When Is Diabetes Distress Clinically Meaningful?
When Is Diabetes Distress Clinically Meaningful?
复制标题
糖尿病困扰何时具有临床意义？
作者：
L. Fisher;D. Hessler;W. Polonsky;J. Mullan
目的探讨17项糖尿病痛苦量表（DDS 17）与糖尿病变量之间的关系，以建立2型糖尿病患者高痛苦的量表切点。研究设计和方法从社区医疗团体招募了506名研究1和392名研究2成人2型糖尿病患者。多元回归方程将DDS 17（一个17项量表，产生平均项目评分）与HbA 1c、糖尿病自我效能、饮食和体力活动相关联。还对两项DDS（DDS 2）筛查进行了关联。分析包括控制变量、线性和二次（曲线）DDS项。结果DDS 17和每个糖尿病变量之间存在显著的二次效应，痛苦的增加与较差的结局相关：研究1 HbA 1c（P < 0.02），自我效能感研究2 HbA 1c（P <0.03）、自我效能（P <0.004）、饮食（P <0.001）、体力活动（P <0.04）。在两项研究中，与所有四个变量的实质性曲线关联开始于出乎意料的低水平DDS 17：斜率在评分1和2之间线性增加，在2和3之间更加柔和，并在3和4之间达到最大值。这表明有三个患者亚组：轻度或无痛苦，<2.0;中度痛苦，2.0-2.9;高度痛苦，≥3.0。DDS 2也出现了类似结果。结论：在两个2型糖尿病患者样本中，我们发现DDS与HbA 1c、糖尿病自我效能、饮食和体力活动之间存在一致的曲线关系。这些关系的形状表明三个患者组的分界点：很少或没有，中度和高度痛苦。
OBJECTIVE To identify the pattern of relationships between the 17-item Diabetes Distress Scale (DDS17) and diabetes variables to establish scale cut points for high distress among patients with type 2 diabetes. RESEARCH DESIGN AND METHODS Recruited were 506 study 1 and 392 study 2 adults with type 2 diabetes from community medical groups. Multiple regression equations associated the DDS17, a 17-item scale that yields a mean-item score, with HbA1c, diabetes self-efficacy, diet, and physical activity. Associations also were undertaken for the two-item DDS (DDS2) screener. Analyses included control variables, linear, and quadratic (curvilinear) DDS terms. RESULTS Significant quadratic effects occurred between the DDS17 and each diabetes variable, with increases in distress associated with poorer outcomes: study 1 HbA1c (P < 0.02), self-efficacy (P < 0.001), diet (P < 0.001), physical activity (P < 0.04); study 2 HbA1c (P < 0.03), self-efficacy (P < 0.004), diet (P < 0.04), physical activity (P = NS). Substantive curvilinear associations with all four variables in both studies began at unexpectedly low levels of DDS17: the slope increased linearly between scores 1 and 2, was more muted between 2 and 3, and reached a maximum between 3 and 4. This suggested three patient subgroups: little or no distress, <2.0; moderate distress, 2.0–2.9; high distress, ≥3.0. Parallel findings occurred for the DDS2. CONCLUSIONS In two samples of type 2 diabetic patients we found a consistent pattern of curvilinear relationships between the DDS and HbA1c, diabetes self-efficacy, diet, and physical activity. The shape of these relationships suggests cut points for three patient groups: little or no, moderate, and high distress.
DOI：
10.1097/00005768-200107000-00010
发表时间：
2001-07-01
期刊：
MEDICINE AND SCIENCE IN SPORTS AND EXERCISE
影响因子：
--
作者：
Stewart, AL;Mills, KM;Ritter, PL
通讯作者：
Ritter, PL
影响因子：
16.2
作者：
Toobert, DJ;Hampson, SE;Glasgow, RE
通讯作者：
Glasgow, RE