The role of social support in the self-management of diabetes mellitus among a Hispanic population

The rising incidence of diabetes mellitus continues to be a major health concern among Hispanic Americans. Social support has been found to be a relevant factor in diabetes self-management, however, it has not been explored within a Hispanic community. This cross-sectional study was therefore conducted with 95 insulin-requiring Hispanic adults to explore the composition of the support network, the type of assistance needed, the degree of satisfaction with support received, and the relationship between social support and diabetes self-management. Overall, the participants had fairly large networks, composed primarily of family members. The greatest need for assistance was associated with transportation or interactions that involved speaking English, and the assistance offered in these areas was viewed as highly satisfactory. Participants were least satisfied with the help they received for diabetes-related self-care, personal care, and financial assistance. Social support was not strongly related to diabetes self-management. Community health nurses must be aware that this population may have needs that are unsatisfactorily met. They should provide education and resources for support persons and carefully evaluate the support network, not only for availability, but also for satisfaction. Effort should also be directed toward developing alternative support for those without available family.     

Albiglutide efficacy and safety in the Latino/Hispanic subpopulation for the integrated phase III program

Objective: to evaluate the efficacy and safety of albiglutide compared with placebo and active comparators from an integrated trial subpopulation of Latino/Hispanic patients whose type 2 diabetes mellitus (T2DM) was inadequately controlled on their current regimen of diet and exercise, with or without oral antidiabetic drugs (OADs) and/or insulin.

Methods: Latino/Hispanic patient subpopulations (N = 1204) across 7 phase III albiglutide studies (N = 4400) were evaluated post-hoc for efficacy and safety. Comparators were placebo, sulfonylureas, insulin, thiazolidinediones, and dipeptidyl peptidase-4 inhibitors. Glycatedhemoglobin (HbA_1c) change from baseline to the time of the primary endpoint assessment (from 26 to 104 weeks) was evaluated in patients on diet and exercise and/or OADs, with or without insulin. Patients were allowed to continue in the study if hyperglycemic rescue was required, according to a prespecified algorithm and at the discretion of the investigator.

Results: At baseline in the Latino/Hispanic subpopulation, the mean HbA_1c was 8.3%, mean age was 53 years, mean body mass index was 32 kg/m², and mean duration of T2DM was 8.0 years. The primary endpoint of mean HbA_1c difference (albiglutide – placebo) was ?0.94% for the Latino/Hispanic subpopulation and ?0.86% (p < 0.001) for the overall phase III population. Changes in fasting plasma glucose mirrored those of HbA_1c. Weight loss with albiglutide was numerically greater than with OADs and insulin in both populations, but it was smaller than with liraglutide. Within the Latino/Hispanic subpopulation, more injection-site reactions were reported with albiglutide vs all comparators, while gastrointestinal and hypoglycemic adverse events were comparable between the two groups, and the latter was uncommon when used without insulin and/or a sulfonylurea.

Conclusions: In the Latino/Hispanic population, albiglutide resulted in effective lowering of glucose and modest weight loss, and it was generally well tolerated.     

Racial differences in activities of daily living limitation onset in older adults with arthritis: a national cohort study

OBJECTIVE: To investigate factors that predict the onset of limitations in activities of daily living (ADLs) in adults 65 years old or older who have arthritis, in order to develop public health programs for minorities (African and Hispanic Americans) and white Americans. DESIGN: Longitudinal cohort study. SETTING: National probability sample. PARTICIPANTS: Older adults with arthritis (N=3541) who participated in the 1998 and 2000 Health and Retirement Study interviews and who had no baseline ADL limitations. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURE: Onset of ADL limitations was identified from reports of 1 or more ADL task limitations at 2-year follow-up. RESULTS: Onset is most frequent among African Americans (24.4%), followed by Hispanics (22.2%), and whites (16.9%). Race specific multivariate analysis showed that the strongest risk factor predicting onset of limitations across all racial and ethnic groups is physical limitations. Low household income was significant for older minorities but not for whites. Comorbid cardiovascular disease was a unique multivariate risk factor among African Americans. CONCLUSIONS: Physical limitation is a strong risk factor for ADL limitation onset that is shared by all racial and ethnic groups. Early identification and treatment of physical limitations may prevent the onset of ADL limitations and thus improve quality of life. Race specific public health interventions should be considered to reduce the development of ADL limitations among older adults with arthritis.     

Cognitive interviews to test and refine questionnaires

Survey data are compromised when respondents do not interpret questions in the way researchers expect. Cognitive interviews are used to detect problems respondents have in understanding survey instructions and items, and in formulating answers. This paper describes methods for conducting cognitive interviews and describes the processes and lessons learned with an illustrative case study. The case study used cognitive interviews to elicit respondents' understanding and perceptions of the format, instructions, items, and responses that make up the Diabetes Symptom Self-Care Inventory (DSSCI), a questionnaire designed to measure Mexican Americans' symptoms of type 2 diabetes and their symptom management strategies. Responses to cognitive interviews formed the basis for revisions in the format, instructions, items, and translation of the DSSCI. All those who develop and revise surveys are urged to incorporate cognitive interviews into their instrumentation methods so that they may produce more reliable and valid measurements.     

