INVESTING TIME IN HEALTH: DO SOCIOECONOMICALLY DISADVANTAGED PATIENTS SPEND MORE OR LESS EXTRA TIME ON DIABETES SELF-CARE?
INVESTING TIME IN HEALTH: DO SOCIOECONOMICALLY DISADVANTAGED PATIENTS SPEND MORE OR LESS EXTRA TIME ON DIABETES SELF-CARE?
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DOI：
10.1002/hec.1394
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发表时间：
2009-06-01
期刊：
影响因子：
2.1
通讯作者：
Thompson, Theodore J.
中科院分区：
文献类型：
--
作者：
Ettner, Susan L.;Cadwell, Betsy L.;Thompson, Theodore J.
背景：关于慢性病自我护理的研究没有检查时间要求。将糖尿病研究转化为行动（TRIAD）是一项针对糖尿病管理护理患者的多中心研究，是第一批评估自我护理时间的研究之一。目的：研究社会经济地位与患者因糖尿病而花费在足部护理、购物/烹饪和锻炼上的额外时间之间的关系。数据：2000年至2001年的11927例患者调查。方法：贝叶斯两部分模型被用来估计协会的自我报告的额外的时间花在自我护理与种族/民族，教育和收入，控制人口和临床特征。结果：患者花费没有额外的时间在足部护理，购物/烹饪和锻炼的比例分别为37，52和31%。在少数种族/族裔、受教育程度较低和收入较低的患者中，用于足部护理和购物/烹饪的额外时间更多。例如，非洲裔美国人约10个百分点，更有可能报告花费额外的时间在足部护理比白人和额外的时间花了约3分钟以上，每天。讨论：额外的时间花在自我护理是更大的社会经济地位低下的患者比patients，也许是因为他们认为的机会成本的时间较低，或者他们买不起替代品。我们的研究结果表明，在弱势群体中控制不佳的糖尿病风险因素可能不是由于自我保健的做法。版权所有（C）2008约翰威利父子有限公司
Background: Research on self-care for chronic disease has not examined time requirements. Translating Research into Action for Diabetes (TRIAD), a multi-site study of managed care patients with diabetes, is among the first to assess self-care time.Objective: To examine associations between socioeconomic position and extra time patients spend on foot care, shopping/cooking, and exercise due to diabetes.Data: Eleven thousand nine hundred and twenty-seven patient surveys from 2000 to 2001.Methods: Bayesian two-part models were used to estimate associations of self-reported extra time spent on self-care with race/ethnicity, education, and income, controlling for demographic and clinical characteristics.Results: Proportions of patients spending no extra time on foot care, shopping/cooking, and exercise were, respectively, 37, 52, and 31%. Extra time spent on foot care and shopping/cooking was greater among racial/ethnic minorities, less-educated and lower-income patients. For example, African-Americans were about 10 percentage points more likely to report spending extra time on foot care than whites and extra time spent was about 3 min more per day.Discussion: Extra time spent on self-care was greater for socioeconomically disadvantaged patients than for advantaged patients, perhaps because their perceived opportunity cost of time is lower or they cannot afford Substitutes. Our findings suggest that poorly controlled diabetes risk factors among disadvantaged populations may not be attributable to self-care practices. Copyright (C) 2008 John Wiley & Sons, Ltd.