Ishak Nor H, Mohd Yusoff Siti S, Rahman Razlina A, Kadir Azidah A
Klinik Kesihatan Jalan lanang, Sibu, Sarawak, Malaysia.
Department of Family Medicine, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kerian, Kelantan, Malaysia.
J Taibah Univ Med Sci. 2017 Jun 16;12(6):504-511. doi: 10.1016/j.jtumed.2017.03.008. eCollection 2017 Dec.
Diabetes is a primarily self-manageable condition. Healthcare professionals usually offer education, treatment, and support, but patients themselves are responsible for the daily management of their condition. Increasing the effectiveness of self-management support may have a considerable impact on health care, especially for elderly people. The aim of this study was to describe diabetes self-care among elderly diabetics and to determine its associated factors.
This report describes a cross-sectional study involving 143 elderly diabetes patients in the outpatient department of the Hospital Universiti Sains Malaysia (HUSM). Self-care activities assessed in this study included dietary control, physical activity, self-monitoring of blood glucose, medication adherence, and situational related adherence behaviour, all of which were obtained using the validated Malay Elderly Diabetes Self-Care Questionnaire (MEDSCaQ).
The mean (±SD) age of the subjects was 67.9 (±5.4) years old. A majority was Malay, with a mean HbA1c of 8.4 (±1.9). The mean diabetes self-care score was 26.5 (±8.0). Factors with a positive impact on diabetes self-care included being non-Malay (β = 5.275, p = 0.002), having family as care givers (β = 8.995, p = 0.004), having a higher level of family support (β = 0.159, p = 0.042), and possessing acceptable (β = 4.375, p = 0.001) or good knowledge of diabetes (β = 5.893, p = 0.004). The presence of neuropathy negatively impacted self-care, while diabetes nephropathy had a positive impact on self care (β = -4.053, p = 0.003).
Elderly individuals with type 2 diabetes in HUSM have a moderate score of diabetes self-care practice based on the MEDSCaQ. Determinants for good diabetes self-care include race, social support, having care-takers during periods of illness, diabetes knowledge, and diabetic microvascular complications.
糖尿病主要是一种可自我管理的疾病。医疗保健专业人员通常会提供教育、治疗和支持，但患者自身负责日常病情管理。提高自我管理支持的有效性可能会对医疗保健产生重大影响，尤其是对老年人而言。本研究的目的是描述老年糖尿病患者的糖尿病自我护理情况，并确定其相关因素。
本报告描述了一项横断面研究，该研究纳入了马来西亚理科大学医院（HUSM）门诊部的143名老年糖尿病患者。本研究评估的自我护理活动包括饮食控制、体育活动、血糖自我监测、药物依从性以及与情境相关的依从行为，所有这些均通过经验证有效的马来语老年糖尿病自我护理问卷（MEDSCaQ）获得。
受试者的平均（±标准差）年龄为67.9（±5.4）岁。大多数为马来人，平均糖化血红蛋白为8.4（±1.9）。糖尿病自我护理平均得分为26.5（±8.0）。对糖尿病自我护理有积极影响的因素包括非马来人（β = 5.275，p = 0.002）、有家人作为照顾者（β = 8.995，p = 0.004）、有更高水平的家庭支持（β = 0.159，p = 0.042）以及对糖尿病有可接受（β = 4.375，p = 0.001）或良好的认知（β = 5.893，p = 0.004）。神经病变的存在对自我护理有负面影响，而糖尿病肾病对自我护理有积极影响（β = -4.053，p = 0.003）。
根据MEDSCaQ，HUSM的老年2型糖尿病患者糖尿病自我护理实践得分中等。良好糖尿病自我护理的决定因素包括种族、社会支持、患病期间有照顾者、糖尿病知识以及糖尿病微血管并发症。
