Aleali Armaghan Moravej, Payami Seyed Peyman, Latifi Seyed Mahmoud, Yazdanpanah Leila, Hesam Saeed, Khajeddin Niloufar
Diabetes Research Center, Health Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
Department of Epidemiology and Biostatics, School of public Health, Tehran University of Medical Sciences, Tehran, Iran.
Diabetes Metab Syndr. 2018 Nov;12(6):929-932. doi: 10.1016/j.dsx.2018.05.017. Epub 2018 May 19.
Various studies have demonstrated that the majority of the factors affecting the reluctance of individuals to insulin injections are rooted in psychological factors. Present study aimed to determine relationships between main causes of refusal to insulin injection in diabetic patients and factors such as age, gender, and educational degree of patients.
MATERIAL & METHODS: This was a descriptive study which was conducted on diabetic patients (n = 505) who need insulin therapy. The data were collected with a questionnaire in following steps. First, the most important causes of patients' reluctance, in the patients' opinion, to insulin therapy were determined using the data of the previous studies. In the second step, the patients were asked to express their opinion on each of these factors and the recorded responses were analyzed.
The results of the study showed that fear of ampoules, fear of pain caused by insulin and the embarrassment of patients from injections in public significantly depended on the gender of the patients, so that these factors were much lower in men than women. In addition, these factors in the patients with higher degrees of education led to lower level of refusal to insulin injections. Another factor influencing the reluctance to insulin injections was the forming of a sense of addiction due to daily insulin injections, which was significantly lower among the patients with higher education, but did not have a significant relationship with sex of the patients. In this regard, another factor was fear of hypoglycemia and insulin side effects, which did not have a significant relationship with gender and educational degree. In addition, there was no significant relationship between the patient's age and any of the factors effective in patients' reluctance to insulin injections.
Psychological factors seem to be effective in the emergence of the sense of reluctance to insulin injections. Therefore, not only patients but also the entire society need to receive training and appropriate services to improve their attitude to this issue with a psychological approach and help to solve this problem.
多项研究表明，影响个体不愿接受胰岛素注射的大多数因素都源于心理因素。本研究旨在确定糖尿病患者拒绝胰岛素注射的主要原因与患者年龄、性别和教育程度等因素之间的关系。
这是一项对需要胰岛素治疗的糖尿病患者（n = 505）进行的描述性研究。数据通过问卷按以下步骤收集。首先，利用先前研究的数据确定患者认为不愿接受胰岛素治疗的最重要原因。第二步，要求患者对这些因素中的每一个发表意见，并对记录的回答进行分析。
研究结果表明，对安瓿的恐惧、对胰岛素引起的疼痛的恐惧以及患者在公共场合注射的尴尬程度在很大程度上取决于患者的性别，男性在这些因素上的程度远低于女性。此外，受教育程度较高的患者中这些因素导致拒绝胰岛素注射的程度较低。另一个影响不愿接受胰岛素注射的因素是由于每日注射胰岛素而形成的成瘾感，在受教育程度较高的患者中这种感觉明显较低，但与患者性别没有显著关系。在这方面，另一个因素是对低血糖和胰岛素副作用的恐惧，与性别和教育程度没有显著关系。此外，患者年龄与任何影响患者不愿接受胰岛素注射的因素之间均无显著关系。
心理因素似乎在产生不愿接受胰岛素注射的感觉方面起作用。因此，不仅患者，整个社会都需要接受培训并获得适当服务，以从心理角度改善对这个问题的态度，并帮助解决这个问题。
