Oluma Adugna, Mosisa Getu, Abadiga Muktar, Tsegaye Reta, Habte Ashenafi, Abdissa Eba
School of Nursing and Midwifery, Institute of Health Sciences, Wollega University, Nekemte, Ethiopia.
Diabetes Metab Syndr Obes. 2020 Sep 18;13:3277-3288. doi: 10.2147/DMSO.S266589. eCollection 2020.
Diabetes is a typical chronic disease that needs integrated and multifaceted approaches. Self-care practices are fundamental to achieve good blood glucose control and prevent long-term complications. Therefore, the aim of the study was to determine the level and predictors of adherence to self-care behavior among patients with diabetes on follow-up at public hospitals of western Ethiopia.
The cross-sectional study design was employed on a sample of 423 diabetic patients on follow-up at public hospitals of western Ethiopia. A systematic random sampling method was employed. The data were entered into Epi data version 3.1 and exported into Statistical Package for the Social Sciences window version 24 for analysis. All variables significant at p-value <0.05 in the bivariable were entered in multivariate regression analysis. Backward stepwise goodness of fit was used to ascertain the suitable variables in multiple linear regression analysis. Finally, multivariate linear regression analysis with adjusted B, CI at 95%, and the significance level was set at p <0.05. All predictive variables were reported in terms of adjusted R2.
The overall mean and standard deviation of adherence to self-care behavior was 23.09 ±6.55. Among the study participants, 42.70% had good self-care behavior. Self-efficacy (B=0.106, p<0.001), home blood glucose test (B=0.075, p<0.001), exercise per week (0.035, P<0.002), meal planning (B=0.039, P<0.001), dietary restriction (B=0.077, P<0.001), duration of diabetes<4 years (B=0.030, P<0.013), non-pharmacological intervention (B=0.055, P<0.011), and good appetite (B=0.039, P<0.045) were significant variables associated with adherence to self-care behaviors.
The overall level of adherence to self-care behavior was low. Therefore, we recommended that it is better if the national health policymaker focused on dietary management modality that engages patients' behavior change to develop self-care practices and closely monitoring of glucose level. Also, we recommended an additional longitudinal study incorporating a qualitative study that focused on behavioral changes.
糖尿病是一种典型的慢性病，需要综合多方面的方法来应对。自我护理措施对于实现良好的血糖控制和预防长期并发症至关重要。因此，本研究的目的是确定埃塞俄比亚西部公立医院随访的糖尿病患者自我护理行为的依从水平及其预测因素。
采用横断面研究设计，对埃塞俄比亚西部公立医院423例接受随访的糖尿病患者进行抽样。采用系统随机抽样方法。数据录入Epi data 3.1版本，并导出到社会科学统计软件包窗口版24进行分析。双变量分析中p值<0.05的所有变量都纳入多因素回归分析。采用向后逐步拟合优度法确定多元线性回归分析中的合适变量。最后，进行多因素线性回归分析，报告调整后的B值、95%置信区间，显著性水平设定为p<0.05。所有预测变量均以调整后的R2表示。
自我护理行为依从性的总体均值和标准差为23.09±6.55。在研究参与者中，42.70%具有良好的自我护理行为。自我效能感（B=0.106，p<0.001）、家庭血糖检测（B=0.075，p<0.001）、每周运动（B=0.035，P<0.002）、饮食计划（B=0.039，P<0.001）、饮食限制（B=0.077，P<0.001）、糖尿病病程<4年（B=0.030，P<0.013）、非药物干预（B=0.055，P<0.011）和食欲良好（B=0.039，P<0.045）是与自我护理行为依从性相关的显著变量。
自我护理行为的总体依从水平较低。因此，我们建议国家卫生政策制定者最好关注饮食管理模式，促使患者改变行为以养成自我护理习惯，并密切监测血糖水平。此外，我们建议开展一项纳入定性研究的额外纵向研究，重点关注行为变化。
