Department of Primary Care Medicine, Faculty of Medicine, Univerisiti Teknologi MARA, Selayang Campus, Batu Caves 68100, Selangor, Malaysia.
Department of Public Health Medicine, Faculty of Medicine, Universiti Teknologi MARA, Sungai Buloh Campus, Sungai Buloh 47000, Selangor, Malaysia.
Int J Environ Res Public Health. 2022 Mar 4;19(5):3031. doi: 10.3390/ijerph19053031.
Self-efficacy (SE) has been shown to be positively correlated with quality of life (QOL) among patients with type 2 diabetes mellitus (T2DM). Medication understanding (MU) on the other hand, leads to good adherence that indirectly improves QOL. Measuring self-efficacy in medication understanding is useful to ascertain patient’s confidence in medication adherence. However, there is a lack of studies on the relationship between self-efficacy in medication understanding with QOL. This study aimed to determine the relationship between self-efficacy in medication understanding and QOL, and the factors associated with QOL in elderly with T2DM on polypharmacy. A cross-sectional study was conducted on these populations at primary care specialist clinic. Malay version of MU in SE questionnaire (MUSE) was used. Higher scores showed a better understanding. A revised Version Diabetic Quality of Life-13 (RVDQOL-13) questionnaire was used with lower scores indicating higher QOL. A total of 321 patients participated, with the majority being male (58.3%), Malay (84.7%), a predominant age group of 60−69 (75.7%) with mean age (±SD) of 66.7 (±0.286) years old. The median (IQR) of MUSE was high—30 (4)—while the RVDQOL-13 was low—19 (8)—which demonstrated high QOL. Inverse correlation was found between MUSE and QOL (r −0.14, p < 0.01). Multiple linear regression analysis demonstrated that MUSE score (β −0.282; 95% CI: (−5.438, −2.581); p < 0.001), low-income group (β −0.144; 95% CI: (−3.118, −0.534); p = 0.006) and duration of medications ≥240 days (β −0.282; 95% CI: (−5.438, −2.581); p < 0.001) were associated with better QOL, while medications ≥10 (β 0.109; 95% CI: 0.214, 4.462; p = 0.031) and those with pills and insulin (β 0.193; 95% CI: 1.206, 3.747; p < 0.001) were associated with poor QOL. In conclusion, higher MUSE is associated with better QOL. Findings suggest emphasizing self-efficacy in medication understanding in the management of elderly with T2DM on polypharmacy to improve QOL.
自我效能感 (SE) 已被证明与 2 型糖尿病 (T2DM) 患者的生活质量 (QOL) 呈正相关。另一方面，药物理解 (MU) 可导致良好的依从性，间接提高 QOL。测量药物理解中的自我效能感有助于确定患者对药物依从性的信心。然而，目前关于药物理解自我效能感与 QOL 之间关系的研究还很少。本研究旨在确定药物理解自我效能感与 QOL 之间的关系，以及与老年 T2DM 患者多药治疗 QOL 相关的因素。在初级保健专家诊所对这些人群进行了一项横断面研究。使用马来语 MU 在 SE 问卷 (MUSE)。更高的分数表示更好的理解。使用修订后的糖尿病生活质量 13 项问卷 (RVDQOL-13)，分数越低表示 QOL 越高。共有 321 名患者参与，其中大多数为男性 (58.3%)、马来人 (84.7%)，年龄组以 60-69 岁为主 (75.7%)，平均年龄 (±SD) 为 66.7 (±0.286) 岁。MUSE 的中位数 (IQR) 较高—30 (4)—而 RVDQOL-13 较低—19 (8)—表明 QOL 较高。MUSE 和 QOL 之间存在负相关 (r =−0.14，p < 0.01)。多元线性回归分析表明，MUSE 评分 (β =−0.282；95%CI：(-5.438，-2.581)；p < 0.001)、低收入组 (β =−0.144；95%CI：(-3.118，-0.534)；p = 0.006) 和药物治疗时间≥240 天 (β =−0.282；95%CI：(-5.438，-2.581)；p < 0.001) 与更好的 QOL 相关，而药物治疗时间≥10 天 (β =0.109；95%CI：0.214，4.462；p = 0.031) 和服用药物和胰岛素的患者 (β =0.193；95%CI：1.206，3.747；p < 0.001) 与较差的 QOL 相关。总之，较高的 MUSE 与更好的 QOL 相关。研究结果表明，在多药治疗 T2DM 老年患者的管理中，强调药物理解中的自我效能感，以提高 QOL。
