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调节糖尿病困扰与掌控感之间的关系:抑郁和赋权的作用。

Moderating the relationship between diabetes distress and mastery: the role of depression and empowerment.

机构信息

School of Nursing and Midwifery, Queen's University Belfast, Belfast, UK.

School of Biomedical Sciences (NICHE), Ulster University, Coleraine, UK.

出版信息

Psychol Health Med. 2022 Apr;27(4):838-847. doi: 10.1080/13548506.2021.1894343. Epub 2021 Mar 1.

Abstract

Type 2 diabetes is a chronic condition primarily self-managed by the individual. Mastery is a protective factor linked to better control of chronic conditions, effective self-management and improved medication adherence. Mastery appears increasingly important as treatment regimens and self-management demands become more complex and burdensome. Diabetes distress negatively impacts self-management, glycaemic control and treatment adherence. Understanding the relationship between diabetes distress and mastery may provide opportunities to improve condition management and adherence . This relationship may be impacted by other factors affecting the individual's perceived sense of control over their condition. This study examined the role of diabetes empowerment and depression in the relationship between diabetes distress and mastery. Data were drawn from a randomised controlled trial of 131 adults with type 2 diabetes transitioning to injection therapy. Participants completed measures of diabetes distress , mastery , depression and empowerment . Diabetes distress and depression were negatively associated with mastery, whilst diabetes empowerment was positively associated . A significant interaction effect ( = .024, (112) = 3.79, p = <.005) confirmed the relationship between diabetes distress and mastery was moderated by depression. Findings highlight the additive deleterious effects of depression. Interventions to improve mastery among those living with type 2 diabetes should address diabetes distress and depression to optimise outcomes.

摘要

2 型糖尿病是一种主要由个体自我管理的慢性疾病。掌握是与更好地控制慢性疾病、有效自我管理和提高药物依从性相关的保护因素。随着治疗方案和自我管理要求变得更加复杂和繁重,掌握似乎变得越来越重要。糖尿病困扰会对自我管理、血糖控制和治疗依从性产生负面影响。了解糖尿病困扰与掌握之间的关系可能为改善病情管理和依从性提供机会。这种关系可能会受到影响个体对自身病情控制感的其他因素的影响。本研究探讨了糖尿病授权和抑郁在糖尿病困扰与掌握之间关系中的作用。数据来自一项针对 131 名 2 型糖尿病患者的随机对照试验,这些患者正在过渡到注射治疗。参与者完成了糖尿病困扰、掌握、抑郁和授权的测量。糖尿病困扰和抑郁与掌握呈负相关,而糖尿病授权与掌握呈正相关。显著的交互效应(= 0.024,(112)= 3.79,p = <.005)证实了糖尿病困扰和掌握之间的关系受到抑郁的调节。研究结果强调了抑郁的附加有害影响。对于 2 型糖尿病患者,提高掌握能力的干预措施应解决糖尿病困扰和抑郁问题,以优化结果。

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