Milo Razel B, Ramira Arlin, Calero Patricia, Georges Jane M, Pérez Alexa, Connelly Cynthia D
Hahn School of Nursing and Health Science, Beyster Institute for Nursing Research, University of San Diego, San Diego, California, USA.
Department of Nursing and Health Occupations, Higher Education Center at Otay Mesa, Southwestern College, San Diego, California, USA.
Health Equity. 2021 Apr 5;5(1):151-159. doi: 10.1089/heq.2020.0075. eCollection 2021.
Increasing patient activation facilitates self-management of health, improves health outcomes, and lowers health care expenditures. Extant research notes mixed findings in patient activation by race/ethnicity. The purpose of the study was to examine the relationships among patient activation, select patient characteristics, and glycemic control among Filipino Americans. A cross-sectional study was conducted with a convenience sample of Filipino Americans (=191), with a diagnosis of diabetes mellitus type 1 or type 2, recruited from a southern California adult primary care clinic between December 2017 and March 2018. Patient activation, select characteristics, and hemoglobin A1c (HbA1c) levels were assessed. Bivariate and logistic regression analyses were used to identify correlates of glycemic control. The Strengthening the Reporting of Observational studies in Epidemiology (STROBE) checklist was used to develop the study. Participants with HgbAC≤7.0% reported statistically higher patient activation measure (13 items) (PAM-13) natural log score (mean []=60.32, standard deviation [SD]=13.50) compared to those with an HgbAC>7.0%, =52.58, SD=10.19, (1)=11.05, <0.001. Multivariate logistic regression using age, low-density lipoprotein, and PAM-13 natural log was statistically reliable distinguishing between AC≤7.0 and AC>7.0, -2 LogLikehood=1183.23, (3)=15.44, <0.001. Patient activation is an important factor in supporting glycemic control. Findings support interventions to target patient activation. Providers are encouraged to use racial/ethnic-centered engagement strategies in resolving health disparity with racial and ethnic minorities to facilitate patient activation and improve health outcomes in patients with diabetes.
提高患者的自我管理能力有助于健康的自我管理,改善健康状况,并降低医疗保健支出。现有研究指出,不同种族/族裔在患者自我管理能力方面的研究结果不一。本研究的目的是探讨菲律宾裔美国人的患者自我管理能力、特定患者特征与血糖控制之间的关系。我们进行了一项横断面研究,从2017年12月至2018年3月期间,在南加州的一家成人初级保健诊所招募了191名确诊为1型或2型糖尿病的菲律宾裔美国人作为便利样本。评估了患者的自我管理能力、特定特征和糖化血红蛋白(HbA1c)水平。采用双变量和逻辑回归分析来确定血糖控制的相关因素。本研究依据加强流行病学观察性研究报告(STROBE)清单开展。与糖化血红蛋白(HbA1c)>7.0%的参与者相比,糖化血红蛋白(HbA1c)≤7.0%的参与者报告的患者自我管理能力测量(13项)(PAM-13)自然对数得分在统计学上更高(均值[]=60.32,标准差[SD]=13.50),分别为52.5(8),标准差=10.19,(1)=11.05,<0.001。使用年龄、低密度脂蛋白和PAM-13自然对数进行的多变量逻辑回归在统计学上能够可靠地区分糖化血红蛋白(HbA1c)≤7.0%和>7.0%的情况,-2对数似然值=1183.23,(3)=15.44,<0.001。患者自我管理能力是支持血糖控制的一个重要因素。研究结果支持针对患者自我管理能力的干预措施。鼓励医疗服务提供者采用以种族/族裔为中心的参与策略,以解决与少数种族和族裔之间的健康差距,促进患者自我管理能力的提升,并改善糖尿病患者的健康状况。