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2型糖尿病患者的糖尿病自我管理能力得分及其相关因素:马来西亚初级保健机构的一项横断面研究

Diabetes empowerment scores among type 2 diabetes mellitus patients and its correlated factors: A cross-sectional study in a primary care setting in Malaysia.

作者信息

Zhu Thew Hui, Mooi Ching Siew, Shamsuddin Nurainul Hana, Mooi Ching Siew

机构信息

Department of Family Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang 43400, Malaysia.

Malaysian Research Institute on Ageing, Universiti Putra Malaysia, Serdang 43400, Malaysia, Department of Medical Sciences, School of Healthcare and Medical Sciences, Sunway University, Bandar Sunway, Selangor, Malaysia.

出版信息

World J Diabetes. 2019 Jul 15;10(7):403-413. doi: 10.4239/wjd.v10.i7.403.

Abstract

BACKGROUND

There are limited studies on diabetes empowerment among type 2 diabetes patients, particularly in the primary care setting.

AIM

To assess the diabetes empowerment scores and its correlated factors among type 2 diabetes patients in a primary care clinic in Malaysia.

METHODS

This is a cross sectional study involving 322 patients with type 2 diabetes mellitus (DM) followed up in a primary care clinic. Systematic sampling method was used for patient recruitment. The Diabetes Empowerment Scale (DES) questionnaire was used to measure patient empowerment. It consists of three domains: (1) Managing the psychosocial aspect of diabetes (9 items); (2) Assessing dissatisfaction and readiness to change (9 items); and (3) Setting and achieving diabetes goal (10 items). A score was considered high if it ranged from 100 to 140. Data analysis was performed using SPSS version 25 and multiple linear regressions was used to identify the predictors of total diabetes empowerment scores.

RESULTS

The median age of the study population was 55 years old. 56% were male and the mean duration of diabetes was 4 years. The total median score of the DES was 110 [interquartile range (IQR) = 10]. The median scores of the three subscales were 40 with (IQR = 4) for "Managing the psychosocial aspect of diabetes"; 36 with (IQR = 3) for "Assessing dissatisfaction and readiness to change"; and 34 with (IQR = 5) for "Setting and achieving diabetes goal". According to multiple linear regressions, factors that had significant correlation with higher empowerment scores among type 2 diabetes patients included an above secondary education level ( < 0.001), diabetes education exposure ( = 0.003), lack of ischemic heart disease ( = 0.017), and lower glycated hemoglobin (HbA1c) levels ( < 0.001).

CONCLUSION

Diabetes empowerment scores were high among type 2 diabetes patients in this study population. Predictors for high empowerment scores included above secondary education level, diabetes education exposure, lack of ischemic heart disease status and lower HbA1c.

摘要

背景

关于2型糖尿病患者糖尿病自我管理能力的研究有限,尤其是在初级保健环境中。

目的

评估马来西亚一家初级保健诊所中2型糖尿病患者的糖尿病自我管理能力得分及其相关因素。

方法

这是一项横断面研究,涉及在一家初级保健诊所接受随访的322例2型糖尿病患者。采用系统抽样方法招募患者。使用糖尿病自我管理能力量表(DES)问卷来测量患者的自我管理能力。它由三个领域组成:(1)管理糖尿病的心理社会方面(9项);(2)评估不满情绪和改变的意愿(9项);(3)设定和实现糖尿病目标(10项)。得分在100至140之间被认为是高得分。使用SPSS 25版进行数据分析,并使用多元线性回归来确定糖尿病自我管理能力总分的预测因素。

结果

研究人群的中位年龄为55岁。56%为男性,糖尿病平均病程为4年。DES的总中位得分为110[四分位间距(IQR)=10]。三个子量表的中位得分分别为:“管理糖尿病的心理社会方面”为40(IQR = 4);“评估不满情绪和改变的意愿”为36(IQR = 3);“设定和实现糖尿病目标”为34(IQR = 5)。根据多元线性回归,与2型糖尿病患者较高自我管理能力得分显著相关的因素包括高中以上教育水平(<0.001)、接受糖尿病教育(=0.003)、无缺血性心脏病(=0.017)和较低的糖化血红蛋白(HbA1c)水平(<0.001)。

结论

本研究人群中2型糖尿病患者的糖尿病自我管理能力得分较高。高自我管理能力得分的预测因素包括高中以上教育水平、接受糖尿病教育、无缺血性心脏病状态和较低的HbA1c水平。

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