The network of psychological variables in patients with diabetes and their importance for quality of life and metabolic control
The network of psychological variables in patients with diabetes and their importance for quality of life and metabolic control
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DOI：
10.2337/diacare.25.1.35
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发表时间：
2002-01-01
期刊：
影响因子：
16.2
通讯作者：
Klapp, BF
中科院分区：
文献类型：
--
作者：
Rose, M;Fliege, H;Klapp, BF
目的-治疗糖尿病患者的主要目标是维持血糖水平尽可能接近正常，使相对正常的生活质量。这两个目标都受到许多身体和心理因素的影响，这些因素应该被视为建立一个复杂的网络。我们研究了是否可以解释一个数学模型，可以描述每个因素的相对重要性，以实现这些治疗目标。研究设计和方法-共有625名患者从32个不同的治疗设施进行了检查（224例1型和401例2型糖尿病患者）使用HbA（1c）值（高效液相色谱法）、继发性疾病的数量以及与健康相关的生活质量的标准化问卷（世界卫生组织生活质量问卷），应对行为（Freiburger疾病应对策略问卷），糖尿病特定知识（糖尿病知识测验），医患关系（医学访谈满意度量表）和人格特征（吉森测试和自我效能和乐观信念评估）。结果：该模型被证明是有效的（chi（2）= 88.5，df = 76，P = 0.16），显示出良好的拟合（调整拟合优度[AGFI] = 0.94）。它解释了62%的生活质量方差和5%的HbA（1c）值。被试的特点是对自我效能感有较强的信念，他们表现出更积极的应对行为，并被证明具有更高的生活质量。积极的应对行为是唯一的心理变量显着的HbA（1C）values.CONCLUSIONS -这是可能的，以说明所涉及的各种因素和他们的相互依赖性和意义的治疗目标。自我效能和积极应对行为的信念似乎与实现主要治疗目标具有最大的相关性。
OBJECTIVE - The primary goals in treating patients with diabetes are maintaining blood glucose levels as close to normal as possible and making a relatively normal quality of life achievable. Both of these goals are influenced by a multitude of somatic and psychological factors that should be seen as building a complex network. We examined whether a mathematical model can be construed that can depict the relative significance of each factor for achieving these treatment goals.RESEARCH DESIGN AND METHODS - A total of 625 patients from 32 different treatment facilities were examined (224 type 1 and 401 type 2 diabetic patients) using HbA(1c) values (high-performance liquid chromatography), number of secondary illnesses, and standardized questionnaires with respect to health-related quality of life (World Health Organization Quality of Life questionnaire), coping behavior (Freiburger Illness-Coping Strategies questionnaire), diabetes-specific knowledge (Test of Diabetes-Specific Knowledge), doctor-patient relationship (Medical Interview Satisfaction Scale), and personality characteristics (Giessen Test and Assessment of Beliefs in Self-Efficacy and Optimism). The analyses were carried out by means of a structural equation model.RESULTS - The model proved to be valid (chi (2) = 88.5, df = 76, P = 0.16), showing a sound fit (adjusted goodness of fit [AGFI] = 0.94). It explained 62% of the variance of the quality of life and 5% of the HbA(1c) values. Subjects characterized by strong beliefs in their self-efficacy and an They demonstrated more active coping behavior and proved to have a higher quality of life. Active coping behavior was the only psychological variable significant for the HbA(1c) values.CONCLUSIONS - It was possible to illustrate the various factors involved and their mutual dependency and significance for the treatment goals. Belief in self-efficacy and active coping behavior appear to have the greatest relevance for achieving the primary treatment goals.