疾病认知与治疗认知与糖尿病自我管理依从性之间的关系：阿拉伯语移民与以英语为母语的白种人患者的比较。

The relationships between illness and treatment perceptions with adherence to diabetes self-care: A comparison between Arabic-speaking migrants and Caucasian English-speaking patients.

作者信息

Alzubaidi Hamzah, Mc Narmara Kevin, Kilmartin Gloria M, Kilmartin John F, Marriott Jennifer

机构信息

Centre for Medicine Use and Safety, Monash University, 381 Royal Parade, Parkville, Victoria 3052, Australia.

Greater Green Triangle University, Department of Rural Health, Flinders University and Deakin University, PO Box 423, Warrnambool, Victoria 3280, Australia; Centre for Medicine Use and Safety, Monash University, 381 Royal Parade, Parkville, Victoria 3052, Australia.

出版信息

Diabetes Res Clin Pract. 2015 Nov;110(2):208-17. doi: 10.1016/j.diabres.2015.08.006. Epub 2015 Sep 11.

DOI:10.1016/j.diabres.2015.08.006

PMID:26415673

Abstract

AIMS

To compare illness and treatment perceptions between Arabic-speaking immigrants and Caucasian English-speaking people with type 2 diabetes, and explore the relationships between these beliefs and adherence to self-care activities.

METHODS

A cross-sectional study was conducted in healthcare settings with large Arabic populations in metropolitan and rural Victoria, Australia. Adherence to self-care activities, illness and treatment perceptions, and clinical data were recorded. Bivariate associations for continuous normally distributed variables were tested with Pearson's correlation. Non-parametric data were tested using Spearman's rank correlation coefficient.

RESULTS

701 participants were recruited; 392 Arabic-speaking participants (ASPs) and 309 English-speaking participants (ESPs). There were significant relationships between participants' illness and treatment perceptions and adherence to diabetes self-care activities. ASPs' negative beliefs about diabetes were strongly and significantly correlated with poorer adherence to diet recommendations, exercise, blood glucose testing and foot care. ASPs were significantly less adherent to all aspects of diabetes self-care compared with ESPs: dietary behaviours (P=<0.01; 95% confidence interval (CI)=-1.17, -0.84), exercise and physical activity (P=<0.001, 95% CI -1.14, -0.61), blood glucose testing (P=<0.001) and foot-care (P=<0.001). 52.8% of ASPs were sceptical about prescribed diabetes treatment compared with only 11.2% of the ESPs. 88.3% of ASPs were non-adherent to prescribed medication, compared with 45.1% of ESPs.

CONCLUSIONS

Arabic-speaking migrants' illness and treatment perceptions were significantly different from the English-speaking group. There is a pressing need to develop new innovative interventions that deliver much-needed improvements in adherence to self-care activities and key health outcomes.

摘要

目的

比较讲阿拉伯语的移民与讲英语的白种2型糖尿病患者对疾病和治疗的认知，并探讨这些信念与自我护理活动依从性之间的关系。

方法

在澳大利亚维多利亚州大城市和农村地区有大量阿拉伯人口的医疗机构中进行了一项横断面研究。记录自我护理活动的依从性、对疾病和治疗的认知以及临床数据。对连续正态分布变量的双变量关联采用Pearson相关性检验。非参数数据采用Spearman等级相关系数检验。

结果

招募了701名参与者；392名讲阿拉伯语的参与者（ASPs）和309名讲英语的参与者（ESPs）。参与者对疾病和治疗的认知与糖尿病自我护理活动的依从性之间存在显著关系。ASPs对糖尿病的负面信念与饮食建议、运动、血糖检测和足部护理的较差依从性密切且显著相关。与ESPs相比，ASPs在糖尿病自我护理的各个方面的依从性明显较低：饮食行为（P<0.01；95%置信区间（CI）=-1.17，-0.84）、运动和体育活动（P<0.001，95%CI -1.14，-0.61）、血糖检测（P<0.001）和足部护理（P<0.001）。52.8%的ASPs对规定的糖尿病治疗持怀疑态度，而ESPs中只有11.2%。88.3%的ASPs不遵守规定的药物治疗，而ESPs中这一比例为45.1%。