Predicting adherence to diabetic eye examinations: development of the compliance withAnnual Diabetic Eye Exams Survey.
Predicting adherence to diabetic eye examinations: development of the compliance withAnnual Diabetic Eye Exams Survey.
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DOI：
10.1016/j.ophtha.2013.12.016
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发表时间：
2014-06
期刊：
影响因子：
13.7
通讯作者：
Mansberger SL
中科院分区：
文献类型：
--
作者：
Sheppler CR;Lambert WE;Gardiner SK;Becker TM;Mansberger SL
使用年度糖尿病眼科检查依从性调查（CADEES）确定预测年度眼科检查依从性的变量，这是一项旨在测量与糖尿病视网膜病变和年度眼科检查相关的健康信念的新问卷。编制调查表。316名成人糖尿病患者。我们开发了CADEES的基础上，回顾文献，健康信念模型的框架，专家的意见，和试点研究数据。为了检查内容的有效性，我们分析了参与者对一个开放式问题的回答，该问题询问人们为什么不进行年度眼科检查;然后我们使用这些结果来确定调查中是否缺少内容区域。我们用主成分分析评估了结构效度，并用Cronbach’s alpha检验了内部一致性。为了评估预测的有效性，我们使用了多变量逻辑回归，以自我报告的依从性作为因变量。与自我报告的依从性（定义为在过去一年中进行了散瞳眼科检查）的相关性。内容分析表明，CADEES项目涵盖了89%的原因，由参与者没有获得年度眼科检查。主成分分析确定了三个信息组成部分，包括32%的方差，和可靠性分析表明，可接受的克朗巴赫的α（>0.60）的所有三个组件。多变量logistic回归模型揭示了几个重要的依从性预测因素，包括以下信念：保险是否涵盖了大部分眼科检查费用（p<0.01），是否存在使眼科检查困难的一般障碍（p<0.01），是否进行眼科检查是最优先考虑的（p=0.02），以及糖尿病性眼病是否可以通过检查发现（p=0.05）。较低的血红蛋白A1 c水平（p<0.01）、有保险（p=0.01）和较长的糖尿病病程（p=0.02）也与依从性相关。包含CADEES项目和人口统计学变量的多变量模型对病例进行了分类，准确率为72%，解释了依从性方差的约24%。CADEES显示出良好的内容和预测效度。虽然在最终确定较短版本的调查之前需要进一步研究，但研究人员和临床医生可能能够通过以下方式提高依从性：（1）向新诊断的患者以及血糖控制不受控制的患者提供关于年度眼科检查重要性的咨询，以及（2）讨论与获得年度眼科检查相关的感知障碍和误解。
To identify variables that predict adherence with annual eye exams using the Compliance with Annual Diabetic Eye Exams Survey (CADEES), a new questionnaire designed to measure health beliefs related to diabetic retinopathy and annual eye exams. Questionnaire development. Three hundred and sixteen adults with diabetes. We developed the CADEES based on a review of the literature, the framework of the Health Belief Model, expert opinion, and pilot study data. To examine content validity, we analyzed participant responses to an open-ended question asking for reasons why people do not obtain annual eye exams; we then used these results to determine whether there were content areas missing from the survey. We evaluated construct validity with principal components analysis and examined internal consistency with Cronbach’s alpha. To assess predictive validity, we used multivariate logistic regression with self-reported adherence as the dependent variable. Associations with self-reported adherence (defined as having a dilated eye exam in the past year). The content analysis showed that CADEES items covered 89% of the reasons given by participants for not obtaining an annual eye exam. The principal components analysis identified three informative components comprising 32% of the variance, and reliability analyses showed acceptable Cronbach’s alphas (>0.60) for all three components. Multivariate logistic regression modeling revealed several significant predictors of adherence, including beliefs concerning: whether insurance covered most of the eye exam cost (p<0.01), whether there were general barriers that make it difficult to get an eye exam (p<0.01), whether obtaining an eye exam was a top priority (p=0.02), and whether diabetic eye disease can be seen with an exam (p=0.05). Lower hemoglobin A1c levels (p<0.01), having insurance (p=0.01), and a longer duration of diabetes (p=0.02) were also associated with adherence. A multivariate model containing CADEES items and demographic variables classified cases with 72% accuracy and explained approximately 24% of the variance in adherence. The CADEES showed good content and predictive validity. While future research is needed before finalizing a shorter version of the survey, researchers and clinicians may be able to improve adherence by (1) counseling newly diagnosed patients, as well as those with uncontrolled blood sugar control, on the importance of annual eye exams, and (2) discussing perceived barriers and misconceptions related to obtaining annual eye exams.
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影响因子：
3
作者：
DiMatteo, M. Robin;Haskard, Kelly B.;Williams, Summer L.
通讯作者：
Williams, Summer L.
影响因子：
3
作者：
Walker, EA;Basch, CE;Shamoon, H
通讯作者：
Shamoon, H
影响因子：
--
作者：
DiMatteo, MR;Lepper, HS;Croghan, TW
通讯作者：
Croghan, TW
DOI：
10.1016/0891-6632(90)90058-d
发表时间：
1990-01-01
期刊：
Journal of Diabetic Complications
影响因子：
--
作者：
NEWCOMB P A;KLEIN R
通讯作者：
KLEIN R
影响因子：
1.8
作者：
Lewis, Karinya;Patel, Daksha;Charteris, David
通讯作者：
Charteris, David