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糖尿病管理中的行为和心理社会动态:一项路径分析,以检验文化适应对阿拉伯移民社区的影响。

Behavioral and Psychosocial Dynamics in Diabetes Management: A Path Analysis to Examine the Influence of Acculturation in Arab Immigrant Communities.

作者信息

Alzubaidi Hamzah, Oliveira Vitor H, Saidawi Ward, Aljobowry Raya, Shaw Jonathan E, Samorinha Catarina

机构信息

Department of Pharmacy Practice and Pharmacotherapeutics, College of Pharmacy, University of Sharjah, Sharjah, United Arab Emirates.

Research Institute for Medical and Health Sciences, University of Sharjah, Sharjah, United Arab Emirates.

出版信息

Ann Behav Med. 2025 Jan 4;59(1). doi: 10.1093/abm/kaae062.

Abstract

BACKGROUND

Type 2 diabetes mellitus (T2DM) prevalence is rising globally. Arab immigrants with T2DM, one of the least studied ethnic minorities, have a higher diabetes prevalence and more prominent management-related challenges compared with mainstream host societies. Acculturation's impact on self-care activities and diabetes distress (DD) is understudied globally.

PURPOSE

To examine how acculturation affects self-care practices and DD in first-generation Arab immigrants with T2DM and how health literacy, illness perceptions, and self-efficacy mediate these associations.

METHODS

This multicenter cross-sectional study was conducted in Victoria, Australia. Eligible patients were invited while waiting for their appointments. The questionnaire included validated tools to assess DD, self-care activities, health literacy, self-efficacy, and acculturation. We tested mediation hypothesis using path analysis, with a maximum likelihood estimation to calculate total, direct, and indirect effects and bias-corrected accelerated 95% CI.

RESULTS

Overall, 382 Arab immigrants with T2DM participated, with an average age of 57.9 years (SD = 8.0). Half were males, most had low education, and were married. Participants lived in Australia for a mean of 19.1 years (SD = 8.3) and had diabetes for 7.1 years (SD =4.7). Higher acculturation was directly associated with decreased DD. Illness perceptions (p = .002) and self-efficacy (p = .001) mediated the association of acculturation with self-care activities, while health literacy did not. Additionally, self-efficacy fully mediated the relationship between acculturation and DD (p = .001).

CONCLUSIONS

This research provided valuable insights into the complex interplay between acculturation, diabetes management, and psychosocial factors. Interventions targeting self-efficacy and illness perceptions may improve self-care activities and reduce DD among Arab immigrants with T2DM.

摘要

背景

2型糖尿病(T2DM)在全球的患病率正在上升。阿拉伯移民中的T2DM患者是研究最少的少数族裔之一,与主流东道国社会相比,他们的糖尿病患病率更高,且在管理方面面临更突出的挑战。全球范围内,文化适应对自我护理活动和糖尿病困扰(DD)的影响研究不足。

目的

探讨文化适应如何影响第一代患有T2DM的阿拉伯移民的自我护理实践和DD,以及健康素养、疾病认知和自我效能如何介导这些关联。

方法

这项多中心横断面研究在澳大利亚维多利亚州进行。符合条件的患者在等待预约时被邀请参与。问卷包括经过验证的工具,用于评估DD、自我护理活动、健康素养、自我效能和文化适应。我们使用路径分析检验中介假设,采用最大似然估计来计算总效应、直接效应和间接效应以及偏差校正加速95%置信区间。

结果

总体而言,382名患有T2DM的阿拉伯移民参与了研究,平均年龄为57.9岁(标准差=8.0)。一半为男性,大多数受教育程度低,且已婚。参与者在澳大利亚平均居住了19.1年(标准差=8.3),患糖尿病7.1年(标准差=4.7)。较高的文化适应程度与DD降低直接相关。疾病认知(p = 0.002)和自我效能(p = 0.001)介导了文化适应与自我护理活动之间的关联,而健康素养则没有。此外,自我效能完全介导了文化适应与DD之间的关系(p = 0.001)。

结论

本研究为文化适应、糖尿病管理和心理社会因素之间的复杂相互作用提供了有价值的见解。针对自我效能和疾病认知的干预措施可能会改善患有T2DM的阿拉伯移民的自我护理活动并减少DD。

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