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

Influence of financial burden on psychological insulin resistance in diabetes patients:The mediating role of coping style

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。

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 select 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 between 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 financial burden on psychological insulin resistance was 0.990,and the indirect effect value was 0.176.Conclusions The coping strategies of diabetes patients were active,and their psychological insulin resistance was severe.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 patients'positive coping strategies,and alleviate their psychological insulin resistance.