Behavioral and Psychosocial Dynamics in Diabetes Management: A Path Analysis to Examine the Influence of Acculturation in Arab Immigrant Communities.

IF 3.6 2区 心理学 Q1 PSYCHOLOGY, MULTIDISCIPLINARY
Hamzah Alzubaidi, Vitor H Oliveira, Ward Saidawi, Raya Aljobowry, Jonathan E Shaw, Catarina Samorinha
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Abstract

Background: Type 2 diabetes mellitus (T2DM) prevalence is rising globally. Arab immigrants with T2DM, one of the least studied ethnic minorities, have a higher diabetes prevalence and more prominent management-related challenges compared with mainstream host societies. Acculturation's impact on self-care activities and diabetes distress (DD) is understudied globally.

Purpose: To examine how acculturation affects self-care practices and DD in first-generation Arab immigrants with T2DM and how health literacy, illness perceptions, and self-efficacy mediate these associations.

Methods: This multicenter cross-sectional study was conducted in Victoria, Australia. Eligible patients were invited while waiting for their appointments. The questionnaire included validated tools to assess DD, self-care activities, health literacy, self-efficacy, and acculturation. We tested mediation hypothesis using path analysis, with a maximum likelihood estimation to calculate total, direct, and indirect effects and bias-corrected accelerated 95% CI.

Results: Overall, 382 Arab immigrants with T2DM participated, with an average age of 57.9 years (SD = 8.0). Half were males, most had low education, and were married. Participants lived in Australia for a mean of 19.1 years (SD = 8.3) and had diabetes for 7.1 years (SD =4.7). Higher acculturation was directly associated with decreased DD. Illness perceptions (p = .002) and self-efficacy (p = .001) mediated the association of acculturation with self-care activities, while health literacy did not. Additionally, self-efficacy fully mediated the relationship between acculturation and DD (p = .001).

Conclusions: This research provided valuable insights into the complex interplay between acculturation, diabetes management, and psychosocial factors. Interventions targeting self-efficacy and illness perceptions may improve self-care activities and reduce DD among Arab immigrants with T2DM.

糖尿病管理中的行为和社会心理动态:研究阿拉伯移民社区文化适应性影响的路径分析》。
背景:全球 2 型糖尿病(T2DM)发病率正在上升。患有 T2DM 的阿拉伯移民是研究最少的少数民族之一,与主流东道国社会相比,他们的糖尿病患病率更高,与管理相关的挑战也更突出。目的:研究文化适应如何影响患有 T2DM 的第一代阿拉伯移民的自我护理实践和糖尿病困扰(DD),以及健康素养、疾病认知和自我效能如何调节这些关联:这项多中心横断面研究在澳大利亚维多利亚州进行。符合条件的患者在候诊时被邀请参加。调查问卷包括用于评估DD、自我护理活动、健康知识、自我效能和文化适应的有效工具。我们使用路径分析检验了中介假设,并用最大似然估计法计算了总效应、直接效应和间接效应,以及偏差校正后的95%加速CI:共有 382 名患有 T2DM 的阿拉伯移民参加,平均年龄为 57.9 岁(SD = 8.0)。半数为男性,大多数受教育程度较低,已婚。参与者在澳大利亚居住的平均年龄为 19.1 年(SD = 8.3),患糖尿病的平均年龄为 7.1 年(SD = 4.7)。文化程度越高,糖尿病发病率越低。疾病认知(p = .002)和自我效能(p = .001)对文化程度与自我护理活动的关系起中介作用,而健康素养则不起中介作用。此外,自我效能感完全调节了文化适应与残疾程度之间的关系(p = .001):这项研究为了解文化适应、糖尿病管理和社会心理因素之间复杂的相互作用提供了宝贵的见解。针对自我效能感和疾病认知的干预措施可能会改善患有 T2DM 的阿拉伯移民的自我护理活动并减少 DD。
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来源期刊
Annals of Behavioral Medicine
Annals of Behavioral Medicine PSYCHOLOGY, MULTIDISCIPLINARY-
CiteScore
7.00
自引率
5.30%
发文量
65
期刊介绍: Annals of Behavioral Medicine aims to foster the exchange of knowledge derived from the disciplines involved in the field of behavioral medicine, and the integration of biological, psychosocial, and behavioral factors and principles as they relate to such areas as health promotion, disease prevention, risk factor modification, disease progression, adjustment and adaptation to physical disorders, and rehabilitation. To achieve these goals, much of the journal is devoted to the publication of original empirical articles including reports of randomized controlled trials, observational studies, or other basic and clinical investigations. Integrative reviews of the evidence for the application of behavioral interventions in health care will also be provided. .
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