Department of Clinical Psychology, Faculty of Psychology and Education, Kharazmi University, Tehran, Iran.
Department of Educational Psychology, Shiraz University, Shiraz, Iran.
Clin Psychol Psychother. 2022 Nov;29(6):1854-1866. doi: 10.1002/cpp.2746. Epub 2022 May 18.
Non-adherence to medical regimens among patients with diabetes is a well-recognized concern in health care. Modified information, motivation, behavioural skills (IMB) model by adding an emotion component to it was tested to explore predictors of treatment adherence among 1,125 Iranian patients with diabetes type I (T1D) and type II (T2D) and due to other medical conditions. The modified IMB model explained 35% of the treatment adherence with large effect-sizes f = 0.56 to 0.69. Self-compassion and interpersonal communication between staff and patients (ICSP) were significant predictors of treatment adherence among patients with T1D, T2D and diabetes due to other medical conditions, while both outperformed the other significant predictors of treatment adherence, i.e., illness perception and social support in all groups. Distress intolerance was a significant predictor of treatment adherence only in patients with T2D. In addition, patients, based on their type of diabetes, exhibited different patterns of illness perception in predicting treatment adherence. Among T2D patients and those with diabetes due to other medical conditions, gender (male; only in T2D) and being single were significant predictors of treatment adherence, while age and diabetes duration were not. Finally, the model demonstrated that above and beyond demographic features, self-compassion, interpersonal communication between patients and health care staff, distress intolerance, perceived social support and illness perception were significant predictors of treatment adherence among patients with diabetes.
糖尿病患者不遵守医疗方案是医疗保健中一个众所周知的问题。本研究通过在信息-动机-行为技能（IMB）模型中加入情绪成分，对其进行了修改，并对 1125 名伊朗 1 型糖尿病（T1D）和 2 型糖尿病（T2D）患者和因其他医疗状况导致糖尿病的患者的治疗依从性的预测因素进行了测试。该修正后的 IMB 模型用较大的效应大小 f（0.56 到 0.69）解释了 35%的治疗依从性。自我同情和医护人员与患者之间的人际沟通（ICSP）是 T1D、T2D 和因其他医疗状况导致糖尿病患者治疗依从性的重要预测因素，而这两者在所有组中都优于其他重要的治疗依从性预测因素，即疾病认知和社会支持。痛苦耐受力仅在 T2D 患者中是治疗依从性的重要预测因素。此外，根据患者的糖尿病类型，他们在预测治疗依从性方面表现出不同的疾病认知模式。在 T2D 患者和因其他医疗状况导致糖尿病的患者中，性别（男性；仅在 T2D 中）和单身是治疗依从性的重要预测因素，而年龄和糖尿病病程不是。最后，该模型表明，除了人口统计学特征外，自我同情、患者与医护人员之间的人际沟通、痛苦耐受力、感知到的社会支持和疾病认知是糖尿病患者治疗依从性的重要预测因素。
