一个将健康素养、药物自我效能、药物依从性和血糖控制联系起来的路径模型。
A path model linking health literacy, medication self-efficacy, medication adherence, and glycemic control.
机构信息
Division of Social and Administrative Sciences, School of Pharmacy, University of Wisconsin-Madison, WI, 53705, USA.
Department of Psychology and Special Education, Texas A&M University-Commerce, TX, 75429, USA.
出版信息
Patient Educ Couns. 2018 Nov;101(11):1906-1913. doi: 10.1016/j.pec.2018.06.010. Epub 2018 Jun 18.
OBJECTIVE
To investigate whether medication self-efficacy moderates or mediates the relationship between health literacy and medication adherence. To propose a path model that illustrates the interrelated relationship between health literacy, medication self-efficacy, medication adherence, and hemoglobin A1c (HbA1c).
METHODS
This cross-sectional study was performed via a face-to-face survey. Factors that may influence medication adherence and HbA1c were identified from the literature review. One hundred and seventy-four participants included were ≥20 years old with diagnosed type 2 diabetes, understood English, and were prescribed at least one oral diabetes medicine. During clinic visits, a questionnaire was administered to evaluate health literacy, medication self-efficacy, and medication adherence. HbA1c values were obtained from electronic medical records. Path analyses were conducted for data analysis.
RESULTS
Medication self-efficacy mediated but did not moderate the relationship between numeracy and diabetes medication adherence. Participants with higher numeracy skills may develop a greater level of medication self-efficacy, which in turn may result in a higher level of diabetes medication adherence and a lower level of HbA1c.
CONCLUSION
Enhancing patients' medication self-efficacy and numeracy skills may be imperative in intervention programs to improve diabetes medication adherence.
PRACTICE IMPLICATIONS
An improvement in numeracy skills and medication self-efficacy is recommended to enhance diabetes medication adherence.
目的
研究药物自我效能是否调节或中介健康素养与药物依从性之间的关系。提出一个路径模型，说明健康素养、药物自我效能、药物依从性和糖化血红蛋白（HbA1c）之间的相互关系。
方法
本横断面研究通过面对面调查进行。从文献综述中确定了可能影响药物依从性和 HbA1c 的因素。纳入的 174 名参与者年龄均≥20 岁，诊断为 2 型糖尿病，理解英语，并至少服用一种口服糖尿病药物。在就诊期间，通过问卷调查评估健康素养、药物自我效能和药物依从性。从电子病历中获取 HbA1c 值。进行路径分析进行数据分析。
结果
药物自我效能调节但不中介数学能力与糖尿病药物依从性之间的关系。具有较高数学技能的参与者可能会发展出更高水平的药物自我效能，这反过来又可能导致更高水平的糖尿病药物依从性和更低水平的 HbA1c。
结论
在改善糖尿病药物依从性的干预计划中，增强患者的药物自我效能和数学技能可能至关重要。
实践意义
建议提高数学技能和药物自我效能，以提高糖尿病药物的依从性。
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