Australian Psychologist：精神健康状况可作为糖尿病自我监护指标

　　斯威本科技大学健康与社会研究中心学者Naomi Hackworth等人开展的一项研究提示，精神健康状况或可作为糖尿病自我监护指标。

　　研究者在城市与农村青年1型糖尿病患者中评估糖尿病自我护理（治疗依从性情况）、代谢控制（糖化血红蛋白水平）以及精神健康的心理社会性预测因子。入选的123例青少年/成年早期（平均年龄16岁）1型糖尿病患者（50例男性，73例女性）均完成一项调研问卷，报告其糖尿病自我护理、代谢控制与精神健康情况，有潜在风险的行为与态度，糖尿病自我效能、社区管理，以及感知到的社会支持。

　　受试者各指标结果并无城乡差异。自我效能较高、风险行为较少，对风险行为态度保守的青少年，糖尿病自我监护结果更好，其结果预测代谢控制、精神健康状况指标结果更好。

　　社会支持与社区医疗活动对糖尿病自我监护无影响。

与糖尿病相关的拓展阅读：

• J Med Life：1型糖尿病合并抑郁者转归较差
• MedPage：加拿大新指南称糖尿病患者40岁时应该使用他汀类药物
• Diabetes Care：维生素D缺乏不能预测糖尿病患者心血管风险 更多信息请点击：有关糖尿病更多资讯

Predictors of Diabetes Self-care, Metabolic Control, and Mental Health in Youth with Type 1 Diabetes
Abstract
The purpose of this study was to explore the psychosocial predictors of diabetes self-care (adherence to care regimes), metabolic control (glycated haemoglobin), and mental health among rural- and urban-dwelling youth with type 1 diabetes. One hundred and twenty three adolescents/young adults (aged 13−25 years, mean = 16 years, standard deviation = 3.8 years) with type 1 diabetes, 50 males and 73 females, completed questionnaires reporting on diabetes self-care, metabolic control, mental health (negative affect, quality of life), risk-taking behaviours and attitudes, diabetes self-efficacy, community engagement, and perceived social support. No rural/urban differences were detected on key predictors or outcome variables. Structural equation modelling revealed that high diabetes self-efficacy, lower risk behaviour, and more conservative attitudes to risk taking predicted better diabetes self-care, which in turn predicted better metabolic control and mental health. Social support and engagement in community activities did not influence diabetes self-care. The study has significance because both diabetes self-efficacy and propensity towards risk behaviour are potential targets for educational and counselling interventions designed to improve diabetes self-care regimes and resultant metabolic and mental health outcomes.