背景:改善生活质量(QOL)是2型糖尿病(T2D)患者早期诊断和治疗的最重要目标。大量研究表明,健康素养的积极作用,社会支持和自我护理行为以及糖尿病困扰和倦怠对T2D患者生活质量的负面影响。了解这些因素对糖尿病患者至关重要。然而,没有研究调查这些变量对生活质量的同时影响.在这项研究中,我们的目标是找出这些变量是如何相互关联的,此外,哪些变量起着中介变量的作用,最后,这些变量在预测T2D患者生活质量方面的累积作用是什么。所以,本研究旨在探讨糖尿病健康素养(DHL)与糖尿病健康素养之间的关系,苦恼,倦怠,社会支持,糖尿病并发症,自我照顾行为,应用路径分析方法对T2D患者的生活质量进行分析。
方法:本研究采用整群抽样的方法对929名参与者进行研究,对820名参与者的数据进行了分析.数据是通过自我报告和人口统计学部分的七个工具收集的,DHL秤,糖尿病困扰量表,糖尿病倦怠量表,糖尿病自我管理问卷(DSMQ),感知到的社会支持,糖尿病生活质量(DQOL)问卷。使用SPSS版本24和AMOS版本24的软件进行分析。
结果:DHL的变量,社会支持,糖尿病困扰,糖尿病并发症预测糖尿病倦怠的方差为38%(R2=0.38)。对糖尿病倦怠的最大影响与糖尿病困扰有关(估计总效应=0.539)。DHL的变量,社会支持,糖尿病困扰,糖尿病并发症,糖尿病倦怠对自我护理行为的预测差异为24%(R2=0.24)。对自我护理行为的最大影响与DHL有关(估计总效果=0.354)。DHL的变量,社会支持,糖尿病困扰,糖尿病倦怠,糖尿病并发症,自我护理行为预测DQOL的方差为49%(R2=0.49)。对DQOL的最大影响与糖尿病困扰的变量有关(估计总效应=-0.613),DHL(估计总效果=0.225),糖尿病倦怠(估计总效应=-0.202),糖尿病并发症(估计总效应=-0.173),社会支持(估计总效应=0.149),和自我护理(估计总效果=0.149),分别。
结论:为了改善T2D患者的生活质量,医疗保健提供者必须制定增加糖尿病患者DHL的干预措施。因为DHL可以减少痛苦和倦怠,增强自我护理技能,创建支持性网络,并最终改善2型糖尿病患者的生活质量。
BACKGROUND: Improving the quality of life (QOL) is the most important goal of early diagnosis and treatment in patients with type 2 diabetes (T2D). Numerous studies have indicated the positive effects of health literacy, social support and self-care behaviors and the negative effects of diabetes distress and burnout on the QOL of patients with T2D. Understanding these factors is crucial for people with diabetes. However, no study has investigated the simultaneous effects of these variables on QOL. In this study, our goals were to find out how these variables are related to each other, in addition, which variables play the role of mediating variables, and finally, what is the cumulative effect of these variables in predicting the QOL of patients with T2D. So, this study aimed to examine the relationship between diabetes health literacy (DHL), distress, burnout, social support, complications of diabetes, self-care behaviors, and QOL among patients with T2D by application Path analysis method.
METHODS: In this study 929 participants were entered to study by cluster sampling method and finally, data were analyzed among 820 participants. Data were gathered by self-report and with seven tools of Demographic section, DHL Scale, Diabetes distress scale, Diabetes Burnout scale, Diabetes Self-Management Questionnaire (DSMQ), Perceived social support, Diabetes Quality of Life (DQOL) Questionnaire. The software\'s of SPSS version 24 and AMOS version 24 were used for analysis.
RESULTS: The variables of DHL, social support, diabetes distress, and complications of diabetes predicted 38% variance in diabetes burnout (R2 = 0.38). Greatest impact on diabetes burnout was related to diabetes distress (estimate total effect = 0.539). The variables of DHL, social support, diabetes distress, complications of diabetes, and diabetes burnout predicted 24% variance in self- care behaviors (R2 = 0.24). Greatest impact on self- care behaviors was related to DHL (estimate total effect = 0.354). The variables of DHL, social support, diabetes distress, diabetes burnout, complications of diabetes, and self- care behaviors predicted 49% variance in DQOL (R2 = 0.49). Greatest impact on DQOL was related to variables of diabetes distress (estimate total effect = -0.613), DHL (estimate total effect = 0.225), diabetes burnout (estimate total effect = -0.202), complications of diabetes (estimate total effect = - 0.173), social support (estimate total effect = 0.149), and self -care (estimate total effect = 0.149), respectively.
CONCLUSIONS: To improve QOL in patients with T2D, health care providers must develop interventions that increase DHL of diabetic. Because DHL can decrease distress and burnout, enhance self -care skills, create supportive networks, and ultimately improve QOL in patients with type 2 diabetes.