目的:综合2型糖尿病(T2D)病耻感与心理,行为,和临床结果。
方法:我们搜索了APAPyschInfo,CochraneCentral,Scopus,WebofScience,Medline,CINAHL和EMBASE至2022年11月。同行评审的观察性研究,研究了T2D污名和心理之间的关联,行为,和/或临床结局符合纳入条件.使用JBI关键评估清单评估偏差风险。在随机效应荟萃分析中汇总相关系数。
结果:我们的搜索产生了9642次引用,29符合纳入标准。包含的文章在2014年至2022年之间发表。我们发现T2D柱头和HbA1C之间存在弱正相关(r=0.16,95%CI:0.08至025,I2=70%,N=7项研究),T2D病耻感与抑郁症状之间呈中度正相关(r=0.49,95%CI:0.44至0.54,I2=26.9%,n=5项研究)和糖尿病困扰(r=0.54,95%CI:0.35至0.72,I2=96.9%,n=7项研究)。患有T2D污名的人经历了污名倾向于较少参与糖尿病自我管理,尽管这种关联较弱(r=-0.17,95%CI:-0.25至-0.08,I2=79.8%,n=7项研究)。
结论:T2D病耻感与负面健康结果相关。需要进一步的研究来解开潜在的因果机制,以指导适当的减少污名的干预措施的发展。
OBJECTIVE: To synthesize quantitative research evidence on the association between type 2 diabetes (T2D) stigma and psychological, behavioral, and clinical outcomes.
METHODS: We searched APA PsycINFO, Cochrane Central, Scopus, Web of Science, Medline, CINAHL and EMBASE through November 2022. Peer-reviewed observational studies examining the association between T2D stigma and psychological, behavioral, and/or clinical outcomes were eligible for inclusion. Risk of bias was assessed with the JBI critical appraisal checklist. Correlation coefficients were pooled in random effect meta-analyses.
RESULTS: Our search produced 9642 citations, 29 met the inclusion criteria. Included articles were published between 2014 and 2022. We found a weak positive correlation between T2D stigma and HbA1C (r = 0.16, 95% CI:0.08 to 025, I2 = 70%, N = 7 studies), a moderate positive correlation between T2D stigma and depressive symptoms (r = 0.49, 95% CI: 0.44 to 0.54, I2 = 26.9%, n = 5 studies) and diabetes distress (r = 0.54, 95% CI: 0.35 to 0.72, I2 = 96.9%, n = 7studies). Persons with T2D stigma who experienced stigma tended to have less engagement in diabetes self-management, though this association was weak (r = -0.17, 95% CI: -0.25 to -0.08, I2 = 79.8%, n = 7studies).
CONCLUSIONS: T2D stigma was associated with negative health outcomes. Further studies are required to disentangle the underlying causal mechanisms to inform the development of appropriate stigma-reduction interventions.