College of Nursing, University of Florida, 1225 Center Drive, Gainesville, FL, 32603, USA.
Department of Medical Education and Clinical Sciences, Washington State University, Seattle, WA, USA.
Qual Life Res. 2021 Sep;30(9):2497-2507. doi: 10.1007/s11136-021-02830-4. Epub 2021 Apr 10.
Little is known about the association of psychosocial factors with health-related quality of life (HRQoL) among American Indians with type 2 diabetes (T2D). This study described functional social support, emotional support, coping, resilience, post-traumatic stress disorder, and HRQoL, among American Indians by diabetes status and, among those with diabetes, examined the association of these factors with HRQoL.
Using data from the Cherokee Nation Health Survey collected between 2017 and 2019, we evaluated differences in each measure of interest according to diabetes status, using t-test and Chi-squared tests of association. We used weighted multiple logistic regression to examine associations between multiple psychosocial factors and HRQoL among those with diabetes.
Compared to individuals without diabetes, participants with diabetes rated their functional social support (4.62 vs. 4.56, respectively) and coping (2.65 vs. 2.61, respectively) slightly lower and were more likely to report ≥ 15 days of poor physical (14% vs. 26%, respectively) and mental health (14% vs. 17%, respectively) in the past month. Odds of reporting poor overall health increased more than sixfold for those who were dissatisfied/very dissatisfied with life (AOR = 6.70). Resilience scores reduced odds of reporting ≥ 15 days with poor physical health, while experiences of post-traumatic stress doubled these odds.
Our study yielded insights into the risk as well as protective factors associated with diabetes outcomes in a large sample of American Indians with T2D. Researchers should design pragmatic trials that deepen understanding of preventive as well as treatment leverage through greater attention to experiences that compromise HRQoL.
关于 2 型糖尿病（T2D）美国印第安人的心理社会因素与健康相关生活质量（HRQoL）之间的关联知之甚少。本研究通过糖尿病状况描述了美国印第安人的功能性社会支持、情感支持、应对方式、韧性、创伤后应激障碍和 HRQoL，并在患有糖尿病的人群中，检查了这些因素与 HRQoL 的关系。
利用 2017 年至 2019 年期间收集的切罗基民族健康调查数据，我们使用 t 检验和卡方检验评估了每个感兴趣的指标根据糖尿病状况的差异。我们使用加权多逻辑回归检查了糖尿病患者中多种心理社会因素与 HRQoL 之间的关联。
与没有糖尿病的个体相比，患有糖尿病的个体自评功能性社会支持（分别为 4.62 和 4.56）和应对方式（分别为 2.65 和 2.61）略低，并且更有可能报告过去一个月内有≥15 天的身体欠佳（分别为 14%和 26%）和心理健康欠佳（分别为 14%和 17%）。对生活不满意/非常不满意的人报告整体健康状况不佳的几率增加了六倍以上（AOR=6.70）。韧性评分降低了报告≥15 天身体欠佳的几率，而创伤后应激体验则使这些几率增加了一倍。
我们的研究为 T2D 美国印第安人大样本中与糖尿病结局相关的风险因素和保护因素提供了深入了解。研究人员应该设计实用的试验，通过更加关注影响 HRQoL 的体验，加深对预防和治疗的理解。
