沙特阿拉伯胡富夫地区基层医疗中心糖尿病患者治疗依从性不佳的相关因素。
Factors contributing to non-compliance among diabetics attending primary health centers in the Al Hasa district of Saudi Arabia.
作者信息
Khan Ataur R, Al-Abdul Lateef Zaki N, Al Aithan Mohammad A, Bu-Khamseen Montaser A, Al Ibrahim Ibrahim, Khan Shabbir A
机构信息
Department of Community Ophthalmology, Al Omran Primary Health Care Center, Al Hasa, Saudi Arabia.
出版信息
J Family Community Med. 2012 Jan;19(1):26-32. doi: 10.4103/2230-8229.94008.
PURPOSE
The purpose of the study was to measure the rate of non-compliance and the factors contributing to non-compliance among the diabetic patients in the Al Hasa region of Saudi Arabia.
MATERIALS AND METHODS
A cross-sectional survey was conducted in the Al Hasa region during the period of June 2010 to June 2011. Random sampling was carried out for the selection of 535 diabetic patients from three chronic disease centers in different parts of Al Hasa. The data were collected by means of interviewing questionnaires and file records. Any patient who had been prescribed optimum treatment and was properly advised on diet and exercise for his / her diabetes, but did not follow the medical advice, with Hb1AC of more than 7% at the time of interview, was considered as non-compliant.
RESULTS
The overall prevalence of therapeutic non-compliance of the participants was 67.9% (n = 318, 95% CI 63.59 - 72.02%). The non-compliance of males (69.34%) was higher than females (65.45%, P = .003). The non-compliance among the urban participants was significantly higher than (71.04 vs. 60.15%, P = .023) in the rural participants. There was a statistically significant difference in the prevalence rate of non-compliance among the participants with different levels of education. Factors found to be significantly associated with non-compliance on bi-variate analysis were: female gender (OR = 1.90, CI =1.32-4.57),level of education (Illiteracy) (OR = 5.27, CI = 4.63 - 7.19), urban population (OR =5.22, CI= 3.65 - 8.22), irregularity of the follow-up (OR = 8.41, CI = 4.90 - 11.92), non-adherence to drug prescription (OR = 4.55 , CI = 3.54 - 5.56), non-adherence to exercise regimen (OR = 5.55, CI = 4.2 6 - 6.), insulin (OR = 1.29, CI = .71 - 1.87), and insulin with oral Metformin (OR = 1.20, CI = .65 - 1.75).
CONCLUSION
The findings indicate that there is a high rate of non-compliance among the diabetes patients in the Al Hasa region of Saudi Arabia and there is a definite need for improvement in the healthcare system, health education, and training of diabetic patients.
目的
本研究旨在测量沙特阿拉伯哈萨地区糖尿病患者的不依从率以及导致不依从的因素。
材料与方法
2010年6月至2011年6月期间在哈萨地区进行了一项横断面调查。从哈萨不同地区的三个慢性病中心随机抽取535名糖尿病患者。通过访谈问卷和档案记录收集数据。任何接受了最佳治疗且在饮食和运动方面得到了关于其糖尿病的适当建议，但未遵循医嘱，且在访谈时糖化血红蛋白（Hb1AC）超过7%的患者，被视为不依从。
结果
参与者治疗不依从的总体患病率为67.9%（n = 318，95%置信区间63.59 - 72.02%）。男性的不依从率（69.34%）高于女性（65.45%，P = 0.003）。城市参与者的不依从率显著高于农村参与者（71.04%对60.15%，P = 0.023）。不同教育水平的参与者在不依从患病率上存在统计学显著差异。在双变量分析中发现与不依从显著相关的因素有：女性性别（比值比[OR] = 1.90，置信区间[CI] = 1.32 - 4.57）、教育水平（文盲）（OR = 5.27，CI = 4.63 - 7.19）、城市人口（OR = 5.22，CI = 3.65 - 8.22）、随访不规律（OR = 8.41，CI = 4.90 - 11.92）、不遵守药物处方（OR = 4.55，CI = 3.54 - 5.56）、不遵守运动方案（OR = 5.55，CI = 4.26 - 6.）、胰岛素（OR = 1.29，CI = 0.71 - 1.87）以及胰岛素与口服二甲双胍联用（OR = 1.20，CI = 0.65 - 1.75）。
结论
研究结果表明，沙特阿拉伯哈萨地区糖尿病患者的不依从率较高，医疗保健系统、健康教育以及糖尿病患者培训方面确实需要改进。
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