Medical School, University of Western Australia, Perth, Western Australia, Australia.
Department of Endocrinology and Diabetes, Fiona Stanley Fremantle Hospitals Group, Perth, Western Australia, Australia.
Intern Med J. 2022 Jun;52(6):952-958. doi: 10.1111/imj.15250. Epub 2022 May 31.
Diabetes distress, self-efficacy and health literacy are associated with diabetes self-management and health outcomes. Measures of coping styles and their impact on diabetes self-management and diabetes-related distress might add value in identifying those at risk of poorer health outcomes. Current evidence of associations between psychological flexibility/inflexibility and diabetes-related health outcomes is limited.
To measure associations of psychological flexibility, self-efficacy and health literacy with diabetes distress and glycated haemoglobin (HbA1c) in adults with type 1 diabetes.
We surveyed 105 adults with type 1 diabetes attending a tertiary diabetes outpatient clinic (mean age 27 ± 7.1 years; 53% men; duration of diabetes 12.6 ± 8.5 years; HbA1c 72 ± 22 mmol/mol, 8.7 ± 2.0%; 34% using insulin pumps). We assessed psychological flexibility, self-efficacy, health literacy and diabetes distress. Regression models explored the relative contributions of different factors to diabetes distress and HbA1c.
The majority of health literacy scores were in the low-risk range. Those with greater psychological flexibility had higher self-efficacy (r = 0.34; P < 0.01) and reported less diabetes distress (r = -0.54; P < 0.001). In multiple regression analyses, psychological flexibility and self-efficacy accounted for 36% of the variance in distress score (P < 0.001). Shorter duration of diabetes (P < 0.001) and greater psychological flexibility (P < 0.01) correlated with lower HbA1c. A 10-point (one standard deviation) higher psychological flexibility score corresponded to a 0.5% lower HbA1c.
Greater psychological flexibility was associated with less diabetes distress and lower HbA1c. The psychological flexibility construct might inform alternative interventional approaches aiming to improve well-being and glycaemic control.
糖尿病困扰、自我效能和健康素养与糖尿病自我管理和健康结果相关。应对方式的衡量及其对糖尿病自我管理和与糖尿病相关的困扰的影响可能有助于确定那些健康结果较差的风险人群。目前，关于心理灵活性/不灵活性与糖尿病相关健康结果之间的关联的证据有限。
测量心理灵活性、自我效能和健康素养与 1 型糖尿病成人的糖尿病困扰和糖化血红蛋白（HbA1c）之间的关系。
我们调查了 105 名在三级糖尿病门诊就诊的 1 型糖尿病成人（平均年龄 27 ± 7.1 岁；53%为男性；糖尿病病程 12.6 ± 8.5 年；HbA1c 为 72 ± 22 mmol/mol，8.7 ± 2.0%；34%使用胰岛素泵）。我们评估了心理灵活性、自我效能、健康素养和糖尿病困扰。回归模型探讨了不同因素对糖尿病困扰和 HbA1c 的相对贡献。
大多数健康素养评分处于低风险范围。心理灵活性较强的患者自我效能较高（r = 0.34；P < 0.01），糖尿病困扰程度较低（r = -0.54；P < 0.001）。在多元回归分析中，心理灵活性和自我效能占困扰评分变异的 36%（P < 0.001）。糖尿病病程较短（P < 0.001）和心理灵活性较高（P < 0.01）与 HbA1c 降低相关。心理灵活性评分提高 10 分（一个标准差）对应 HbA1c 降低 0.5%。
较强的心理灵活性与较低的糖尿病困扰和较低的 HbA1c 相关。心理灵活性结构可能为旨在改善幸福感和血糖控制的替代干预方法提供信息。
