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50岁及以上的个体对认知状况和身体状况的看法是否不同?来自2型糖尿病和轻度认知障碍疾病认知综合分析的证据。

Do Individuals Aged 50 or Older View Cognitive Conditions Differently Than Physical Conditions? Evidence From a Pooled Analysis of Illness Perceptions in Type 2 Diabetes and Mild Cognitive Impairment.

作者信息

Kim Hyejin, Lingler Jennifer H, Bender Catherine M, Albert Steven M, Sereika Susan M

机构信息

Department of Adult Health and Gerontological Nursing, Rush University College of Nursing, Chicago, Illinois, USA.

Department of Health and Community Systems, University of Pittsburgh School of Nursing, Pittsburgh, Pennsylvania, USA.

出版信息

Innov Aging. 2023 Apr 13;7(3):igad027. doi: 10.1093/geroni/igad027. eCollection 2023.

Abstract

BACKGROUND AND OBJECTIVES

Type 2 diabetes (T2DM) and mild cognitive impairment (MCI) are common late-life physical and cognitive health conditions. Illness perceptions, an individual's personal beliefs about the conditions, should be explored in the context of disease characteristics (physical or cognitive). This secondary analysis explored illness perceptions with a priori hypotheses about control (perceived controllability) and coherence (perceived understanding) dimensions among persons with T2DM and MCI, treating each as an exemplar of late-life physical and cognitive health conditions. We also explored whether age, education, and comorbid conditions moderate the relationships between T2DM or MCI condition groups and illness perceptions.

RESEARCH DESIGN AND METHODS

This cross-sectional, descriptive study examined baseline data collected from 146 T2DM to 90 MCI participants in 2 independent studies. The 9-item Brief Illness Perception Questionnaire was used to identify the similarities and differences in illness perceptions among persons with T2DM and MCI. We performed hierarchical linear regression controlling for identified covariates.

RESULTS

We found that T2DM and MCI participants had significantly different illness perceptions, including perceptions of personal control ( = -0.943, = .009), treatment control ( = -1.619, < .001), and coherence ( = -1.265, = .001), after controlling for covariates. The results suggest that persons with MCI were likely to believe that their condition is less controllable (through their own strategies or medical treatment) and less understandable compared with their T2DM counterparts. Such associations remained statistically significant when the interactions were added to the models.

DISCUSSION AND IMPLICATIONS

As T2DM and MCI are prevalent late-life conditions, health care professionals should consider individuals' subjective perceptions about their conditions in the context of disease characteristics when counseling secondary prevention strategies for disease management. Further research on illness perceptions in other conditions is needed to ensure the replicability of our findings.

摘要

背景与目的

2型糖尿病(T2DM)和轻度认知障碍(MCI)是常见的老年期身体和认知健康状况。疾病认知,即个体对这些状况的个人信念,应在疾病特征(身体或认知)的背景下进行探究。本二次分析探讨了T2DM和MCI患者关于控制(感知可控性)和一致性(感知理解)维度的先验假设的疾病认知,将二者分别视为老年期身体和认知健康状况的范例。我们还探讨了年龄、教育程度和共病状况是否会调节T2DM或MCI病情组与疾病认知之间的关系。

研究设计与方法

这项横断面描述性研究检查了从两项独立研究中收集的146名T2DM患者和90名MCI参与者的基线数据。使用9项简短疾病认知问卷来确定T2DM和MCI患者在疾病认知方面的异同。我们进行了分层线性回归,并对确定的协变量进行了控制。

结果

在控制协变量后,我们发现T2DM和MCI参与者在疾病认知方面存在显著差异,包括个人控制感(=-0.943,=0.009)、治疗控制感(=-1.619,<0.001)和一致性(=-1.265,=0.001)。结果表明,与T2DM患者相比,MCI患者可能更倾向于认为自己的病情较难控制(通过自身策略或医疗手段)且更难理解。当将交互作用纳入模型时,这种关联在统计学上仍然显著。

讨论与启示

由于T2DM和MCI是常见的老年期疾病,医疗保健专业人员在为疾病管理咨询二级预防策略时,应在疾病特征的背景下考虑个体对自身病情的主观认知。需要对其他疾病状况下的疾病认知进行进一步研究,以确保我们研究结果的可重复性。

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