50 岁及以上 2 型糖尿病患者的疾病感知、自我效能感和自我报告的药物依从性。
Illness Perceptions, Self-efficacy, and Self-reported Medication Adherence in Persons Aged 50 and Older With Type 2 Diabetes.
出版信息
J Cardiovasc Nurs. 2021;36(4):312-328. doi: 10.1097/JCN.0000000000000675.
BACKGROUND
Illness perceptions, patients' beliefs about their health condition, may affect medication adherence as well as self-efficacy for managing the condition in type 2 diabetes (T2DM).
OBJECTIVES
The aims of this study were to investigate the associations between illness perceptions, self-efficacy, and self-reported medication adherence among persons (≥50 years of age) with T2DM and explore whether the number of comorbid conditions moderates these associations.
METHODS
This secondary analysis of cross-sectional data used baseline data from persons with T2DM. Self-administered questionnaires, including the Brief Illness Perception Questionnaire, Self-efficacy for Managing Chronic Disease, and the 4-item Morisky-Green-Levine Medication Adherence Scale, were used. We performed hierarchical multiple linear regression analyses.
RESULTS
Participants (N = 146) were 57.5% female, 67.1% white, and on average 64 years old. Six dimensions of illness perceptions (ie, consequences, personal control, treatment control, identity, concerns, and emotional representations) were associated with self-efficacy for managing T2DM. Five dimensions (ie, timeline, personal control, treatment control, coherence, and emotional representations) were significant predictors of self-reported medication adherence. Whereas the number of comorbid conditions was significantly associated with self-efficacy for managing T2DM in all models (P values < .001), the number of comorbid conditions was not associated with self-reported medication adherence.
CONCLUSIONS
This study suggests that illness perceptions and comorbid conditions may play a critical role in either self-efficacy or self-reported medication adherence in persons (≥50 years of age) with T2DM. Future research should incorporate an individual's illness perceptions and comorbid conditions into the development of interventions that may improve both self-efficacy and medication adherence in T2DM.
背景
疾病认知，即患者对自身健康状况的信念，可能会影响药物治疗的依从性，以及 2 型糖尿病（T2DM）患者自我管理疾病的效能。
目的
本研究旨在调查 T2DM 患者的疾病认知、自我效能感与自我报告的药物治疗依从性之间的关联，并探讨共病数量是否会调节这些关联。
方法
本研究使用 T2DM 患者的基线数据进行了横断面数据的二次分析。采用自我管理问卷，包括简明疾病认知问卷、慢性病管理自我效能感量表和 4 项 Morisky-Green-Levine 药物依从性量表，对患者进行调查。我们进行了分层多重线性回归分析。
结果
参与者（N=146）中，57.5%为女性，67.1%为白人，平均年龄为 64 岁。疾病认知的六个维度（即后果、个人控制、治疗控制、身份、担忧和情绪表达）与 T2DM 自我管理效能感相关。五个维度（即时间线、个人控制、治疗控制、连贯性和情绪表达）是自我报告药物治疗依从性的显著预测因素。尽管共病数量在所有模型中与 T2DM 自我管理效能感显著相关（P 值均<.001），但与自我报告的药物治疗依从性无关。
结论
本研究表明，疾病认知和共病数量可能在 T2DM 患者的自我效能感或自我报告的药物治疗依从性中起着关键作用。未来的研究应将个体的疾病认知和共病数量纳入 T2DM 干预措施的开发中，以提高自我效能感和药物治疗依从性。
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