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2型糖尿病患者的患者激活:相关因素及胰岛素的作用

Patient activation in individuals with type 2 diabetes mellitus: associated factors and the role of insulin.

作者信息

van Vugt Heidi A, Boels Anne Meike, de Weerdt Inge, de Koning Eelco Jp, Rutten Guy Ehm

机构信息

Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, 3508 GA Utrecht, Utrecht, the Netherlands,

Dutch Diabetes Federation, Amersfoort 3818 LE, the Netherlands.

出版信息

Patient Prefer Adherence. 2018 Dec 28;13:73-81. doi: 10.2147/PPA.S188391. eCollection 2019.

Abstract

AIM

This study explored the relationship between insulin use and patient activation (a person's internal readiness and capabilities to undertake health-promoting actions) in individuals with type 2 diabetes mellitus and aimed to identify demographic, clinical and psychosocial factors involved in patient activation.

METHODS

In this cross-sectional study, baseline data from a Dutch nationwide study were analyzed. Patient activation was assessed with the Patient Activation Measure 13. A linear mixed model was used to take clustering into account.

RESULTS

In total, 1,189 persons were included (310 of whom were on insulin), enrolled via 47 general practices and six hospitals. Their mean Patient Activation Measure 13 score was 59±12. We found no association between insulin therapy and patient activation. In the multivariable analysis, individuals with a better health status, very good or very poor social support (vs good social support), individuals who felt they had greater control over their illness and those with a better subjective understanding of their illness showed higher patient activation. Individuals with a lower educational level and those who expected their illness to continue showed a lower activation level.

CONCLUSION

Patient activation does not differ between individuals with type 2 diabetes mellitus on insulin therapy and those on other therapies.

摘要

目的

本研究探讨了2型糖尿病患者胰岛素使用与患者激活度(一个人采取促进健康行动的内在准备和能力)之间的关系,并旨在确定与患者激活度相关的人口统计学、临床和社会心理因素。

方法

在这项横断面研究中,对一项荷兰全国性研究的基线数据进行了分析。使用患者激活度量表13评估患者激活度。采用线性混合模型来考虑聚类情况。

结果

总共纳入了1189人(其中310人使用胰岛素),通过47家全科诊所和6家医院招募。他们的患者激活度量表13平均得分为59±12。我们发现胰岛素治疗与患者激活度之间无关联。在多变量分析中,健康状况较好、社会支持非常好或非常差(与良好社会支持相比)、感觉对疾病有更大控制权以及对疾病有更好主观理解的个体表现出更高的患者激活度。教育水平较低以及预期疾病会持续的个体激活度较低。

结论

接受胰岛素治疗的2型糖尿病患者与接受其他治疗的患者在患者激活度方面没有差异。

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