The University of Notre Dame Australia, School of Medicine Sydney, Melbourne Clinical School, Werribee, VIC, Australia.
University of Western Australia, Faculty of Health and Medical Sciences, Perth, WA, Australia.
Endocrine. 2021 Oct;74(1):80-89. doi: 10.1007/s12020-021-02771-5. Epub 2021 Jul 3.
A key component of effective diabetes care is understanding patients' perceptions about diabetes management. Patients' attitudes and intentions towards taking medical advice may predict the outcomes for effective diabetes care. This study aims to measure participants' attitudes, beliefs and intentions towards following medical advice to manage their diabetes using the Theory of Planned Behaviour (TPB). The domains of the TPB are correlated with clinical measures of diabetes to determine if these attitudes and intentions are predictive of better diabetes control.
A pilot study was conducted. A 34-item survey was designed using the Theory of Planned Behaviour (TPB) framework and administered via mail by four general practice clinics. Included participants (N = 104; response rate 29.5%) had a diagnosis of type 2 diabetes and were taking medication for glycaemic control. Scores for each domain of the TPB survey were correlated with participants' clinical indicators for diabetes: HbA1c, blood pressure, lipid profile, cholesterol, and kidney health (eGFR and albumin: creatinine ratio) and BMI.
Participants surveyed generally reported positive attitudes and intention to follow medical advice. Medical advice was perceived to be beneficial and useful by the majority. However, in general, there was no correlation between positive intentions and improved clinical indicators of disease. Clinical indicators did not improve with duration of illness. The burden of illness is likely a mitigating factor for positive intention as participants perceive medical advice as difficult and inconvenient to follow.
Patients' individual capacity to implement medical advice should be addressed in shared-decision making models to potentially improve patient outcomes towards therapeutic targets.
有效糖尿病护理的一个关键组成部分是了解患者对糖尿病管理的看法。患者对接受医疗建议的态度和意图可能预示着有效糖尿病护理的结果。本研究旨在使用计划行为理论（TPB）衡量参与者对遵循医学建议来管理其糖尿病的态度、信念和意图。TPB 的各个领域与糖尿病的临床测量相关联，以确定这些态度和意图是否可以预测更好的糖尿病控制。
进行了一项试点研究。使用计划行为理论（TPB）框架设计了一个包含 34 个项目的调查问卷，并通过四家全科诊所通过邮件进行管理。纳入的参与者（N=104；响应率 29.5%）被诊断患有 2 型糖尿病，并正在服用药物控制血糖。TPB 调查的每个领域的分数都与参与者的糖尿病临床指标相关联：HbA1c、血压、血脂谱、胆固醇和肾脏健康（eGFR 和白蛋白：肌酐比）以及 BMI。
接受调查的参与者普遍报告了积极的态度和遵循医疗建议的意愿。大多数人认为医疗建议是有益和有用的。然而，总体而言，积极的意图与改善疾病的临床指标之间没有相关性。随着疾病持续时间的延长，临床指标并没有改善。疾病负担可能是积极意图的一个缓解因素，因为参与者认为医疗建议难以遵循且不方便。
在共同决策模型中，应该解决患者实施医疗建议的个体能力，以潜在改善患者朝着治疗目标的结果。
