Barriers to Self-Management in Depressed Women With Type 2 Diabetes.
Barriers to Self-Management in Depressed Women With Type 2 Diabetes.
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DOI：
10.1177/0844562117736699
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发表时间：
2017-12
期刊：
影响因子：
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通讯作者：
Penckofer S
中科院分区：
文献类型：
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作者：
Ridosh MM;Roux G;Meehan M;Penckofer S
描述在完成一项随机临床试验(RCT)的女性中，家庭功能对2型糖尿病(T2 DM)和抑郁症自我管理的影响，这些女性使用维生素D3(每周5,000或50,000国际单位)治疗抑郁症。在经历抑郁时，女性患T2 DM严重程度增加的风险更高。采用的是叙事性调查。本研究采用半结构式访谈的方法，旨在了解管理2型糖尿病和抑郁症的有效策略和障碍。此外，女性被问及她们对家庭生活质量(FQOL)的意义。21名妇女在完成RCT为期六个月的最后访问后参加了访问。平均年龄55.2岁。参与者是24%的西班牙裔，48%的非裔美国人和52%的高加索人。所产生的主要主题与影响其自我管理的家庭问题有关，但参与者不想给自己的家庭带来“过错”。出现了三个主题：(A)家庭困难的经历--“对我来说很难”；(B)没有向家人透露自己抑郁的情况--“与他们交谈没有意义”；(C)需要与家人和其他人建立联系--“Way It With to…”像一家人一样亲密无间。以家庭为中心的方法可以解决自我管理的障碍。实践和研究的“家庭视角”可能会改善健康状况。
Describe the impact of family functioning on the self-management of type 2 diabetes (T2DM) and depression in a subsample of women who completed a randomized clinical trial (RCT) using vitamin D3 (5,000 or 50,000 IUs weekly) for depression treatment. Women are at higher risk for increased severity of T2DM when experiencing depression. Narrative inquiry was used. A semi-structured interview was conducted to understand helpful strategies and barriers in managing T2DM and depression. In addition, women were asked their meaning of family quality of life (FQOL). Twenty-one women participated after completion of the six-month final visit in the RCT. The mean age was 55.2 years. Participants were 24% Hispanic, 48% African-American, and 52% Caucasian. The major themes generated related to family issues that impacted their self-management, yet participants did not want to “bring fault” to their families. Three themes emerged: (a) experience of family hardships—”it’s been hard for me”, (b) lack of disclosure to family about being depressed—”no point in talking to them”, and (c) the need for connectedness with family and others—”the way it used to be … close as a family.” Family-centered approaches could address barriers to self-management. A ‘family lens’ for practice and research may improve health outcomes.