Murphy D J, Williamson P S, Nease D E
University of Kansas School of Medicine, MO.
Fam Pract Res J. 1994 Dec;14(4):323-31.
Family members usually become involved during the course of care for a chronic illness. This study identified the diabetic adult's perceived supportive family member(s) and analyzed whether family participation was associated with the diabetic adults' level of metabolic control.
A telephone survey of 131 diabetic adults was conducted from a family practice residency office asking patients to identify family members participating in their diabetes care and to enumerate specific support activities. Demographic and metabolic control data were abstracted from patient records.
Two broad categories of family participation exist. The first is the family health monitor (FHM), or internal "health expert" for the family. The other is the often distinct primary supportive family member; or "helper," defined as a family member who performs at least one supportive task in the care of the illness. Three-fourths of diabetic adults identified an FHM within their families. Eighty-seven percent of FHM's were women, usually adult daughters of diabetic women or wives of diabetic men. Forty-nine percent of diabetic women and 70% of diabetic men also identified a "helper." The most frequent helping tasks involved: dietary issues (48%), medication (23%), general support (15%) and blood sugar monitoring (9%). No relationship emerged between the presence or absence of an FHM or a helper and the level of metabolic control as measured by HbA1C level, which was categorized as "poor" in 55% of the sample.
An FHM or some other helping family member is available to most diabetic adults in our patient population. The mere presence of an available FHM or other potential resource person is not necessarily related to a positive influence on metabolic control.
在慢性病护理过程中,家庭成员通常会参与进来。本研究确定了成年糖尿病患者所认为的提供支持的家庭成员,并分析了家庭参与是否与成年糖尿病患者的代谢控制水平相关。
从一家家庭医疗住院医师办公室对131名成年糖尿病患者进行了电话调查,询问患者确定参与其糖尿病护理的家庭成员,并列举具体的支持活动。人口统计学和代谢控制数据从患者记录中提取。
存在两大类家庭参与情况。第一类是家庭健康监测者(FHM),即家庭内部的“健康专家”。另一类是通常不同的主要支持家庭成员,即“帮助者”,定义为在疾病护理中执行至少一项支持任务的家庭成员。四分之三的成年糖尿病患者在其家庭中确定了一名FHM。87%的FHM是女性,通常是糖尿病女性的成年女儿或糖尿病男性的妻子。49%的糖尿病女性和70%的糖尿病男性也确定了一名“帮助者”。最常见的帮助任务包括:饮食问题(48%)、用药(23%)、一般支持(15%)和血糖监测(9%)。FHM或帮助者的有无与通过糖化血红蛋白(HbA1C)水平衡量的代谢控制水平之间没有关系,在样本的55%中,HbA1C水平被归类为“差”。
在我们的患者群体中,大多数成年糖尿病患者都有一名FHM或其他一些提供帮助的家庭成员。仅仅有一名可用的FHM或其他潜在资源人并不一定与对代谢控制产生积极影响相关。