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轨迹的社会支持与健康结果和抑郁症状在老年台湾成年人与糖尿病髋部骨折手术后。

Trajectories of social support are associated with health outcomes and depressive symptoms among older Taiwanese adults with diabetes following hip-fracture surgery.

机构信息

Post-Baccalaureate Program in Nursing, College of Nursing, Asia University, Taichung, Taiwan.

Department of Health Management and Policy, School of Public Health, University of Michigan, Ann Arbor, Michigan, USA.

出版信息

Int J Geriatr Psychiatry. 2022 Dec;37(12). doi: 10.1002/gps.5842.

Abstract

OBJECTIVE

This study examined trajectories of social support and their relationships with health outcomes over 2 years post hip-fracture surgery for older adults with diabetes mellitus (DM).

METHODS

This was a secondary analysis of data derived from a clinical trial, which included 158 hip fractured older adults with DM who had completed the Medical Outcomes Study Social Support Survey at 1-, 12-, 18-, and 24-months following hospital discharge. Health outcomes for self-care, physical and nutritional status, mental health, and depression were assessed at 3-month intervals up to 24-months after hospital discharge. Trajectories of social support were derived with latent class analysis while hierarchical linear models were employed to assess the associations of social-support trajectory with health outcomes.

RESULTS

Four social-support trajectories were derived for persons with DM following hip-fracture surgery: poor and declining (n = 18, 11.4%), moderate and stable (n = 29, 18.4%), high but declining (n = 34, 21.5%), and high and stable (n = 77, 48.7%). Relative to those in the poor and declining group, participants in the high and stable trajectory group performed better in Activities of Daily Living and quadriceps muscle power, had better mental Health-Related Quality of Life and nutritional status, and had fewer depressive symptoms. These differences persisted over the 2 years following hospital discharge.

CONCLUSIONS

These results suggest social support for persons with DM should be continually assessed following hip-fracture surgery.

摘要

目的

本研究考察了 2 年髋部骨折手术后老年糖尿病患者社会支持的轨迹及其与健康结果的关系。

方法

这是一项来自临床试验的二次分析,其中包括 158 名患有糖尿病的髋部骨折老年人,他们在出院后 1、12、18 和 24 个月完成了医疗结果研究社会支持调查。在出院后 24 个月内,每 3 个月评估一次自我护理、身体和营养状况、心理健康和抑郁等健康结果。采用潜在类别分析得出社会支持轨迹,采用分层线性模型评估社会支持轨迹与健康结果的关系。

结果

在髋部骨折手术后,有 4 种社会支持轨迹可用于患有糖尿病的患者:较差且下降(n=18,11.4%)、中等且稳定(n=29,18.4%)、高但下降(n=34,21.5%)和高且稳定(n=77,48.7%)。与较差且下降组相比,高且稳定轨迹组的参与者在日常生活活动和股四头肌力量方面表现更好,心理健康相关生活质量和营养状况更好,抑郁症状更少。这些差异在出院后 2 年内持续存在。

结论

这些结果表明,髋部骨折手术后应持续评估糖尿病患者的社会支持。

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