School of Health and Social Care, Edinburgh Napier University, Edinburgh.
School of Nursing, University of Ulster, Belfast.
Diabet Med. 2020 Dec;37(12):2035-2043. doi: 10.1111/dme.14365. Epub 2020 Aug 16.
To compare the frequency and factors associated with diabetes medication-taking (depression, perceived side effects, self-efficacy and social support) in people with mild to moderate intellectual disability and those without intellectual disability.
In stage 1 of this study, we collated information on diabetes medication-taking and associated factors in 111 people with diabetes: 33 adults with mild to moderate intellectual disability and 78 adults without intellectual disability. Validated instruments measuring medicine-taking, self efficacy, depressive symptoms, perceived level of social support and perceived side effects were administered in both groups. In stage 2, we used an abductive qualitative approach to triangulate stage 1 findings with carers responses (n = 12).
The instruments showed good internal reliability (Cronbach's α = 0.7-0.9). Comparisons between people with intellectual disabilities and those without revealed similar frequency of medication-taking (70% vs 62%; P = 0.41). People with intellectual disabilities and diabetes had significantly higher depressive symptoms, as measured by the Glasgow Depression Scale for people with a Learning Disability (P = 0.04), higher levels of perceived side effects (P = 0.01), and lower confidence levels, as measured by the Perceived Confidence Scale (P = 0.01). The results of stage 2 showed how carers of people with intellectual disabilities and diabetes optimized medication-taking yet infrequently discussed the side effects of medicines.
Further investigation of medication-taking and side effects may result in the development of an evidence-informed intervention to improve medicines safety in people with intellectual disabilities.
比较轻度至中度智力障碍者和无智力障碍者糖尿病药物治疗（抑郁、感知副作用、自我效能和社会支持）的频率和相关因素。
在这项研究的第一阶段，我们整理了 111 名糖尿病患者的药物治疗和相关因素信息：33 名轻度至中度智力障碍的成年人和 78 名无智力障碍的成年人。在两组中均使用了经过验证的测量药物治疗、自我效能、抑郁症状、感知社会支持水平和感知副作用的工具。在第二阶段，我们使用归纳定性方法将第一阶段的发现与照顾者的反应进行三角剖分（n = 12）。
这些工具表现出良好的内部可靠性（Cronbach's α = 0.7-0.9）。智力障碍者和无智力障碍者之间的比较显示出相似的药物治疗频率（70%对 62%；P = 0.41）。患有智力障碍和糖尿病的人，如使用学习障碍者格拉斯哥抑郁量表（Glasgow Depression Scale for people with a Learning Disability）测量，抑郁症状明显更高（P = 0.04），感知副作用水平更高（P = 0.01），自信心水平更低，如使用感知信心量表（Perceived Confidence Scale）测量（P = 0.01）。第二阶段的结果表明，智力障碍者和糖尿病患者的照顾者如何优化药物治疗，但很少讨论药物的副作用。
对药物治疗和副作用的进一步研究可能会开发出循证干预措施，以提高智力障碍者的药物安全性。
