The relationship between depressive symptoms and medication nonadherence in type 2 diabetes: the role of social support.
The relationship between depressive symptoms and medication nonadherence in type 2 diabetes: the role of social support.
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DOI：
10.1016/j.genhosppsych.2012.01.015
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发表时间：
2012-05
影响因子：
7
通讯作者：
Egede LE
中科院分区：
文献类型：
--
作者：
Osborn CY;Egede LE
需要药物依从性促进干预措施，目标是可改变的行为因素，这些因素有助于抑郁症状和糖尿病自我护理行为依从性差之间的联系。为了确定哪些因素导致这种联系，我们研究了社会支持作为抑郁症状和药物不依从性之间关系的中介的作用。我们招募了139名2型糖尿病患者。使用间接效应检验与偏差校正自举法，我们测试是否抑郁症状有一个间接的影响，通过缺乏社会支持的药物不遵守。更多的抑郁症状与药物不依从性相关（总效应= 0.06，p <0.001），更多的抑郁症状与更少的社会支持相关（预测因子对中介因子的直接效应=-0.96，p = 0.02），更少的社会支持与药物不依从性相关（中介因子对结局的直接效应=-0.01，p <0.01）。虽然更多的抑郁症状和药物不依从性之间的关系持续与社会支持在预测的途径，这种关系的程度部分解释了更多的抑郁症状和更少的社会支持之间的关系（间接效应= 0.01，95%BC自举CI为0.0005至0.0325）。为有抑郁症状的糖尿病患者提供社会支持可能会减轻抑郁症状对药物不依从性的一些有害影响，但仅靠社会支持是不够的。
Medication adherence promotion interventions are needed that target modifiable behavioral factors contributing to the link between depressive symptoms and poor adherence to diabetes self-care behaviors. In an effort to identify what factors contribute to this link, we examined the role of social support as a mediator of the relationship between depressive symptoms and medication non-adherence. We recruited 139 subjects with type 2 diabetes. Using an indirect effect test with bias corrected bootstrapping, we tested whether depressive symptoms had an indirect effect on medication non-adherence through a lack of social support. More depressive symptoms were associated with medication non-adherence (total effect =.06, p < .001), more depressive symptoms were associated with less social support (direct effect of the predictor on the mediator = −.96, p = .02), and less social support was associated with medication non-adherence (direct effect of the mediator on the outcome = −.01, p < .01). While the relationship between more depressive symptoms and medication non-adherence persisted with social support in the predicted pathway, the degree of this relationship was partially explained by a relationship between more depressive symptoms and less social support (indirect effect = .01, 95% BC bootstrapped CI of .0005 to .0325). Providing social support to patients with diabetes who have symptoms of depression may ameliorate some of the deleterious effects of depressive symptoms on medication non-adherence, but social support alone is not enough.
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影响因子：
7.6
作者：
BARON, RM;KENNY, DA
通讯作者：
KENNY, DA
影响因子：
3.3
作者：
Lustman, PJ;Griffith, LS;McGill, JB
通讯作者：
McGill, JB
DOI：
10.1023/a:1026595011371
发表时间：
2000-12-01
期刊：
Prevention science : the official journal of the Society for Prevention Research
影响因子：
--
作者：
MacKinnon, D P;Krull, J L;Lockwood, C M
通讯作者：
Lockwood, C M
影响因子：
4.2
作者：
Fortmann, Addie L.;Gallo, Linda C.;Philis-Tsimikas, Athena
通讯作者：
Philis-Tsimikas, Athena
DOI：
10.1177/0145721710361389
发表时间：
2010-03
期刊：
The Diabetes educator
影响因子：
--
作者：
Egede LE;Osborn CY
通讯作者：
Osborn CY