Gender Differences in Self-Efficacy for Diabetes Self-Management Among Hispanics: The Mediating Role of Perceived Support and Depressive Symptoms.

Carol L Mansyur, Luis O Rustveld, Susan G Nash, Maria L Jibaja-Weiss
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Abstract

Purpose: The purpose of this study is to examine the extent to which perceived support and depressive symptoms might interfere with Hispanic patients' ability to manage their diabetes and whether these effects vary by gender.

Methods: Data were collected from a cohort of 232 Hispanic men and women with type 2 diabetes mellitus (T2DM). Conditional process analysis was used to test a moderated mediation model of the time-lagged processes associating gender, diabetes support, and depressive symptoms with reported self-efficacy after 3 months.

Results: Increased depressive symptoms were associated with lower self-efficacy, but the conditional effects varied among men and women. The index of moderated mediation was significant, indicating that among women, the indirect effect of depressive symptoms on self-efficacy was contingent on lower levels of perceived support. Among men, increased depressive symptoms were directly associated with declines in self-efficacy and were not conditional on perceived support.

Conclusions: Results of the study have important implications for gender health equity. Mental health screening and an assessment of support needs may be important for determining appropriate complementary therapies when treating Hispanic women with chronic conditions such as diabetes. Attention to possible differences in gender-specific mental health needs could lead to improved self-management, better glycemic control, and more equitable health outcomes.

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西班牙裔糖尿病自我管理自我效能的性别差异:感知支持和抑郁症状的中介作用
目的:本研究的目的是检查在多大程度上感知支持和抑郁症状可能干扰西班牙裔患者管理糖尿病的能力,以及这些影响是否因性别而异。方法:收集了232名西班牙裔2型糖尿病(T2DM)患者的数据。使用条件过程分析来检验3个月后性别、糖尿病支持和抑郁症状与自我效能报告相关的滞后过程的调节中介模型。结果:抑郁症状的增加与自我效能感的降低有关,但条件效应在男性和女性之间有所不同。有调节的中介指数显著,表明在女性中,抑郁症状对自我效能的间接影响取决于较低的感知支持水平。在男性中,抑郁症状的增加与自我效能感的下降直接相关,并且不以感知到的支持为条件。结论:本研究结果对促进两性健康平等具有重要意义。在治疗患有糖尿病等慢性疾病的西班牙裔妇女时,心理健康筛查和支持需求评估对于确定适当的补充疗法可能很重要。注意性别心理健康需求可能存在的差异,可以改善自我管理,更好地控制血糖,并获得更公平的健康结果。
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