Mousavizadeh Seyedeh Narjes, Ashktorab Tahereh, Ahmadi Fazlollah, Zandi Mitra
Nursing and Midwifery School, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Department of Medical-Surgical Nursing, Nursing and Midwifery School, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Iran J Med Sci. 2018 Mar;43(2):150-157.
Poor adherence of patients with type 2 diabetes to treatment is one of the most complex and important clinical concerns. It is the main issue of the present decade and acknowledged as a challenge to control and treat diabetes. This study was carried out to explore and understand how adherence to treatment process occurs among Iranian patients with type 2 diabetes.
The present study is qualitative with grounded theory approach. The data were collected from December 2015 to July 2016 in Tehran (Iran) through individual semi-structured in-depth interviews, field notes, and memos from 21 patients with type 2 diabetes; combined with two members of their families and a healthcare professional. The data were analyzed based on Corbin and Strauss constant comparative analysis (2008).
Adherence to treatment is a transitional, interactive, and continuous process. For patients with diabetes, this process includes unperceived threat in diagnosis time (poor knowledge and skills, bottleneck of dependencies, superficial understanding of the new situation), bitter belief (downhill quality of life, physical and emotional treatment feedbacks), and adaptation to treatment (self-care dominance, regimen integration in daily activities). The process of adherence to treatment was influenced by knowledge and skill, social support, beliefs and values, psychological characteristics of people, and the nature of diabetes.
Adherence to treatment in Iranian people with diabetes depends on the family and social context, which is challenging for the patient and leads to the negligence of health behaviors. It is vital for healthcare providers to identify these factors to encourage patients to adhere and commit to treatment in order to prevent irreversible complications of diabetes.
2型糖尿病患者治疗依从性差是最复杂且重要的临床问题之一。这是当前十年的主要问题，被公认为糖尿病控制和治疗的一项挑战。本研究旨在探索和了解伊朗2型糖尿病患者的治疗依从过程。
本研究采用扎根理论方法进行定性研究。2015年12月至2016年7月期间，在德黑兰（伊朗）通过对21名2型糖尿病患者进行个人半结构化深度访谈、现场记录和备忘录收集数据；并结合他们的两名家庭成员和一名医疗保健专业人员的情况。数据基于科尔宾和施特劳斯的持续比较分析法（2008年）进行分析。
治疗依从性是一个过渡性、互动性和持续性的过程。对于糖尿病患者来说, 这个过程包括诊断时未察觉到的威胁（知识和技能不足、依赖瓶颈、对新情况的肤浅理解）、痛苦的信念（生活质量下降、身体和情感治疗反馈）以及对治疗的适应（自我护理主导、将治疗方案融入日常活动）。治疗依从过程受到知识和技能、社会支持、信念和价值观、人的心理特征以及糖尿病的性质的影响。
伊朗糖尿病患者的治疗依从性取决于家庭和社会背景，这对患者来说具有挑战性，并导致健康行为的疏忽。医疗保健提供者识别这些因素对于鼓励患者坚持并致力于治疗以预防糖尿病不可逆转的并发症至关重要。
