Links of Communal Coping in Couples with Diabetes to Self-care Behavior

糖尿病夫妇的共同应对与自我保健行为的联系

• 批准号: 8685616
• 负责人: VICKI S HELGESON
• 金额: $ 2.81万
• 依托单位: CARNEGIE-MELLON UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-09-01 至 2017-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8685616
• 关键词: Adult; Affect; African American; Age; Area; Behavior; Behavior Control; Blood Glucose; Caucasians; Caucasoid Race; Cause of Death; Child; Chronic Disease; Code; Communities; Complex; Country; Couples; Diabetes Mellitus; Diagnosis; Diet; Direct Costs; Disease; Emotional; Energy Metabolism; Enrollment; Epidemic; Ethnic Origin; Facilities and Administrative Costs; Feeling; Female; Gender; Gender Role; Glucose; Health; Healthcare; Healthcare Systems; Heart Diseases; Helping Behavior; Hour; Insulin; Intervention; Interview; Joints; Kidney Diseases; Laboratories; Laboratory Study; Lead; Life; Link; Literature; Lower Extremity; Measures; Mediating; Mental Health; Methods; Monitor; Neuropathy; Newly Diagnosed; Non-Insulin-Dependent Diabetes Mellitus; Obesity; Observational Study; Outcome; Partner in relationship; Patients; Persons; Pharmaceutical Preparations; Play; Population; Prevention; Process; Public Health; Quality of life; Race; Reaction; Regimen; Reporting; Research; Resistance; Resources; Role; Self Care; Self Determination; Self Efficacy; Self Management; Sex Characteristics; Social Controls; Social Environment; Social Interaction; Social support; Source; Spouses; Stroke; Surveys; Thinking; Time; United States; Videotape; Woman; Work; behavior observation; coping; cost; design; diet and exercise; disability; economic cost; effective intervention; improved; indexing; limb amputation; longitudinal design; male; medication compliance; member; men; nervous system disorder; neuronal cell body; physical conditioning; prevent; primary outcome; racial difference; sex; stressor; theories

DESCRIPTION (provided by applicant): Type 2 diabetes is a public health problem of great significance. The key determinant of whether health complications ensue is patient self-management. However, the self-care regimen for diabetes is complex and the health care system has limited resources to assist patients. Thus, it is not a surprise that self-care is poor. The present application recognizes that patient self-care takes place in a social context and aims to explore the impact of partner behaviors on patient self-care, self-efficacy, and mental and physical health. We propose to enroll 220 persons who have been diagnosed with type 2 diabetes in the past 2 years and their partners. Half of the couples will be African-American, and half will be Caucasian. Within these two groups, half will consist of female patients and half will consist of male patients. We hypothesize that communal coping in couples will lead to better patient self-care, while maintaining high levels of patient self-efficacy and good mental health. We hypothesize that partner supportive behaviors will mediate these relations. We will explore racial and gender differences in communal coping and supportive behavior as well as whether relations of communal coping and partner behavior are differentially related to outcomes due to race and gender. We propose to use multiple methods to assess independent and dependent variables. Methods include: (1) survey instruments that assess communal coping, patient and partner behavior, patient self-care, self- efficacy, and mental health; (2) a dyadic interview measure of communal coping; (3) a laboratory observational study in which couples discuss the way patients manage their disease so that raters can code the videotaped interactions for communal coping, supportive and unsupportive behavior, and affect; (4) an extension of the laboratory study in which patients view the videotapes, recall thoughts and feelings at key points, and raters code the behavior that precipitated the reactions; (5) in person assessments of physical health parameters; and (6) a 14-day ecological momentary assessment (EMA) study that consists of patients/partners completing a brief survey about patient-partner interactions at the end of each day. During the EMA study, three 24-hour dietary recall interviews will be performed, and patients/partners will wear accelerometers to capture activity and energy expenditure. Couples will be contacted six months later to repeat the survey, physical health assessment, and 24-hour recall interviews. The results of this study can be used to design a couples' intervention aimed at maximizing behaviors that help and minimizing behaviors that hinder self-care.

描述（由申请人提供）：2型糖尿病是一个重要的公共卫生问题。健康并发症是否随之而来的关键决定因素是病人的自我管理。然而，糖尿病的自我护理方案是复杂的，并且卫生保健系统具有有限的资源来帮助患者。因此，自我照顾不好也就不足为奇了。 本申请认识到患者自我护理发生在社会背景中，并且旨在探索伴侣行为对患者自我护理、自我效能以及精神和身体健康的影响。我们计划招募220名在过去2年内被诊断为2型糖尿病的患者及其伴侣。一半的夫妇将是非洲裔美国人，一半将是白人。在这两组中，一半将由女性患者组成，另一半将由女性患者组成。 由男性患者组成。我们假设，夫妻共同应对将导致更好的病人自我护理，同时保持高水平的病人自我效能和良好的心理健康。我们假设，合作伙伴的支持行为将调解这些关系。我们将探讨种族和性别的差异，社区应对和支持行为，以及社区应对和合作伙伴行为的关系是否差异相关的结果，由于种族和性别。我们建议使用多种方法来评估自变量和因变量。方法包括：（1）评估社区应对、患者和伴侣行为、患者自我护理、自我效能和心理健康的调查工具;（2）社区应对的二元访谈测量;（3）实验室观察性研究，其中夫妇讨论患者管理疾病的方式，以便评分者可以对社区应对、支持和不支持行为以及影响的录像互动进行编码;（4）实验室研究的延伸，患者观看录像带，回忆关键点的想法和感受，评分员对促成反应的行为进行编码;（5）亲自评估身体健康参数;和（6）为期14天的生态瞬时评估（EMA）研究，包括患者/合作伙伴完成关于患者-在每天结束时与伙伴互动。在EMA研究期间，将进行三次24小时饮食回忆访谈，患者/伴侣将佩戴加速计以捕获活动和能量消耗。六个月后，研究人员将联系这些夫妇，重复调查、身体健康评估和24小时回忆访谈。这项研究的结果可以用来设计一个夫妇的干预，旨在最大限度地提高行为，帮助和最小化行为，阻碍自我照顾。