Adherence to self-care and glycaemic control among people with insulin-dependent diabetes mellitus
Adherence to self-care and glycaemic control among people with insulin-dependent diabetes mellitus
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DOI：
10.1046/j.1365-2648.2001.01808.x
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发表时间：
2001-06-01
影响因子：
3.8
通讯作者：
Hentinen, M
中科院分区：
文献类型：
--
作者：
Toljamo, M;Hentinen, M
研究的目的。采用自我报告问卷和生化指标（糖化血红蛋白）对213例胰岛素依赖型糖尿病患者的自我护理和血糖控制依从性相关因素进行了研究。这些数据是在芬兰北部的奥卢健康中心和拉普兰中心医院收集的。应答率为76%。为了验证这些工具的信度和效度，我们使用了相关系数、因子分析和项目-总量分析。内部一致性采用Cronbach’s alpha检验。采用交叉表法检验自我保健与背景变量之间的关系。大多数受试者按计划完成了胰岛素治疗，但在自我护理的其他方面有更多困难。调查结果显示，五分之一（19%）的受访者忽视了自我护理。其他人则采取灵活的（46%）、遵循治疗方案的（16%）或自行计划的自我护理（19%）。坚持自我保健的被试比忽视自我保健的被试有更好的代谢控制。经logistic回归分析，代谢控制不良（P=0.003）、吸烟（P=0.009）、独居（P=0.014）与忽视自我护理相关。性别、糖尿病引起的并发疾病和并发症增加了风险，但与坚持或忽视自我保健没有显著关联。研究结果表明，坚持自我保健并不总是导致良好的代谢控制，但忽视自我保健可能导致代谢控制不良。
Aim of the study. Factors associated with adherence to self-care and glycaemic control were studied in 213 people with insulin-dependent diabetes mellitus using a self-report questionnaire and a biochemical indicator (glycosylated haemoglobin).Methods. The data were collected in the Oulu Health Center and the Central Hospital of Lapland in Northern Finland. The response rate was 76%. In order to verify the reliability and validity of the instruments, we used correlation coefficients, factor analysis and item-total analysis. Internal consistency was checked by Cronbach's alpha. The connections between self-care and the background variables were examined by cross-tabulation.Findings. The majority of subjects accomplished their insulin treatment as scheduled, but had more difficulties with the other aspects of self-care. According to the findings, a fifth (19%) of the respondents were neglecting their self-care. The others undertook flexible (46%), regimen-adherent (16%) or self-planned self-care (19%). The subjects who were adherent to self-care had better metabolic control than those who neglected self-care. According to logistic regression analysis, poor metabolic control (P=0.003), smoking (P=0.009) and living alone (P=0.014) were associated with neglect of self-care. Gender, concurrent diseases and complications as a result of diabetes increased the risk, but had no significant association with adherence to or neglect of self-care.Conclusion. The findings demonstrated that adherence to self-care does not always lead to good metabolic control, but neglect of self-care is likely to lead to poor metabolic control.