Public Health School of Fujian Medical University, Fuzhou, China.
School of Health Sciences, Merrimack College, North Andover, MA, USA.
Inquiry. 2021 Jan-Dec;58:469580211012491. doi: 10.1177/00469580211012491.
The purpose of the study was to examine the social-ecological factors associated with diabetic self-management compliance among elders with diabetes in China. A total of 2,586 rural elderly residents who were 60-years-old or above participated in the survey. Socio-demographic factors, social support, healthcare accessibility and health risk factors were measured, along with self-reported medication and blood glucose monitoring data. Among the 117 individuals with diabetes, the medication compliance rate was 79.49%. The elderly who had high economic status were more likely to meet medication treatment compliance. Only 58.97% of study participants monitored blood glucose once a month. Younger age (<70-year-old), higher economic status, more social support and better healthcare accessibility were associated with higher blood glucose monitoring compliance odds. Diabetic medication and blood glucose testing tools should be more comprehensively covered by the national insurance program. Healthcare accessibility should be increased through transportation support, building more local facilities, such as mobile labs, and promoting affordable home-visit care. Self-management education programs about diabetes for rural elders should be promoted.
本研究旨在探讨中国老年糖尿病患者糖尿病自我管理依从性的社会生态因素。共有 2586 名 60 岁及以上的农村老年居民参与了调查。测量了社会人口统计学因素、社会支持、医疗可及性和健康风险因素，以及自我报告的药物治疗和血糖监测数据。在 117 名糖尿病患者中，药物治疗依从率为 79.49%。经济状况较好的老年人更有可能达到药物治疗的依从性。只有 58.97%的研究参与者每月监测一次血糖。年龄较轻（<70 岁）、经济状况较好、社会支持较多、医疗可及性较好的老年人，其血糖监测依从性更高。国家医疗保险计划应更全面地涵盖糖尿病药物治疗和血糖检测工具。应通过交通支持、建设更多的当地设施（如移动实验室）以及推广负担得起的上门护理来增加医疗可及性。应推广针对农村老年人的糖尿病自我管理教育计划。