糖尿病对COVID-19患者疾病严重程度和死亡率影响的Meta分析

目的 糖尿病是一种慢性疾病,身体各个系统都有不同程度的损伤。大量研究指出糖尿病患者在新型冠状病毒肺炎(COVID-19)流行期间更加容易感染COVID-19并且更容易出现重症。本研究拟通过Meta分析来探明糖尿病与COVID-19严重程度和死亡率的关联性。方法 使用关键词(1)“COVID-19” OR “SARS-CoV-2” OR “Coronavirus” OR “novel coronavirus” AND “clinical characteristics” (2)“COVID-19” OR “SARS-CoV-2” AND “Diabetes” 检索PubMed, Embase和中国知网的数据,筛选截至2021年2月发表的英文和中文期刊论著,提取数据后使用RevMan 5.4进行Meta分析,并使用Stata 12.0评估发表偏倚。结果 共纳入82篇文献,合计35 715例患者。Meta分析结果显示,患糖尿病与COVID-19预后较差有关[OR 2.29 (2.14, 2.46), P<0.01; I²: 52%, P<0.01]。COVID-19患者中糖尿病患者相对非糖尿病患者发生重症[OR 2.40 (2.20, 2.62), P<0.01; I²: 49%, P<0.01]和死亡[OR 2.08 (1.70, 2.56 ), P<0.01; I²: 60%, P<0.01]的风险均升高。结论 糖尿病是影响COVID-19患者的重症率和死亡率升高的一个重要因素,而针对糖尿病如何影响COVID-19预后的确切作用机制亟需进一步研究阐明。     

Effects of acculturation and social exchange on the expectations of filial piety among Hispanic/Latino parents of adult children

This study explores the effects of acculturation and social exchange variables on the expectations of filial piety (values and beliefs about parents' care) among Hispanic/Latino parents of adult children. A convenience sample of 318 Hispanics/Latinos with adult children was assembled in Texas and North Carolina, USA, for face-to-face interviews in order to collect information about their families and to assess their expectations of filial piety by their adult children. The number of years in the USA, age, gender, the eldest child's age, and living with a person > or = 65 years of age had significant relationships to scores from a new Spanish version of the Expectations of Filial Piety Scale (EFPS). The significant variables explained 46.3% of the variance in the EFPS scores. A conceptual model that includes both acculturation and social exchange variables is a useful approach for understanding the expectations of filial piety by Hispanic/Latino parents of adult children.     

湖南省二级以上综合医院糖尿病专科护理发展现状调查与思考

目的：了解湖南省二级以上综合医院糖尿病（DM）专科护理发展的现状,分析DM专科护理发展中存在的问题与对策。方法：2007年12月对湖南省135家二级以上综合医院进行问卷调查,问卷内容包括医院目前基本信息、内分泌或DM专科设置、专科发展设想、DM专科护士培训及认证、DM教育、DM专科护士护理实践等。结果：①在135家医院中,有32.6%的医院开设了内分泌或DM专科病房,仅有4家医院有护士获得过国内DM护士规范化培训结业证书。②接受调查的135家医院中,有83.7%的医院有开设内分泌或DM专科的愿望和设想,且33.0%的医院认为DM专科在急诊、供应室、手术室、重症监护、产科、内分泌专科、新生儿、血液透析、器官移植、肿瘤、介入等11个专科中应排在前3位;57.6%的认为DM专科应排在前6位,是需优先发展的专科。③在44家已开设内分泌专科病房的医院中,84.1%的医院已开展了DM健康教育,47.7%的医院配备了专门的DM教育室,29.6%的医院对DM专科护士进行了DM知识专科培训或进修,50%的医院在院内开展了DM护理会诊。结论：在湖南省二级以上综合医院发展DM专科护理有较大的空间,并且可放到医院专科发展的优先位置;在目前已开设内分泌或DM专科病房的医院,仍需要加大力度,加强其专科硬件和护理队伍人才建设。     

社区人群糖尿病及代谢综合征的流行病学调查

目的:调查和了解上海市平凉社区>20岁人群糖尿病、代谢综合征及相关疾病的患病率。方法:采用多级分层随机抽样的流行病学方法,对平凉社区2200例常住居民进行问卷调查,并进行口服75g葡萄糖耐量试验、血脂谱、血压、身高、体重的测定。结果:平凉社区居民糖尿病,糖调节受损的患病率分别为9.90%,11.99%,代谢综合征、高血压、血脂紊乱、超重/肥胖的患病率分别为13.38%,35.46%,41.80%,43.93%;糖尿病与代谢综合征的患病率随年龄增加而增加(P<0.01)。结论:上海市平凉社区>20岁人群糖尿病、糖调节受损的患病率较高,代谢综合征及相关疾病的患病率较高,上述疾病的患病率及患病危险性均随年龄的增加而递增。     

