Hidaka Tomoo, Takahashi Noriko, Hashimoto Katsue, Inoue Mariko, Terada Yukiko, Endo Shota, Kakamu Takeyasu, Tsukahara Taro, Abe Koichi, Fukushima Tetsuhito
Department of Hygiene and Preventive Medicine, Fukushima Medical University, Hikarigaoka 1, Fukushima, Fukushima, 9601295, Japan.
Koriyama City Public Health Center, 15-1, Asahi 2, Koriyama, Fukushima, 9638024, Japan.
Diabetes Ther. 2021 Dec;12(12):3187-3199. doi: 10.1007/s13300-021-01175-y. Epub 2021 Oct 27.
Future time perspective (FTP) means the capacity to foresee, anticipate, and plan for future desired outcomes, and it contributes to persistent treatment for type 2 diabetes mellitus (T2DM). However, the components of FTP specific to T2DM patients have not been clarified. This study aimed to explore the components of FTP and to examine the associations between such components and persistent/impersistent diabetes treatment.
In this cross-sectional study, using qualitative and quantitative methods, 106 T2DM patients were enrolled by purposive sampling. The participants were interviewed in October and November 2018 by public health nurses in Koriyama City Public Health Center, Japan. In addition to the participants' status of treatment engagement (persistent/impersistent), their responses regarding reasons for persistent/impersistent treatment were collected and then summarized into nine subthemes, which were then merged into two main themes according to the presence or absence of FTP with a sense of T2DM ownership for analysis.
The main theme, "presence of FTP with a sense of T2DM ownership," included subthemes such as "securing social independence," "planning on living a long and healthy life," "prioritizing avoiding being a burden on family and friends," "valuing improvement of diabetes," "avoiding tragic results," "optimistically viewing treatment as a form of self-development," and "improving mental health," whereas the main theme, "absence of FTP with a sense of T2DM ownership," included "lack of consciousness of disease" and "living a dissipated life." The association between the presence of FTP with a sense of T2DM ownership and persistent treatment for T2DM was found using Fisher's exact test (p < 0.001).
Health care professionals should support T2DM patients in having an FTP with a sense of T2DM ownership and purpose in life instead of treatment goals when such patients mention their dissipated life or lack of insight into the disease.
未来时间观（FTP）是指预见、预期和规划未来期望结果的能力，它有助于2型糖尿病（T2DM）患者坚持治疗。然而，T2DM患者特有的FTP组成部分尚未明确。本研究旨在探索FTP的组成部分，并检验这些组成部分与持续性/非持续性糖尿病治疗之间的关联。
在这项横断面研究中，采用定性和定量方法，通过目的抽样纳入了106例T2DM患者。2018年10月和11月，日本郡山市公共卫生中心的公共卫生护士对参与者进行了访谈。除了参与者的治疗参与状态（持续/非持续）外，还收集了他们关于持续/非持续治疗原因的回答，然后总结为九个子主题，再根据是否具有T2DM主人翁意识的FTP将其合并为两个主要主题进行分析。
主要主题“具有T2DM主人翁意识的FTP存在”包括“确保社会独立”“计划长寿健康地生活”“优先避免成为家人和朋友的负担”“重视糖尿病的改善”“避免悲剧结果”“乐观地将治疗视为自我发展的一种形式”以及“改善心理健康”等子主题，而主要主题“缺乏T2DM主人翁意识的FTP不存在”包括“疾病意识淡薄”和“生活放荡”。使用Fisher精确检验发现具有T2DM主人翁意识的FTP存在与T2DM持续治疗之间的关联（p < 0.001）。
当T2DM患者提及他们生活放荡或对疾病缺乏洞察力时，医疗保健专业人员应支持他们拥有具有T2DM主人翁意识和生活目标而非治疗目标的FTP。
