Wolfson Research Institute for Health and Wellbeing, Durham University, School of Medicine, Pharmacy and Health, Queen's Campus, Stockton on Tees TS17 6BH, UK.
Appetite. 2013 Sep;68:56-62. doi: 10.1016/j.appet.2013.04.016. Epub 2013 Apr 24.
Adherence to a gluten-free diet is the mainstay of treatment for coeliac disease. Non-adherence is common as the diet is restrictive and can be difficult to follow. This study aimed to determine the rates of intentional and inadvertent non-adherence in adult coeliac disease and to examine the factors associated with both. A self-completion questionnaire was mailed to adult coeliac patients identified from the computer records of 31 family practices within the North East of England. We received 287 responses after one reminder. Intentional gluten consumption was reported by 115 (40%) of respondents. 155 (54%) had made at least one known mistaken lapse over the same period and 82 (29%) reported neither intentional nor mistaken gluten consumption. Using logistic regression analysis, low self-efficacy, perceptions of tolerance to gluten and intention were found to be independently predictive of intentional gluten consumption. A statistical model predicted 71.8% of cases reporting intentional lapses. Intentional non-adherence to the GFD was found to be common but not as frequent as inadvertent lapses. Distinguishing the factors influencing both intentional and inadvertent non-adherence is useful in understanding dietary self-management in coeliac disease.
遵循无麸质饮食是治疗乳糜泻的主要方法。由于该饮食受到限制且难以遵循，因此不遵守饮食规定的情况很常见。本研究旨在确定成年乳糜泻患者故意和无意不遵守饮食规定的比率，并研究与两者相关的因素。我们从英格兰东北部 31 家家庭实践的计算机记录中确定了成年乳糜泻患者，并向他们邮寄了一份自我完成的问卷。在一次提醒后，我们收到了 287 份回复。115 名（40%）受访者报告有意摄入麸质。155 名（54%）在同一时期至少有一次已知的错误疏忽，82 名（29%）报告既没有故意也没有错误地摄入麸质。使用逻辑回归分析，发现自我效能感低、对麸质的耐受性和意图是导致故意摄入麸质的独立预测因素。统计模型预测报告故意疏忽的病例占 71.8%。发现故意不遵守 GFD 很常见，但不如无意疏忽频繁。区分影响故意和无意不遵守饮食规定的因素有助于理解乳糜泻的饮食自我管理。
