Distress and type 2 diabetes-treatment adherence: A mediating role for perceived control.
Distress and type 2 diabetes-treatment adherence: A mediating role for perceived control.
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DOI：
10.1037/hea0000131
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发表时间：
2015-05
影响因子：
4.2
通讯作者：
Safren, Steven A.
中科院分区：
文献类型：
--
作者：
Gonzalez, Jeffrey S.;Shreck, Erica;Psaros, Christina;Safren, Steven A.
了解成人2型糖尿病患者的情绪困扰、服药依从性和血糖控制之间的独立途径，以及疾病控制感和自我效能感的潜在中介效应。成年2型糖尿病患者(N=142)参加了一项干预研究，评估认知行为疗法对依从性和抑郁症的影响。通过半结构式访谈评估抑郁症状的严重程度。经过验证的自我报告评估了糖尿病相关的痛苦、对糖尿病的感知控制(感知控制)、糖尿病自我管理的自我效能和服药依从性。用糖化血红蛋白(A1C)评价血糖控制情况。相关分析和线性回归分析中只包括基线数据。知觉控制是影响服药依从性和糖化血红蛋白结果的重要因素。具体地说，回归分析表明，糖尿病痛苦，而不是抑郁症的严重程度，与服药依从性和糖化血红蛋白显著相关。自我效能感和控制感也与服药依从性和糖化血红蛋白独立相关。中介分析表明，通过知觉控制和自我效能，对糖尿病痛苦和服药依从性有显著的间接影响。苦恼与A1C之间的关系是通过知觉控制的间接效应来解释的。结果表明，在成人2型糖尿病患者中，与糖尿病相关的情绪困扰与较差的治疗依从性和血糖控制有关；这些关系部分是通过感知对糖尿病的控制来调节的。对一个人影响糖尿病的个人能力的看法可能对理解情绪困扰和糟糕的糖尿病治疗结果之间的途径很重要。
To understand independent pathways linking emotional distress, medication adherence and glycemic control in adults with type 2 diabetes, as well as the potential mediating effects of perceived control over illness and self-efficacy. Adults with type 2 diabetes (N = 142) were recruited for an intervention study evaluating cognitive behavioral therapy for adherence and depression. Depressive symptom severity was assessed via semi-structured interview. Validated self-reports assessed diabetes-related distress, perceived control over diabetes (perceived control), self-efficacy for diabetes self-management and medication adherence. Glycemic control was evaluated by hemoglobin A1c (A1C). Only baseline data were included in correlational and linear regression analyses. Perceived control was an important mediator for both medication adherence and A1C outcomes. Specifically, regression analyses demonstrated that diabetes distress, but not depression severity, was significantly related to medication adherence and A1C. Self-efficacy and perceived control were also independently associated with medication adherence and A1C. Mediation analyses demonstrated a significant indirect effect for diabetes distress and medication adherence, through perceived control and self-efficacy. The relationship between distress and A1C was accounted for by an indirect effect through perceived control. Results demonstrate that diabetes-related emotional distress is associated with poorer treatment adherence and glycemic control among adults with type 2 diabetes; these relationships were partially mediated through perceived control over diabetes. Perceptions of one’s personal ability to influence diabetes may be important in understanding the pathway between emotional distress and poor diabetes treatment outcomes.
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影响因子：
8.2
作者：
Gonzalez, J. S.;Delahanty, L. M.;Safren, S. A.;Meigs, J. B.;Grant, R. W.
通讯作者：
Grant, R. W.
影响因子：
3.3
作者：
Georgiades, Anastasia;Zucker, Nancy;Surwit, Richard S.
通讯作者：
Surwit, Richard S.
影响因子：
3.1
作者：
Cherrington, Andrea;Wallston, Kenneth A.;Rothman, Russell L.
通讯作者：
Rothman, Russell L.
影响因子：
0.7
作者：
Gonzalez, Jeffrey;McCarl, Lauren;Safren, Steven
通讯作者：
Safren, Steven
DOI：
10.1016/j.sapharm.2005.09.002
发表时间：
2005-12-01
期刊：
Research in social & administrative pharmacy : RSAP
影响因子：
--
作者：
Chao, Jingdong;Nau, David P;Taylor, Stephanie D
通讯作者：
Taylor, Stephanie D