Cheng Li, Leung Doris Yin-Ping, Sit Janet Wing-Hung, Li Xiao-Mei, Wu Yu-Ning, Yang Miao-Yan, Gao Cui-Xia, Hui Rong
The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Ma Liu Shui, Shatin, New Territories, Hong Kong.
The Department of Nursing, Faculty of Medicine, The Xi'an Jiaotong University, Xi'an, People's Republic of China.
Patient Prefer Adherence. 2016 Jan 12;10:37-44. doi: 10.2147/PPA.S94275. eCollection 2016.
The study was conducted to investigate the diet barriers perceived by patients with poorly controlled type 2 diabetes and examine the associations between diet barriers and sociodemographic characteristics, medical condition, and patient-centered variables.
Secondary subgroup analyses were conducted based on the responses of 246 adults with poorly controlled type 2 diabetes from a multicenter, cross-sectional study. Diet barriers were captured by the Diet Barriers subscale of the Personal Diabetes Questionnaire. Participants also completed validated measures of diet knowledge, empowerment level, and appraisal of diabetes. Multiple regression techniques were used for model building, with a hierarchical block design to determine the separate contribution of sociodemographic characteristics, medical condition, and patient-centered variables to diet barriers.
Diet barriers were moderately evident (2.23±0.86) among Chinese patients with poorly controlled type 2 diabetes. The feeling of deprivation as a result of complying with a diet was the most recognized diet barrier (3.24±1.98), followed by "eating away from home" (2.79±1.82). Significantly higher levels of diet barriers were observed among those with lower levels of diet knowledge (β=-0.282, P<0.001) and empowerment (β=-0.190, P=0.015), and more negative appraisal (β=0.225, P=0.003).
Culturally tailored, patient-centered intervention programs that acknowledge individuals' preferences and allow for flexibility in diet management should be launched. Interventions programs that could enhance diet knowledge, promote positive appraisal, and improve empowerment level might effectively address diet barriers perceived by patients with poorly controlled type 2 diabetes.
本研究旨在调查2型糖尿病控制不佳患者所感知到的饮食障碍,并探讨饮食障碍与社会人口学特征、健康状况及以患者为中心的变量之间的关联。
基于一项多中心横断面研究中246名2型糖尿病控制不佳的成年人的回答进行二次亚组分析。饮食障碍通过《个人糖尿病问卷》的饮食障碍分量表进行评估。参与者还完成了饮食知识、自我效能水平和糖尿病认知的有效测量。采用多元回归技术进行模型构建,采用分层块设计来确定社会人口学特征、健康状况及以患者为中心的变量对饮食障碍的单独贡献。
在2型糖尿病控制不佳的中国患者中,饮食障碍较为明显(2.23±0.86)。因遵循饮食而产生的匮乏感是最常见的饮食障碍(3.24±1.98),其次是“外出就餐”(2.79±1.82)。饮食知识水平较低(β=-0.282,P<0.001)、自我效能较低(β=-0.190,P=0.015)以及认知更消极(β=0.225,P=0.003)的患者饮食障碍水平显著更高。
应开展针对文化背景、以患者为中心的干预项目,承认个体的偏好并在饮食管理中允许灵活性。能够增强饮食知识、促进积极认知并提高自我效能水平的干预项目可能有效解决2型糖尿病控制不佳患者所感知到的饮食障碍。