Factors Associated with Insulin Reluctance in Individuals with Type 2 Diabetes

2 型糖尿病患者胰岛素抵抗的相关因素

• 批准号: 7488144
• 负责人: Soohyun Nam
• 金额: $ 3.1万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
• 依托单位国家: 美国
• 财政年份: 2008
• 资助国家: 美国
• 起止时间: 2008-05-14 至 2010-05-13
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7488144
• 关键词: Accounting; Acute; Address; Adult; Affect; American; Applications Grants; Attitude; Behavior; Belief; Caring; Centers for Disease Control and Prevention (U.S.); Chronic Disease; Class; Clinical; Cross-Sectional Studies; Diabetes Mellitus; Disease; Dose; Education; Educational Intervention; Educational workshop; Ethnic group; Exposure to; Health; Health Personnel; Health Professional; Individual; Insulin; Knowledge; Linear Regressions; Medical; Modeling; Non-Insulin-Dependent Diabetes Mellitus; Participant; Patient Care; Patients; Perception; Personal Satisfaction; Population; Prevalence; Psychosocial Factor; Public Health; Purpose; Questionnaires; Research; Research Design; Research Personnel; Risk; Self Efficacy; Self Management; Testing; Time; Training; United States; Work; care systems; design; diabetic; glycemic control; pre-doctoral; predictive modeling; prevent; psychologic; satisfaction; statistics

DESCRIPTION (provided by applicant): The purpose of this training grant application (F31) is to provide predoctoral support that will allow this investigator to examine the factors associated with a reluctance to use insulin therapy in individuals with type 2 diabetes. Common misconceptions about the need for transitioning to insulin therapy may affect a patient's ability to agree to and participate in self-management of type 2 diabetes using the prescribed therapy. Current approaches to address reluctance to begin and/or increase insulin therapy are largely educational, using classes and workshops to change attitudes and behavior. Little research exists, however, to determine which factors influence patients' reluctance to use insulin therapy. Therefore, the overall purpose of this study is to identify the factors related to reluctance to initiate insulin therapy (Insulin Reluctance= IR) in individuals with type 2 diabetes. The specific aims are 1) to examine the actual predictors of IR and to describe the relationship among IR in individuals with type 2 diabetes and their sociodemographic, biomedical, and psychosocial factors; and 2) to develop predictive model of IR. To accomplish these aims, a descriptive, correlational, cross-sectional study design will be used. All participants (n=139) will be asked to complete a study questionnaire. Descriptive statistics, uhivariate and bivariate analyses and multiple linear regression will be performed. To describe the relationship among IR, sociodemographic factors, biomedical factors, and psychosocial factors, Pearson correlation coefficients will be computed. To develop a predictive model of IR, multiple linear regression will be conducted. First the overall R-square of the complete model will be examined for significance. If the overall model is significant, the unique contribution of each separate variable in explaining the variance of IR will be tested. Given the significant burden of diabetes, public health care systems are seeking increasingly effective means of providing diabetes care. The proposed study will contribute to knowledge about IR, specifically about more appropriate clinical approaches for health professionals to use in working with type 2 diabetes patients. Thus, health care providers can make the transition to insulin therapy easier and facilitate timely introduction of insulin therapy to achieve optimal glycemic control. Furthermore, study findings may guide more effective educational interventions to reduce psychological barriers to insulin treatment.

描述（由申请人提供）：本培训补助金申请（F31）的目的是提供博士前支持，使本研究者能够检查与不愿在2型糖尿病患者中使用胰岛素治疗相关的因素。关于需要过渡到胰岛素治疗的常见误解可能会影响患者同意并参与使用处方治疗的2型糖尿病自我管理的能力。目前解决不愿开始和/或增加胰岛素治疗的方法主要是教育性的，使用课程和研讨会来改变态度和行为。然而，几乎没有研究来确定哪些因素影响患者不愿使用胰岛素治疗。 因此，本研究的总体目的是确定2型糖尿病患者不愿开始胰岛素治疗（胰岛素不愿= IR）的相关因素。具体目标是：1）检查IR的实际预测因子，并描述2型糖尿病患者IR与其社会人口学、生物医学和心理社会因素之间的关系; 2）开发IR的预测模型。为了实现这些目标，将采用描述性、相关性、横断面研究设计。将要求所有参与者（n=139）完成研究问卷。将进行描述性统计、单变量和双变量分析以及多元线性回归。为了描述IR、社会人口因素、生物医学因素和心理社会因素之间的关系，将计算Pearson相关系数。为了开发IR的预测模型，将进行多元线性回归。首先，将检查完整模型的总体R方的显著性。如果总体模型显著，则将检验每个单独变量在解释IR方差方面的独特贡献。 鉴于糖尿病的重大负担，公共卫生保健系统正在寻求提供糖尿病护理的日益有效的手段。这项拟议的研究将有助于了解IR，特别是卫生专业人员在与2型糖尿病患者合作时使用的更合适的临床方法。因此，卫生保健提供者可以使过渡到胰岛素治疗更容易，并促进及时引入胰岛素治疗，以实现最佳的血糖控制。此外，研究结果可以指导更有效的教育干预，以减少胰岛素治疗的心理障碍。