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在埃塞俄比亚一所大学医院的门诊就诊的 2 型糖尿病成年患者中,糖尿病健康素养及其与血糖控制的关系。

Diabetic health literacy and its association with glycemic control among adult patients with type 2 diabetes mellitus attending the outpatient clinic of a university hospital in Ethiopia.

机构信息

Department of Clinical Pharmacy, School of Pharmacy, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia.

Department of Pharmacognosy, School of Pharmacy, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia.

出版信息

PLoS One. 2020 Apr 8;15(4):e0231291. doi: 10.1371/journal.pone.0231291. eCollection 2020.

Abstract

BACKGROUND

Despite how much effect of low health literacy is on diabetic treatment cannot be accurate, it has an impact on controlling blood glucose level. Less is known about diabetic health literacy in Ethiopian diabetic patients which can affect patient medication adherence, self-care, and glycemic control.

OBJECTIVE

This study was aimed to assess the diabetic health literacy level and its association with glycemic control among adult patients with type 2 diabetes mellitus attending the outpatient clinic of University of Gondar Comprehensive Specialized Hospital (UOGCSH): Northwest Ethiopia.

METHODS

A cross-sectional study was employed at the outpatient clinic of the University of Gondar Comprehensive Specialized Hospital from May, 1 -May 30, 2019. The comprehensive 15-items diabetic health literacy questions with a 5-point Likert scale used to measure diabetic health literacy. The mean score calculated and switched to the percentage (5 points as 100%) to determine the level of diabetic health literacy. Morisky Green Levine Scale 4 item adherence assessment tool was used to assess the diabetic patient's level of adherence. Binary and multivariable logistic regression analysis was used to assess the association between sociodemographic, clinical variables, diabetic-related literacy, and glycemic control. Independent samples t-test and One-way ANOVA test was employed to compare the mean literacy score difference in different groups.

RESULT

400 respondents were included in the study. Of all the respondents, 17.3%, 26.3%, and 56.5% had low, medium and high diabetic-related health literacy, respectively. The proportions of patients with low, medium and high adherence to medication were 9.8%, 56.3%, and 34% respectively. Patients with high diabetes literacy are 1.85 times more likely to achieve target glycemic control than lower diabetic literacy patients with 95% CI Adjusted Odds Ratio (AOR). 1.85(1.09-3.40). While patients with good adherence 1.61 times more likely to achieve target glycemic control than patients with low adherence; 95% CI AOR 1.61(1.04-4.79). Diabetic patients with morbidity have 67% less likelihood to achieve the target glycemic control; 95% CI AOR 0.33(0.15-0.73).

CONCLUSION

Adequate diabetic health literacy and better glycemic control are highly correlated. Adjusting all variables; younger age, high diabetic health literacy and good adherence are associated with achieving the target glycemic control.

摘要

背景

尽管低健康素养对糖尿病治疗的影响程度尚不清楚,但它确实会影响血糖水平的控制。在埃塞俄比亚的糖尿病患者中,关于糖尿病健康素养的了解较少,这可能会影响患者的用药依从性、自我护理和血糖控制。

目的

本研究旨在评估 2 型糖尿病成年患者的糖尿病健康素养水平及其与血糖控制的关系,这些患者在埃塞俄比亚贡德尔大学综合专科医院(UOGCSH)的门诊就诊。

方法

这是一项 2019 年 5 月 1 日至 5 月 30 日在贡德尔大学综合专科医院门诊进行的横断面研究。采用包含 15 个项目的糖尿病健康素养综合问卷,每个项目采用 5 点李克特量表进行评估。通过计算平均得分并转换为百分比(5 分制换算为 100%)来确定糖尿病健康素养水平。采用 Morisky Green Levine 量表的 4 项依从性评估工具来评估糖尿病患者的依从性。采用二元和多变量逻辑回归分析评估社会人口学、临床变量、糖尿病相关知识和血糖控制之间的关联。采用独立样本 t 检验和单因素方差分析比较不同组间的平均文化素养得分差异。

结果

共纳入 400 名受访者。在所有受访者中,分别有 17.3%、26.3%和 56.5%的人具有低、中、高的糖尿病相关健康素养。低、中、高药物治疗依从性的患者比例分别为 9.8%、56.3%和 34%。与低糖尿病素养患者相比,具有较高糖尿病素养的患者达到目标血糖控制的可能性高 1.85 倍,调整后的优势比(AOR)为 95%可信区间(CI)1.85(1.09-3.40)。而依从性好的患者达到目标血糖控制的可能性是依从性差的患者的 1.61 倍;95%可信区间 AOR 为 1.61(1.04-4.79)。有合并症的糖尿病患者达到目标血糖控制的可能性降低 67%;95%可信区间 AOR 为 0.33(0.15-0.73)。

结论

适当的糖尿病健康素养与更好的血糖控制密切相关。调整所有变量后,年龄较小、糖尿病健康素养高和依从性好与达到目标血糖控制相关。

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