显著关联(β=-.318;95%CI,.577,-.0581;P=.017),MSPSS 家庭分量表评分与总 PAID 评分之间也存在统计学显著关联(β=-.761;95%CI,-1.35,-.168;P=.012)。在 3 个 MSPSS 分量表中,较高的家庭成员感知支持与较低的总 PAID 评分显著相关(β=-.761;95%CI,-1.35,-.168;P=.012)。

结论

我们的研究结果表明,2 型糖尿病患者感知到的社会支持水平越高,与糖尿病相关的痛苦程度越低。骨病医生在提供全面、以患者为中心、整体护理方面发挥着核心作用,关注慢性病管理中的社会支持可以帮助消除提供最佳护理的障碍。

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