Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, 119228, Singapore.
J Community Health. 2012 Jun;37(3):653-62. doi: 10.1007/s10900-011-9496-x.
A cross-sectional survey of 507 in- and out-patients, with diagnosed Type 2 diabetes mellitus (T2DM) was undertaken to study the relationships between personal, disease and treatment-related factors and diabetes control in a tertiary care hospital. On multivariate logistic regression analysis, self-efficacy (odds ratio (OR) =2.94; 95% confidence interval (CI) =1.92-4.54); P<0.001) was the single most important determinant of current diabetes control (HbA1c ≤7%), along with absence of hyperglycemic symptoms in the past year (OR=1.83; 95% CI=1.15-2.93, P<0.01), current treatment with oral medication (OR=1.77; 95% CI=1.17-2.66; P<0.007), and adherence to dietary restrictions (OR=2.7; 95% CI=1.28-5.88; P<0.009). Self-efficacy was itself influenced by educational status, employment, availability of family support, and positive mental attitudes. Our findings suggest that health care delivery inputs, patients' personal characteristics including education and attitude, and family support for care are complexly processed to determine patients' ability to manage their disease, which ultimately influences disease outcomes.
本研究对 507 例 2 型糖尿病（T2DM）门诊和住院患者进行了横断面调查，以研究个人、疾病和治疗相关因素与三级医院糖尿病控制之间的关系。多变量逻辑回归分析显示，自我效能（比值比（OR）=2.94；95%置信区间（CI）=1.92-4.54）；P<0.001）是当前糖尿病控制（HbA1c ≤7%）的唯一最重要决定因素，此外，过去一年无高血糖症状（OR=1.83；95%CI=1.15-2.93，P<0.01）、目前接受口服药物治疗（OR=1.77；95%CI=1.17-2.66；P<0.007）和遵守饮食限制（OR=2.7；95%CI=1.28-5.88；P<0.009）也是如此。自我效能本身受教育程度、就业、家庭支持的可用性以及积极的心态影响。我们的研究结果表明，医疗保健投入、患者的个人特征（包括教育和态度）以及家庭对护理的支持是复杂的处理过程，以确定患者管理疾病的能力，而这最终影响疾病结局。
