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Followup: Links of Communal Coping in Couples with Diabetes to Diabetes Outcomes

后续：糖尿病夫妇的共同应对与糖尿病结果的联系

基本信息

批准号：
9750711
负责人：
VICKI S HELGESON
金额：
$ 56.71万
依托单位：
CARNEGIE-MELLON UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2012
资助国家：
美国
起止时间：
2012-09-01 至 2022-06-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9750711
关键词：
Adopted Affect African American American Area Behavior Behavior Control Blood Glucose Blood Pressure Caring Cause of Death Child Chronic Disease Collaborations Communities Complex Country Couples Data Diabetes Mellitus Diagnosis Diet Discipline Disease Ecological momentary assessment Education Environmental Risk Factor Epidemic Equilibrium Evaluation Family Female Fostering Friends Glycosylated hemoglobin A Goals Health Healthcare Heart Diseases Income Individual Intervention Interview Joints Kidney Diseases Language Length Life Link Lipids Literature Lower Extremity Measures Mental Health Methods Monitor Newly Diagnosed Non-Insulin-Dependent Diabetes Mellitus Outcome Parents Participant Patient Self-Report Patients Pattern Persons Pharmaceutical Preparations Physical Exercise Physical assessment Play Population Quality of life Race Regimen Reporting Research Resources Role Sampling Self Care Self Efficacy Self Management Social Environment Social Network Social support Source Spouses Stroke Surveys Testing Time United States Videotape Well in self behavioral outcome care providers caucasian American clinical care college commune comparison group coping design diabetes management diet and exercise ethnic diversity follow-up glucose monitor glycemic control limb amputation male member physical conditioning prevent primary outcome psychological outcomes psychosocial racial difference recruit sex trend

项目摘要

Diabetes is the 7th leading cause of death in the United States and is associated with health complications that pose serious threats to quality and quantity of life. Preventing complications involves adhering to a labor- intensive self-care regimen, involving changes in diet, exercise, glucose monitoring, and taking medications to control blood glucose levels and associated conditions (e.g., blood pressure). Previous research in the area of diabetes emphasizes how person factors contribute to outcomes, but diabetes is a chronic illness that takes place in an interpersonal context that extends beyond the person with diabetes. Over the past 5 years, we adopted a communal coping framework to understand the role of the spouse/partner in patient adjustment to newly diagnosed type 2 diabetes (R01 DK095780). Communal coping represents a joint appraisal of the problem (i.e., “our” problem instead of “his/her” problem) and couple collaboration to manage the problem. To date, we have recruited 191 (goal 220) couples from the community in which the patient was diagnosed with type 2 diabetes in the past 3 years. Patients are diverse in terms of race (56% white, 44% black), income, and sex (56% male). We have examined communal coping with multiple methods (self-report, language, behavior) and report promising results. With this competing continuation, we have a rare opportunity to collect 5-year longitudinal data on a large sample of Whites and African Americans with type 2 diabetes to examine changes in psychological and physical health with a rich set of psychosocial predictor variables. Primary Aim 1 is to examine how communal coping changes over 5 years and determine if initial communal coping and changes in communal coping predict changes in psychological well-being, self-care behavior, and glycemic control. Primary Aim 2 is to examine sex and race as moderators of the relation of communal coping to health. A secondary exploratory aim is to recruit a comparison group of people without romantic partners to determine if communal coping and the relation of communal coping to outcomes extends to family and friends. Because African Americans are less likely than Whites to be married and are more likely than Whites to have significant non-spousal sources of support, this aim is directed at African Americans. We plan to re-recruit 220 current study couples 5 years after the initial interview and recruit 50 new non-romantic partnered African American dyads. Study methods include: (1) survey instruments to assess communal coping, patient/partner behavior, patient self-care, self-efficacy, and mental health; (2) interview measure of communal coping; (3) evaluation of videotaped couple conversations about diabetes-related problems to assess communal coping, supportive and unsupportive behavior, and affect; (4) in person assessments of physical health parameters, including HbA1c; and (5) 14-day ecological momentary assessment that consists of patients/partners completing brief surveys about their interactions and diabetes care at the end of each day. The results of this study can be used to design dyadic interventions aimed at fostering self-care behavior among persons with type 2 diabetes. 1

糖尿病是美国第七大死亡原因，与健康并发症有关，对生活的质量和数量构成严重威胁。预防并发症包括坚持分娩- 强化自我护理方案，包括改变饮食、锻炼、血糖监测和服用药物，控制血糖水平和相关状况（例如，血压）。以前的研究领域糖尿病强调个人因素如何影响结果，但糖尿病是一种慢性疾病，在人际关系的背景下，超越糖尿病患者。在过去的五年里，我们采用社区应对框架来了解配偶/伴侣在患者适应中的作用，新诊断的2型糖尿病（R 01 DK 095780）。共同应对是对问题（即，“我们的”问题而不是“他/她的”问题）和夫妇合作来管理问题。到迄今为止，我们从患者被诊断为患有糖尿病的社区招募了191对（目标220）夫妇。 2型糖尿病在过去三年患者在种族（56%白色，44%黑人）、收入和性别（56%男性）。我们用多种方法（自我报告，语言，行为）研究了社区应对并报告有希望的结果。随着这一竞争的延续，我们有一个难得的机会，收集5年 2型糖尿病患者的大样本白人和非洲裔美国人的纵向数据，以检查在心理和身体健康方面具有丰富的心理社会预测变量。主要目标1是研究社区应对如何在5年内发生变化，并确定最初的社区应对和社区应对可预测心理健康、自我护理行为和血糖控制的变化。主要目的2是研究性别和种族的关系，社区应对健康的主持人。一第二个探索性目标是招募一组没有浪漫伴侣的人作为对照，以确定社区应对和社区应对与结果的关系延伸到家庭和朋友。因为非裔美国人比白人结婚的可能性更小，比白人更有可能拥有重要的婚姻。非配偶的支持来源，这一目标是针对非裔美国人。我们计划重新招募220名现任在最初的面试后5年，研究了50对新的非浪漫伴侣的非裔美国人二分体研究方法包括：（1）调查工具，以评估社区应对，病人/伙伴的行为，病人自我照顾、自我效能与心理健康;（2）社区因应的访谈测量;（3）对夫妇关于糖尿病相关问题的对话进行录像，以评估社区应对、支持和不支持的行为和影响;（4）身体健康参数的个人评估，包括HbA 1c; 和（5）14天的生态瞬时评估，包括患者/伴侣完成简短调查关于他们的互动和糖尿病护理在每一天结束时。本研究结果可用于设计 2型糖尿病患者的自我保健行为。 1