The family and disease management in hispanic and European-American patients with type a diabetes
The family and disease management in hispanic and European-American patients with type a diabetes
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DOI：
10.2337/diacare.23.3.267
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发表时间：
2000-03-01
期刊：
影响因子：
16.2
通讯作者：
Lutz, CP
中科院分区：
文献类型：
--
作者：
Fisher, L;Chesla, CA;Lutz, CP
目的 - 确定参与疾病管理的家庭特征与西班牙裔和欧美 (EA) 2 型糖尿病患者的自我护理实践之间的关系。 研究设计和方法 - 从管理式医疗机构招募的总共 74 名西班牙裔和 113 名 EA 2 型糖尿病患者在家庭生活的三个领域（家庭结构/组织、家庭世界观和家庭情绪管理 [四个量表]）和五个疾病领域进行评估管理（生物、一般健康和功能状态、情绪基调、生活质量和行为[七个量表]）。分析评估了患者性别、家庭以及家庭互动中的性别与疾病管理的独立关联。结果 - 性别和家庭生活的三个领域都与疾病管理相关，但结果因种族群体而异。对于 EA 患者，性别、家庭世界观和家庭情绪管理与疾病管理相关（家庭一致性得分与 HbA(1c) 水平和抑郁呈负相关，冲突解决得分较差与高度抑郁相关）；对于西班牙裔患者，性别和家庭结构/组织与疾病管理相关（组织凝聚力高分与良好的饮食和锻炼相关，家庭性别角色传统主义高分与高质量生活相关）。与性别没有发生显着的相互作用。结论——进行疾病管理的家庭环境特征与患者的自我保健行为显着相关，并且这些联系因患者种族而异。家庭的多个独立维度为干预提供了多个目标，应考虑家庭规范、结构和情绪管理的差异，以确保干预措施与疾病管理的背景相适应。
OBJECTIVE - To determine the relationship between the characteristics of families involved in disease management and the self-care practices of Hispanic and European-American (EA) patients with type 2 diabetes.RESEARCH DESIGN AND METHODS - A total of 74 Hispanic patients and 113 EA patients with type 2 diabetes recruited from managed care settings were assessed on three domains of family life (family structure/organization, family world view, and family emotion management [four scales]) and five areas of disease management (biological, general health and function status, emotional tone, quality of life, and behavioral [seven scales]). Analyses assessed the independent associations of patient sex, family, and sex by family interactions with disease management.RESULTS - Both sex and the three domains of family life were related to disease management, but the results varied by ethnic group. For EA patients, sex, family world view, and family emotion management were related to disease management (scores for Family Coherence were negatively associated with HbA(1c) level and depression, and poor scores for Conflict Resolution were linked with high depression); for Hispanic patients, sex and family structure/organization were related to disease management (high scores for Organized Cohesiveness were associated with good diet and exercise, and high scores for Family Sex-Role Traditionalism were related to high quality of life). No significant interactions with sex occurred.CONCLUSIONS - Characteristics of the family setting in which disease management takes place are significantly linked to patient self-care behavior, and these linkages vary by patient ethnicity. A family's multiple independent dimensions provide multiple targets for intervention, and differences in family norms, structures, and emotion management should be considered to ensure that interventions are compatible with the setting of disease management.