成人2型糖尿病的家庭类型学:糖尿病管理和幸福的纵向稳定性和有效性。

IF 14.8 1区 医学 Q1 ENDOCRINOLOGY & METABOLISM
Diabetes Care Pub Date : 2023-11-01 DOI:10.2337/dc23-0827
Lindsay S Mayberry, Shilin Zhao, McKenzie K Roddy, Andrew J Spieker, Cynthia A Berg, Lyndsay A Nelson, Robert A Greevy
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引用次数: 0

摘要

目的:我们纵向验证了2型糖尿病成年人糖尿病特异性家庭功能的类型学(命名为协作和帮助、满足于低参与、希望更多参与和关键参与)。研究设计和方法:我们对九个维度进行了k均值聚类分析,以确定类型学是否在不同的样本中复制,以及类型分配是否对样本和包含维度的变化具有稳健性。在一个经过9个月反复评估的子样本中,我们检查了类型学的稳定性和有效性。我们还应用了多项逻辑回归方法,使类型学在个人层面上可用,就像诊断工具一样。结果:参与者(N=717)51%为男性,超过三分之一报告为少数民族,平均年龄57岁,平均血红蛋白A1c为7.9%(63 mmol/mol;纵向子样本为8.7%[72 mmol/mol])。类型学是在类型的数量和维度模式方面复制的。类型分配对采样变化是稳健的(模拟之间的一致性为97%)。随着时间的推移,该类型在参与者中的稳定性平均为52%;不稳定性不能用测量误差来解释。在9个月的时间里,类型与HbA1c、糖尿病自我效能感、糖尿病药物依从性、糖尿病困扰和抑郁症状独立相关(均P<0.05)。结论:糖尿病特异性家庭功能的类型学是重复的,纵向分析表明类型更像是一种动态状态,而不是一种稳定的特征。然而,类型随着糖尿病自我管理和幸福感的变化而变化,这是一个一致的独立结果指标。该类型学已准备好应用于行为和心理社会糖尿病研究和护理的进一步精确医学方法。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Family Typology for Adults With Type 2 Diabetes: Longitudinal Stability and Validity for Diabetes Management and Well-being.

Objective: We validated longitudinally a typology of diabetes-specific family functioning (named Collaborative and Helpful, Satisfied with Low Involvement, Want More Involvement, and Critically Involved) in adults with type 2 diabetes.

Research design and methods: We conducted k-means cluster analyses with nine dimensions to determine if the typology replicated in a diverse sample and if type assignment was robust to variations in sampling and included dimensions. In a subsample with repeated assessments over 9 months, we examined the stability and validity of the typology. We also applied a multinomial logistic regression approach to make the typology usable at the individual level, like a diagnostic tool.

Results: Participants (N = 717) were 51% male, more than one-third reported minority race or ethnicity, mean age was 57 years, and mean hemoglobin A1c (HbA1c) was 7.9% (63 mmol/mol; 8.7% [72 mmol/mol] for the longitudinal subsample). The typology was replicated with respect to the number of types and dimension patterns. Type assignment was robust to sampling variations (97% consistent across simulations). Type had an average 52% stability over time within participants; instability was not explained by measurement error. Over 9 months, type was independently associated with HbA1c, diabetes self-efficacy, diabetes medication adherence, diabetes distress, and depressive symptoms (all P < 0.05).

Conclusions: The typology of diabetes-specific family functioning was replicated, and longitudinal analyses suggest type is more of a dynamic state than a stable trait. However, type varies with diabetes self-management and well-being over time as a consistent independent indicator of outcomes. The typology is ready to be applied to further precision medicine approaches to behavioral and psychosocial diabetes research and care.

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来源期刊
Diabetes Care
Diabetes Care 医学-内分泌学与代谢
CiteScore
27.80
自引率
4.90%
发文量
449
审稿时长
1 months
期刊介绍: The journal's overarching mission can be captured by the simple word "Care," reflecting its commitment to enhancing patient well-being. Diabetes Care aims to support better patient care by addressing the comprehensive needs of healthcare professionals dedicated to managing diabetes. Diabetes Care serves as a valuable resource for healthcare practitioners, aiming to advance knowledge, foster research, and improve diabetes management. The journal publishes original research across various categories, including Clinical Care, Education, Nutrition, Psychosocial Research, Epidemiology, Health Services Research, Emerging Treatments and Technologies, Pathophysiology, Complications, and Cardiovascular and Metabolic Risk. Additionally, Diabetes Care features ADA statements, consensus reports, review articles, letters to the editor, and health/medical news, appealing to a diverse audience of physicians, researchers, psychologists, educators, and other healthcare professionals.
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