Division of General Internal Medicine, Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin, United States of America.
Center for Advancing Population Science, Medical College of Wisconsin, Milwaukee, Wisconsin, United States of America.
PLoS One. 2023 May 8;18(5):e0285373. doi: 10.1371/journal.pone.0285373. eCollection 2023.
Social support (SS) is important in diabetes self-management; however, little is known about how different types of SS influence diabetes outcomes in men and women with type 2 diabetes mellitus (T2DM). Therefore, the aims of this study were to investigate the relationships between types of SS and glycemic control and self-care behaviors and assess whether the relationships differ by gender.
Cross-sectional study of 615 adults from two primary care clinics in the southeastern U.S. Outcomes were hemoglobin A1c (HbA1c) extracted from the medical records, and self-management behaviors (general diet, specific diet, exercise, blood glucose testing, foot care) measured using the Summary of Diabetes Self-Care Activities (SDSCA). Independent variable was SS (emotional/informational, tangible, affectionate, positive social interaction) measured using the Medical Outcomes Study (MOS) SS Scale. Structural equation modeling (SEM) was used to understand pathways between SS and glycemic control based on a theoretical model.
Tangible support was significantly associated with self-care (r = 0.16; p = 0.046) and affectionate support was marginally associated with glycemic control (r = 0.15; p = 0.08) for both men and women. Using SEM to test gender invariance, there was no statistically significant difference in the meaning of SS between men and women. However, unique invariances in responses occurred, including a stronger relationship between tangible support and self-care for women (r = 0.24; p = 0.061).
Of the four components of SS, tangible and affectionate support had the strongest influence on glycemic control. While affectionate support will improve glycemic control in both men and women, tangible support will improve self-care management, particularly in women.
社会支持（SS）在糖尿病自我管理中很重要；然而，对于不同类型的 SS 如何影响 2 型糖尿病（T2DM）男性和女性的糖尿病结局知之甚少。因此，本研究的目的是调查 SS 的不同类型与血糖控制和自我护理行为之间的关系，并评估这些关系是否因性别而异。
横断面研究了美国东南部的两个初级保健诊所的 615 名成年人。结局是从病历中提取的血红蛋白 A1c（HbA1c），以及使用糖尿病自我护理活动总结（SDSCA）测量的自我管理行为（一般饮食、特殊饮食、运动、血糖测试、足部护理）。自变量是 SS（情感/信息、有形、亲情、积极的社会互动），使用医疗结果研究（MOS）SS 量表进行测量。基于理论模型，使用结构方程模型（SEM）来理解 SS 与血糖控制之间的途径。
有形支持与自我护理显著相关（r = 0.16；p = 0.046），情感支持与血糖控制呈边缘相关（r = 0.15；p = 0.08），对男性和女性均如此。使用 SEM 测试性别不变性，SS 在男性和女性之间的含义没有统计学上的显著差异。然而，在反应中确实存在独特的不变性，包括有形支持与女性自我护理之间的关系更强（r = 0.24；p = 0.061）。
在 SS 的四个组成部分中，有形和情感支持对血糖控制的影响最大。虽然情感支持会改善男性和女性的血糖控制，但有形支持会改善自我护理管理，特别是在女性中。
