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印度糖尿病患者慢性病护理概况及其对其依从性的作用。

Profile of diabetes patients' chronic illness care in India and its role in their adherence.

机构信息

Centre for Health Psychology, School of Medical Sciences, University of Hyderabad, Hyderabad, India.

Department of Psychology, Osmania University, Hyderabad, India.

出版信息

Diabetes Metab Syndr. 2021 Jan-Feb;15(1):303-308. doi: 10.1016/j.dsx.2021.01.001. Epub 2021 Jan 11.

Abstract

BACKGROUND AND AIMS

Negligence of illness care in terms of non-adherence may give rise to serious health outcomes in patients with type 2 diabetes mellitus. Considering the importance of both chronic illness care and adherence, the primary purpose of the study is to explore the profile of diabetic patients' chronic illness care and examine its role in their clinical adherence. In addition to this, we have also investigated the major confounding variables in understanding the chronic illness care of diabetic patients.

METHODS

We have conducted this study using a simple retrospective design with one group involving the patients primarily diagnosed with type 2 diabetes (N = 200) in India.

RESULTS

The cluster analysis (k-Means) has yielded three clusters on the basis of five domains of chronic illness care-patient activation, delivery system design, goal setting, problem solving, and follow-up/coordination. The findings further reveal that the profile of chronic illness care plays a significant role in deciding the clinical adherence of patients with type 2 diabetes. The three clusters of diabetes patients, however, are confounded by health risk behaviour.

CONCLUSIONS

These initial findings are suggestive of an association between chronic illness care, clinical adherence, and health risk behaviour of patients with type 2 diabetes. More research on this topic, however, needs to be undertaken involving other important dimensions of health care system like patient-provider relationship and quality of life during hospitalisation. The implications and shortcomings are discussed.

摘要

背景和目的

忽视疾病护理方面的遵医行为可能会给 2 型糖尿病患者带来严重的健康后果。考虑到慢性病护理和遵医行为的重要性,本研究的主要目的是探讨 2 型糖尿病患者慢性病护理的特征,并研究其对临床遵医行为的作用。此外,我们还研究了理解 2 型糖尿病患者慢性病护理的主要混杂变量。

方法

我们采用简单的回顾性设计,对印度 200 名初诊为 2 型糖尿病的患者进行了研究。

结果

基于患者激活、交付系统设计、目标设定、问题解决和随访/协调五个慢性病护理领域,聚类分析(k-均值)得出了三个聚类。研究结果进一步表明,慢性病护理特征在决定 2 型糖尿病患者的临床遵医行为方面起着重要作用。然而,糖尿病患者的这三个聚类受到健康风险行为的影响。

结论

这些初步发现提示 2 型糖尿病患者的慢性病护理、临床遵医行为和健康风险行为之间存在关联。然而,需要进一步开展更多涉及医疗保健系统其他重要方面(如医患关系和住院期间的生活质量)的研究。本文讨论了研究的意义和局限性。

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