KITE-Toronto Rehabilitation Institute, University Health Network, Toronto, Ontario, Canada; Healthy Living for Pandemic Event Protection (HL - PIVOT) Network, Toronto, Ontario, Canada; Rehabilitation Sciences Institute, University of Toronto, Toronto, Ontario, Canada; Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, Ontario, Canada.
KITE-Toronto Rehabilitation Institute, University Health Network, Toronto, Ontario, Canada; Ontario Tech University, Faculty of Health Science, Oshawa, Ontario, Canada.
Can J Diabetes. 2022 Apr;46(3):277-286.e1. doi: 10.1016/j.jcjd.2021.11.001. Epub 2021 Nov 11.
Our aim in this study was to determine sex differences and predictors of noncompletion of a comprehensive adapted cardiac rehabilitation program (CRP) for people with type 2 diabetes (no known cardiac disease).
Reasons for noncompletion of a 6-month adapted diabetes exercise-based CRP were ascertained by interview between 2006 and 2017. Regression analyses were conducted to determine demographic, cardiopulmonary, medical and psychosocial predictors of noncompletion in all participants and in females and males separately.
Among all participants (460 females and 375 males), predictors of dropout included higher depression score, being unemployed, higher glycated hemoglobin (A1C), younger age and fewer comorbidities. There was no difference in completion rate between females and males in bivariate (28% vs 28.3%, p=0.9) or multivariate (odds ratio=1.089, 95% confidence interval 0.79 to 1.5, p=0.6) analyses, but predictors of dropout varied. In females, these predictors included being married/partnered, living with obesity and having a higher depression score, A1C and triglycerides level, independent of age. For males, only higher depression score and younger age predicted dropout. There was no difference in medical dropouts between females and males (37.2% vs 34% of all dropouts, p=0.6) or in reasons for dropout (p>0.05 for all) or attendance to prescheduled sessions in completers (69.2±16.8% vs 70.4±18.8%, p=0.5) or dropouts (24.7±15.7% vs 25.2±16.1%, p=0.8), respectively.
There was no sex difference in noncompletion, attendance or reasons for dropout from a diabetes CRP. However, being married/partnered, living with obesity and having higher A1C and triglycerides were unique predictors of dropout for females and younger age for males. Being unemployed, glycemic control and depressive symptoms are targets for promoting completion in all participants that can be addressed by multidisciplinary CRP teams.
本研究旨在确定 2 型糖尿病（无已知心脏病）患者综合适应性心脏康复计划（CRP）完成情况的性别差异和预测因素。
2006 年至 2017 年间，通过访谈确定了 6 个月适应性糖尿病运动为基础 CRP 未完成的原因。回归分析用于确定所有参与者以及女性和男性中完成情况的人口统计学、心肺、医学和心理社会预测因素。
在所有参与者（460 名女性和 375 名男性）中，辍学的预测因素包括较高的抑郁评分、失业、较高的糖化血红蛋白（A1C）、较年轻的年龄和较少的合并症。在单变量（28%与 28.3%，p=0.9）或多变量（比值比=1.089，95%置信区间 0.79 至 1.5，p=0.6）分析中，女性和男性的完成率没有差异，但辍学的预测因素有所不同。在女性中，这些预测因素包括已婚/有伴侣、与肥胖者同住和具有较高的抑郁评分、A1C 和甘油三酯水平，与年龄无关。对于男性，只有较高的抑郁评分和较年轻的年龄预测辍学。女性和男性的医疗辍学率没有差异（所有辍学者中的 37.2%与 34%，p=0.6）或辍学原因（所有 p>0.05）或完成者预定会议的出勤率（69.2±16.8%与 70.4±18.8%，p=0.5）或辍学者（24.7±15.7%与 25.2±16.1%，p=0.8）。
在糖尿病 CRP 完成情况、出勤率或辍学原因方面，没有性别差异。然而，已婚/有伴侣、与肥胖者同住和较高的 A1C 和甘油三酯是女性辍学的独特预测因素，而男性的年龄较小是辍学的独特预测因素。失业、血糖控制和抑郁症状是促进所有参与者完成的目标，可以由多学科 CRP 团队解决。
