Kyngäs Helvi A
University of Oulu, Department of Nursing and Health Administration, Box 5300, 90014 Oulu, Finland.
Chronic Illn. 2007 Mar;3(1):20-8. doi: 10.1177/1742395307079191.
The purpose of this study was to identify the factors that predict good adherence to health regimens by adolescents with diabetes (insulin-dependent diabetes mellitus).
Altogether, 300 individuals aged 13-17 years were randomly selected from the Finnish Social Insurance Institution's register. Ninety-seven per cent (N=289) of the selected adolescents returned the questionnaire. The data were analysed using the SPSS (Statistical Package for Social Sciences) for Windows software package. Logistic regression was used to find the factors that predict good adherence to health regimens.
About one-fifth (19%) of the respondents with diabetes felt that they complied fully with the health regimens, while 75% placed themselves in the category of satisfactory adherence, and the remaining 6% reported poor adherence. The most powerful predictor was the threat to mental wellbeing. The likelihood that adolescents who felt the disease to be a threat to their mental wellbeing would comply with health regimens was 7.68-fold as compared to those who did not regard the disease as a threat to their mental wellbeing. The next most powerful predictor was support from physician. The support from nurses, and the motivation, energy and willpower to take care of themselves and the threat to physical wellbeing, also predicted good adherence. The logistic regression model explained 82% of the variance, and the model predicted correctly 88% of the adolescents with good adherence.
This paper shows that adolescents with diabetes show quite good adherence. It also indicates the factors that predict good adherence to health regimens. To improve adherence, these factors should be given special attention in the care of adolescents.
本研究旨在确定预测糖尿病青少年（胰岛素依赖型糖尿病）良好坚持健康方案的因素。
从芬兰社会保险机构的登记册中随机抽取300名13 - 17岁的个体。选定的青少年中有97%（N = 289）返回了问卷。使用适用于Windows的SPSS（社会科学统计软件包）软件包对数据进行分析。采用逻辑回归来找出预测良好坚持健康方案的因素。
约五分之一（19%）的糖尿病受访者认为他们完全遵守健康方案，而75%将自己归为依从性令人满意的类别，其余6%报告依从性差。最有力的预测因素是对心理健康的威胁。认为疾病对其心理健康构成威胁的青少年遵守健康方案的可能性是那些不认为疾病对其心理健康构成威胁的青少年的7.68倍。其次最有力的预测因素是医生的支持。护士的支持、自我照顾的动力、精力和意志力以及对身体健康的威胁也预测了良好的依从性。逻辑回归模型解释了82%的方差，该模型正确预测了88%依从性良好的青少年。
本文表明糖尿病青少年表现出相当好的依从性。它还指出了预测良好坚持健康方案的因素。为了提高依从性，在青少年护理中应特别关注这些因素。
