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青少年 1 型糖尿病患者糖尿病困扰的相关因素。

Factors associated with diabetes distress among adolescents with type 1 diabetes.

机构信息

Xiangya School of Nursing, Central South University, Changsha, China.

Institute of Metabolism and Endocrinology, The Second Xiangya Hospital, Key Laboratory of Diabetes Immunology, Ministry of Education, Central South University, National Clinical Research Center for Metabolic Diseases, Changsha, China.

出版信息

J Clin Nurs. 2021 Jul;30(13-14):1893-1903. doi: 10.1111/jocn.15742. Epub 2021 Apr 7.

Abstract

AIMS

To describe the specific domains of diabetes distress and factors associated with these domains.

BACKGROUND

Diabetes distress is a common problem but not well recognised in adolescents by healthcare providers or adolescents themselves. There is insufficient evidence on how specific domains of diabetes distress exist in adolescents, making it challenging to select precise components to alleviate diabetes stress.

DESIGN

A quantitative, descriptive and cross-sectional study.

METHODS

Data were collected on socio-demographic and clinical characteristics, diabetes distress, perceived stress, self-efficacy and diabetes self-management using established questionnaires. Multivariate linear regression was conducted to examine the associations between specific factors and four domains in diabetes distress. STROBE checklist was used as the guideline for this study.

RESULTS

A total of 100 adolescents with type 1 diabetes aged 12 to 18 years participated in this study. Adolescents experienced the highest levels of distress in the regimen-related distress [2.41 (SD =0.82)] and physician-related distress [2.40 (SD =0.80)] domains. Older age, female gender, more diabetes problem-solving and higher levels of perceived stress were associated with higher regimen-related distress (β = 0.21 ~ 0.45, p < 0.05). Older age, female gender, a lower degree of endorsement of relevant diabetes-related goals and higher levels of perceived stress were associated with higher physician-related distress (β = -0.29 ~ 0.34, p < 0.05).

CONCLUSIONS

Diabetes distress was reported more on regimen-related and physician-related domains among adolescents with type 1 diabetes in China, associating with older age, female, increased perceived stress and poor diabetes-related problem-solving.

RELEVANCE TO CLINICAL PRACTICE

Nurses need to screen the specific domains of diabetes distress among adolescents with type 1 diabetes, especially for the older adolescents and girls. This study highlighted the importance of incorporating diabetes-related problem-solving support and stress management strategies into diabetes management for adolescents with type 1 diabetes, which could help relieve diabetes distress.

摘要

目的

描述糖尿病困扰的特定领域以及与这些领域相关的因素。

背景

糖尿病困扰是一个常见问题,但医疗保健提供者或青少年本身并未充分认识到青少年中存在这种问题。目前,关于青少年中存在哪些特定的糖尿病困扰领域的证据不足,因此难以选择精确的缓解糖尿病压力的成分。

设计

定量、描述性和横断面研究。

方法

使用已建立的问卷收集社会人口统计学和临床特征、糖尿病困扰、感知压力、自我效能和糖尿病自我管理的数据。采用多元线性回归分析特定因素与糖尿病困扰的四个领域之间的关系。本研究采用 STROBE 清单作为指导。

结果

共有 100 名 12 至 18 岁的 1 型糖尿病青少年参与了这项研究。青少年在与治疗方案相关的困扰[2.41(SD=0.82)]和与医生相关的困扰[2.40(SD=0.80)]方面经历了最高水平的困扰。年龄较大、女性、更多的糖尿病问题解决能力和更高的感知压力与更高的与治疗方案相关的困扰相关(β=0.210.45,p<0.05)。年龄较大、女性、对相关糖尿病目标的认可度较低以及更高的感知压力与更高的与医生相关的困扰相关(β=-0.290.34,p<0.05)。

结论

在中国,1 型糖尿病青少年报告的糖尿病困扰更多地集中在与治疗方案和医生相关的领域,与年龄较大、女性、感知压力增加和较差的糖尿病相关问题解决能力相关。

临床意义

护士需要对 1 型糖尿病青少年进行糖尿病困扰的特定领域筛查,尤其是针对年龄较大的青少年和女孩。本研究强调了在 1 型糖尿病青少年的糖尿病管理中纳入糖尿病相关问题解决支持和压力管理策略的重要性,这有助于缓解糖尿病困扰。

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