A systematic review of the relationships among psychosocial factors and coping in adults with type 2 diabetes mellitus

Type 2 diabetes mellitus contributes to poor health outcomes including mortality, yet there is a gap in the literature when seeking to understand the influence of psychosocial factors on coping in this population. The paper presents a systematic review of quantitative studies that examined relationships among psychosocial determinants and coping in adults with type 2 diabetes. This review is the second layer of knowledge discovery for the concept, “Taking on a life-altering change is a rhythmical journey of experiencing ups and downs on the way to acceptance.” The life-altering change was determined to be a diagnosis of type 2 diabetes, the journey is the ups and downs of coping with the diagnosis as people work toward acceptance of type 2 diabetes. The review includes a synthesis of findings from 22 quantitative studies of psychosocial factors and coping in adults with type 2 diabetes. Anxiety, depression, stress, and diabetes distress were identified as key influential psychosocial factors. Increased social support was inversely related to emotional distress and coping styles were related to social well-being, psychological health, and physical health outcomes. The positive coping style of problem-focused coping was linked to improved psychological and physical health. Emotional responses to diagnosis were related to depression and anxiety. Negative coping styles of resignation, protest, or isolation were higher in women and linked to poorer quality of life, while avoidance was linked to increased diabetes-related distress and depressive symptoms.     

The role of religiosity as a protective factor against marijuana use among African American,White, Asian,and Hispanic adolescents

Given the moves toward legalization of marijuana in the United States and problems associated with adolescent marijuana use, this study focused on examining the role of religiosity in protecting African American, White, Hispanic, and Asian American adolescents from using marijuana. It also tested the moderation effects of race on religiosity and marijuana use. Results of the main effects revealed that religiosity may serve as a protective factor against marijuana use for African American, White, Hispanic, and Asian American adolescents. Race did not have moderating effects on the relationship between religiosity and marijuana use in the sample. Implications for clinical practice are discussed.     

COPD合并糖尿病患者糖尿病认知的现状调查及分析

目的了解某三级甲等医院COPD合并糖尿病患者的糖尿病认知现状。方法采用自制COPD合并糖尿病患者糖尿病认知现状调查问卷,对240例COPD合并糖尿病患者进行问卷调查。结果不同性别患者在糖尿病低血糖反应症状及处理原则方面差异具有统计学意义(P<0.01);不同年龄患者在糖尿病病因、糖尿病临床表现及并发症、糖尿病治疗方面差异具有统计学意义(P<0.01或P<0.05);不同文化程度患者在长期使用糖皮质激素与糖尿病发生的相关性和糖尿病治疗方面差异具有统计学意义(P<0.01或P<0.05);不同COPD病程患者在长期使用糖皮质激素与糖尿病发生的相关性、糖尿病病因、糖尿病低血糖反应症状及处理原则、糖尿病治疗方面差异具有统计学意义(P<0.01或P<0.05);不同糖尿病病程患者在糖尿病病因、糖尿病临床表现及并发症、糖尿病低血糖反应症状及处理原则、糖尿病治疗方面差异具有统计学意义(P<0.01或P<0.05)。结论临床护士应根据COPD合并糖尿病患者的具体情况对患者实施个体化的糖尿病相关知识的健康教育,以便更好地控制患者的血糖,促进COPD的预后,提高COPD合并糖尿病患者的血糖自我管理水平。     

四川省德阳贫困农村糖尿病及代谢综合征的流行病学调查

目的了解德阳市中江县年龄≥20岁农村居民糖尿病和代谢综合征的患病情况并分析相关因素。方法采用多阶段随机抽样的方法,从中江县随机抽取20岁以上常住居民共计678人进行问卷调查、人体测量学指标测定以及实验室检查。用SPSS统计软件分析该县常住人口的糖尿病和代谢综合征的患病情况。结果中江县年龄≥20岁常住人口糖尿病患病率为7.50%,其中男性患病率为4.42%,女性为9.4%。不同性别、年龄、文化程度以及肥胖、糖尿病家族史、脂代谢和高血压等因素与糖尿病患病率之间的关系具有统计学差异(P0.05)。代谢综合征的患病率为44.3%,在糖尿病患者中,代谢综合征患者有40人,患病率为81.6%。结论糖尿病及代谢综合征的患病与多因素相关,应针对高危人群重点防控,以降低居民的糖尿病患病率,改善生存质量。