首页|经济负担对糖尿病患者心理性胰岛素抵抗的影响——应对方式的中介作用

经济负担对糖尿病患者心理性胰岛素抵抗的影响——应对方式的中介作用

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目的 了解经济负担对心理性胰岛素抵抗的影响路径.方法 采用多阶段分层随机抽样的方法选取山东省27个村或社区中心糖尿病患者进行问卷调查,回收有效问卷660份.调查问卷包括一般资料调查表、简易应对方式问卷、我对胰岛素看法量表.使用皮尔逊相关性分析探讨经济负担、应对方式与心理性胰岛素抵抗的相关性,基于偏差矫正Bootstrap法检验中介效应的显著性.结果 糖尿病患者心理性胰岛素抵抗得分(72.97±11.38)分,应对方式得分(9.21±7.62)分.患者的经济负担、应对方式、心理性胰岛素抵抗间存在显著相关性.经济负担对心理性胰岛素抵抗的直接效应值为0.990,间接效应值为0.176.结论 糖尿病患者应对方式积极,心理性胰岛素抵抗较为严重,应对方式在经济负担与心理性胰岛素抵抗间存在中介作用.应加大医疗保险对胰岛素的报销比例,培养患者积极的应对方式,减轻患者心理性胰岛素抵抗程度.
Influence of financial burden on psychological insulin resistance in diabetes patients:The mediating role of coping style
Objective To know about the impact pathways of financial burden on psychological insulin resistance in diabetes patients.Methods A multi-stage stratified random sampling was performed to randomly se-lect diabetes patients from 27 villages or communities in Shandong Province,China,and 660 valid questionnaires were collected.The questionnaire was composed of basic information,a survey on simple coping strategies,and a scale of My Opinion on Insulin(MOI).Pearson correlation analysis was conducted to analyze the correlation be-tween the financial burden,coping strategies and psychological insulin resistance.Bootstrap methods tested the importance of the mediating effect.Results The scores of psychological insulin resistance and coping strategies of diabetes patients were(72.97±11.38)and(9.21±7.62),respectively.Pearson correlation analysis showed that financial burden and coping strategies positively correlated with psychological insulin resistance(r=0.119,P<0.01;r=0.081,P<0.05).The intermediary effect analysis results showed that the direct effect value of fi-nancial burden on psychological insulin resistance was 0.990,and the indirect effect value was 0.176.Conclu-sions The coping strategies of diabetes patients were active,and their psychological insulin resistance was se-vere.Coping strategies mediated financial burden and psychological insulin resistance in diabetes patients,which suggested that we should increase the proportion of medical insurance reimbursement for insulin,cultivate pa-tients'positive coping strategies,and alleviate their psychological insulin resistance.

DiabetesFinancial burdenCoping strategyPsychological insulin resistanceMediating role

张世龙、马兴丽、张馨丹、范文瑜、王海鹏

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山东大学齐鲁医学院公共卫生学院卫生管理与政策研究中心,山东济南 250012

国家卫生健康委员会卫生经济与政策研究重点实验室(山东大学),山东济南,250012

糖尿病 经济负担 应对方式 心理性胰岛素抵抗 中介作用

国家重点研发计划国家重点研发计划

2020YFC20065002020YFC2006505

2024

中国农村卫生事业管理
中华预防医学会

中国农村卫生事业管理

影响因子:0.744
ISSN:1005-5916
年,卷(期):2024.44(5)
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