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The relationship between depressive symptoms and medication nonadherence in type 2 diabetes: The role of social support

机译：2型糖尿病患者抑郁症状与药物不依从性的关系：社会支持的作用

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Objective: Medication adherence promotion interventions are needed that target modifiable behavioral factors contributing to the link between depressive symptoms and poor adherence to diabetes self-care behaviors. In an effort to identify what factors contribute to this link, we examined the role of social support as a mediator of the relationship between depressive symptoms and medication nonadherence. Method: We recruited 139 subjects with type 2 diabetes. Using an indirect effect test with bias-corrected (BC) bootstrapping, we tested whether depressive symptoms had an indirect effect on medication nonadherence through a lack of social support. Results: More depressive symptoms were associated with medication nonadherence (total effect=.06, P<.001), more depressive symptoms were associated with less social support (direct effect of the predictor on the mediator=-.96, P=.02), and less social support was associated with medication nonadherence (direct effect of the mediator on the outcome=-.01, P<.01). While the relationship between more depressive symptoms and medication nonadherence persisted with social support in the predicted pathway, the degree of this relationship was partially explained by a relationship between more depressive symptoms and less social support (indirect effect=.01, 95% BC bootstrapped confidence interval of .0005 to .0325). Conclusion: Providing social support to patients with diabetes who have symptoms of depression may ameliorate some of the deleterious effects of depressive symptoms on medication nonadherence, but social support alone is not enough.
机译：目的：需要药物依从性促进干预措施，这些干预措施应针对可改变的行为因素，这些行为因素促成抑郁症状与对糖尿病自我护理行为依从性差之间的联系。为了确定哪些因素促成了这一联系，我们研究了社会支持作为抑郁症状与药物不依从之间关系的中介者的作用。方法：我们招募了139名2型糖尿病患者。使用带有偏倚校正（BC）自举的间接效应测试，我们测试了抑郁症状是否由于缺乏社会支持而对药物非依从性产生了间接影响。结果：抑郁症状多与药物不依从有关（总效果= .06，P <.001），抑郁症状多与社会支持较少有关（预测因子对介体的直接影响=-。96，P = .02） ），较少的社会支持与药物的不依从性相关（调解员对结局的直接影响=-。01，P <.01）。虽然抑郁症的症状和药物非依从性之间的关系在预测的途径中持续存在社会支持，但这种关系的程度部分由抑郁症的症状与社会支持减少之间的关系部分解释（间接作用= .01，95％的卑诗省增强了信心时间间隔为.0005至.0325）。结论：为患有抑郁症的糖尿病患者提供社会支持可减轻抑郁症状对药物非依从性的某些有害影响，但仅靠社会支持是不够的。

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