Impact of Diabetes Self-Management Education on Psychological Distress and Health Outcomes Among African Americans and Hispanics/Latinos With Diabetes.
Impact of Diabetes Self-Management Education on Psychological Distress and Health Outcomes Among African Americans and Hispanics/Latinos With Diabetes.
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DOI：
10.2337/ds18-0081
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发表时间：
2019-11-01
期刊：
影响因子：
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通讯作者：
Ory, Marcia G
中科院分区：
文献类型：
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作者：
Pena-Purcell, Ninfa;Han, Gang;Ory, Marcia G
目的：糖尿病自我管理教育和支持（DSME/S）是改善健康结果的有效策略。然而，人们对正式 DSME/S 对少数群体心理困扰的影响知之甚少。研究目的是 1) 探索文化定制的 DSME/S 干预对非裔美国人和西班牙裔/拉丁裔参与者的心理困扰和糖尿病相关结果的影响，2) 检查各组在自我护理、自我效能、糖尿病知识和心理困扰方面的差异。 方法：采用测试前和测试后研究设计，分别在干预的第 1 周和第 7 周进行基线和测试后评估。统计分析包括人口变量和四种结果（自我保健、自我效能、知识和心理困扰评分）的描述性统计、测试后结果的一般线性回归分析以及心理困扰评分与结果之间的 Spearman 相关性。 结果：与非裔美国参与者 (n = 122) 相比，西班牙裔/拉丁裔参与者 (n = 137) 明显更年轻且受教育程度更低。两组在性别、收入和健康状况方面具有可比性。每组在测试前和测试后的自我护理、自我效能和心理困扰方面都有显着改善。糖尿病知识有中等程度的提高。与非裔美国人相比，西班牙裔/拉丁裔美国人的测试后自我效能感和自我保健得分明显更高。对于非裔美国人和西班牙裔/拉丁裔参与者来说，较低的心理困扰分数通常与较高的自我效能和自我保健相关。非裔美国人或西班牙裔/拉丁裔参与者的心理困扰评分与知识没有显着相关。仅对于非裔美国人来说，更好的健康状况与更少的心理困扰显着相关。结论：DSME/S 计划有可能改善非裔美国人和西班牙裔/拉丁裔的心理健康，从而带来更好的糖尿病结局。
PURPOSE: Diabetes self-management education and support (DSME/S) is an effective strategy to improve health outcomes. However, little is known about the impact of formal DSME/S on psychological distress among minority populations. The study purposes were to 1) explore the impact of a culturally tailored DSME/S intervention on psychological distress and diabetes-related outcomes among African-American and Hispanic/Latino participants and 2) examine differences across groups in self-care, self-efficacy, diabetes knowledge, and psychological distress.METHODS: Using a pre- and post-test research design, baseline and post-test assessments were conducted at weeks 1 and 7 of the intervention, respectively. Statistical analyses included descriptive statistics for demographic variables and four outcomes (self-care, self-efficacy, knowledge, and psychological distress score), general linear regression analysis of the post-test outcomes, and the Spearman correlation between psychological distress score and the outcomes.RESULTS: Compared to African-American participants (n = 122), Hispanic/Latino participants (n = 137) were significantly younger and less educated. The two groups were comparable in sex, income, and health status. Significant pre- to post-test improvements were seen in each group for self-care, self-efficacy, and psychological distress. Diabetes knowledge had moderate improvement. Hispanics/Latinos had significantly greater post-test self-efficacy and self-care scores compared to African Americans. For both African-American and Hispanic/Latino participants, lower psychological distress scores were generally associated with greater self-efficacy and self-care. Psychological distress scores were not significantly associated with knowledge in African-Amerian or Hispanic/Latino participants. For African Americans only, better health status was significantly associated with less psychological distress.CONCLUSION: DSME/S programs have the potential to improve psychological health among African Americans and Hispanics/Latinos, which can lead to better diabetes outcomes.