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Understanding the factors influencing diabetes self-management in Chinese people with type 2 diabetes using structural equation modeling.

机译：使用结构方程模型了解影响中国2型糖尿病患者糖尿病自我管理的因素。

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摘要

Background. In China, more than 20 million people were diagnosed with diabetes in 2000 and it was estimated there would be 42.3 million people with diabetes by 2030 (Wild, Roglic, Green, Sicree, & King, 2004). Diabetes mellitus self-management (DMSM) is considered the cornerstone for controlling diabetes and preventing diabetic complications. To develop effective interventions to promote DMSM in China, it is critical to identify the factors influencing DMSM relevant to this population. The purposes of this study were to test a hypothesized model describing the effects of individual and environmental factors on DMSM in patients with type 2 diabetes in China, and to test if the estimated effects are the same between two subgroups, patients treated with insulin vs. patients treated without insulin. The individual factors included diabetes knowledge, beliefs of treatment effectiveness, and diabetes self-efficacy. Environmental factors included social support from family members and provider-patient communication.;Methods. A cross-sectional survey research design was used in this study. The study was conducted at a major hospital in Beijing China. A convenience sample of 201 Chinese adult patients with type 2 diabetes mellitus who attended the outpatient department of the Endocrinology unit at the hospital from September 2004 to November 2004 was obtained for this study. Data were collected using a self-reported questionnaire. Structural equation modeling (SEM) analysis was conducted to test the hypothesized model, and examine and explore the relationships between and among the individual and environmental factors and DMSM.;Findings. The initial hypothesized model did not fit the observed data. Based on statistical findings and theoretical soundness, the model was modified. The final model had a good fit to the data. The key findings were that belief in treatment effectiveness and diabetes self-efficacy were key proximal factors affecting DMSM. Knowledge and the environmental factors indirectly affected DMSM through belief in treatment effectiveness and self-efficacy. The findings based on the multi-group SEM analysis indicated that patient-provider communication was a more important factor affecting DMSM for the insulin-treated subgroup, while family support was more important for the non-insulin treated subgroup.;Conclusions. The good fit of the final model indicated that significant determinants of DMSM described in American studies were also important predictors of DMSM in Chinese with diabetes. The model illustrated that individual and environmental factors affected DMSM both directly and indirectly. Understanding the complex relationships between and among the individual and environmental factors and DMSM helps the practitioner to design intervention programs promoting DMSM using a more comprehensive approach. The practitioner should also be aware of the differences between the subgroups when developing intervention programs.
机译：背景。在2000年，中国有2000万人被诊断出患有糖尿病，据估计，到2030年将有4230万人患有糖尿病（Wild，Roglic，Green，Sicree和King，2004年）。糖尿病自我管理（DMSM）被认为是控制糖尿病和预防糖尿病并发症的基石。为了制定有效的干预措施在中国推广DMSM，确定影响与该人群相关的DMSM的因素至关重要。这项研究的目的是检验一个假设模型，该模型描述个体和环境因素对中国2型糖尿病患者DMSM的影响，并检验在两个亚组之间（胰岛素治疗组与胰岛素治疗组之间）估计的效果是否相同。没有胰岛素治疗的患者。个体因素包括糖尿病知识，对治疗效果的信念以及糖尿病自我效能感。环境因素包括家庭成员的社会支持和医患之间的沟通。本研究使用横断面调查研究设计。这项研究是在中国北京的一家大型医院进行的。从2004年9月至2004年11月在医院内分泌科门诊就诊的201例中国成人2型糖尿病患者的便利样本被获得。使用自我报告的问卷收集数据。进行了结构方程模型（SEM）分析以检验假设的模型，并检查和探索个体与环境因素和DMSM之间的关系。最初的假设模型不符合观察到的数据。根据统计结果和理论上的合理性，对模型进行了修改。最终模型非常适合数据。关键发现是，对治疗有效性和糖尿病自我效能的信念是影响DMSM的关键近端因素。知识和环境因素通过对治疗有效性和自我效能的信念间接影响了DMSM。基于多组SEM分析的结果表明，患者与医务人员的沟通是影响DMSM的更重要因素，而对于非胰岛素治疗的亚组而言，家庭支持更为重要。最终模型的良好拟合表明，美国研究中描述的DMSM的重要决定因素也是中国糖尿病患者DMSM的重要预测因子。该模型表明，个人和环境因素直接或间接地影响了DMSM。了解个人因素与环境因素以及DMSM之间的复杂关系有助于从业者设计干预计划，以使用更全面的方法来促进DMSM。在制定干预计划时，从业人员还应该意识到亚组之间的差异。

著录项

  • 作者

    Xu, Yin.;

  • 作者单位

    University of Cincinnati.;

  • 授予单位 University of Cincinnati.;
  • 学科 Health Sciences Nursing.;Health Sciences Public Health.
  • 学位 Ph.D.
  • 年度 2005
  • 页码 162 p.
  • 总页数 162
  • 原文格式 PDF
  • 正文语种 eng
  • 中图分类
  • 关键词

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