Patient and health care provider views of depressive symptoms and diabetes in American Samoa.
Patient and health care provider views of depressive symptoms and diabetes in American Samoa.
复制标题
患者和医疗保健提供者对美属萨摩亚抑郁症状和糖尿病的看法。
DOI：
10.1037/a0020089
复制
发表时间：
2010
影响因子：
3.3
通讯作者：
McGarvey,Stephen
中科院分区：
文献类型：
--
作者：
Held,RachelForster;DePue,Judith;Rosen,Rochelle;Bereolos,Nicole;Nu'usolia,Ofeira;Tuitele,John;Goldstein,Michael;House,Meaghan;McGarvey,Stephen
2型糖尿病的高患病率与最近饮食和体力活动的文化变化有关，这是美属萨摩亚领土的特点。世界范围内糖尿病和抑郁症并存的比率很高，并导致消极的糖尿病结果；美属萨摩亚尚未对这些比率进行评估。在这项研究中，对39名患有糖尿病的美国萨摩亚成年人进行了6个焦点小组的研究；问题包括对糖尿病和抑郁症状的看法。13名卫生保健人员进行了访谈，以深入了解美属萨摩亚的糖尿病护理。焦点小组和卫生保健人员的访谈被翻译、转录并进入NVivo 8，以便于分析。专题分析显示，糖尿病患者认为抑郁症状是导致高血糖的直接原因。然而，这些症状很少自发提到，提供者报告说他们很少在患者身上评估这些症状。许多患者和医护人员认为，应对抑郁情绪的最好方法是放松、离开困难的环境或进食。工作人员还讨论了与抑郁症相关的文化污名，以及在讨论之前建立融洽关系的重要性。美属萨摩亚的卫生保健提供者需要进行培训，以提高他们对抑郁症筛查阳性患者的抑郁症状对糖尿病管理的负面影响的认识。在建立融洽的关系后，所有提供者必须在支持性的背景下处理该主题。这些信息将被用于对一名社区卫生工作者的文化翻译和对美属萨摩亚成人糖尿病患者的初级保健协调干预，目的是创建有效和可持续的干预措施。
High Type 2 diabetes prevalence, associated with recent cultural changes in diet and physical activity, characterizes the US territory of American Samoa. Comorbid diabetes and depression rates are high worldwide and contribute to negative diabetes outcomes; these rates have not been assessed in American Samoa. In this study, 6 focus groups were conducted with 39 American Samoan adults with diabetes; questions on perceptions of diabetes and depressive symptoms were included. Thirteen health care staff interviews were conducted to gain insight into diabetes care in American Samoa. Focus groups and health care staff interviews were translated, transcribed, and entered into NVivo 8 to facilitate analysis. Thematic analysis showed that diabetes patients saw depressive symptoms as directly contributing to high blood sugar. However, these symptoms were rarely mentioned spontaneously, and providers reported they seldom assess them in patients. Many patients and health care staff believed the best ways to respond to feelings of depression involved relaxing, leaving difficult situations, or eating. Staff also discussed cultural stigma associated with depression and the importance of establishing rapport before discussing it. Health care providers in American Samoa need training to increase their awareness of depressive symptoms' negative impact on diabetes management in patients who screen positive for depression. All providers must approach the subject in a supportive context after establishing rapport. This information will be used for cultural translation of a community health worker and primary care-coordinated intervention for adults with diabetes in American Samoa, with the goal of creating an effective and sustainable intervention.(PsycInfo Database Record (c) 2024 APA, all rights reserved)