卡塔尔 1 型糖尿病青少年和年轻成人健康饮食和身体活动的决定因素：一项定性研究。
Determinants of healthful eating and physical activity among adolescents and young adults with type 1 diabetes in Qatar: A qualitative study.
机构信息
Care and Public Health Research Institute (CAPHRI), Maastricht University, Netherlands, The Netherlands.
Faculty of Psychology, Department of Health Psychology, Open University of The Netherlands, Heerlen, The Netherlands.
出版信息
PLoS One. 2022 Jul 6;17(7):e0270984. doi: 10.1371/journal.pone.0270984. eCollection 2022.
BACKGROUND
In Qatar, as in the rest of the world, the sharp rise in the prevalence of type 1 diabetes (T1D) is a leading cause for concern, in terms associated with morbidity, mortality, and increasing health costs. Besides adhering to medication, the outcome of diabetes management is also dependent on patient adherence to the variable self-care behaviors including healthful eating (HE) and physical activity (PA). Yet, dietary intake and PA in adolescents and young adults (AYAs) with T1D are known to fall short of recommended guidelines. The aim of this study was to develop an in-depth understanding of the behavioral determinants of HE and PA adherence among Arab AYAs within the age range of 17-24 years with T1D attending Hamad General Hospital.
METHODS
Semi-structured, face-to-face individual interviews were conducted with 20 participants. Interviews were based on an integrative health behavior change model, the I-Change model (ICM). All interviews were audio-recorded, transcribed verbatim, and analyzed using the framework method.
RESULTS
More participants reported non-adherence than adherence. Several motivational determinants of adherence to HE and PA were identified. The majority of participants were cognizant of their own behaviors towards HE and PA. Yet, some did not link low adherence to HE and PA with increased risks of health problems resulting from T1D. Facilitators to adherence were identified as being convinced of the advantages of HE and PA, having support and high self-efficacy, a high level of intention, and a good health care system.
CONCLUSION
The suboptimal adherence in AYAs to HE and PA needs more attention. Supportive actions are needed to encourage adherence to a healthy lifestyle to achieve benefits in terms of glycemic control and overall health outcomes, with a special focus on adolescents. Interventions are needed to foster motivation by addressing the relevant determinants in order to promote adherence to these two behaviors in AYAs with T1D.
背景
在卡塔尔，与世界其他地区一样，1 型糖尿病（T1D）患病率的急剧上升令人担忧，这与发病率、死亡率和不断增加的医疗成本有关。除了坚持用药外，糖尿病管理的结果还取决于患者对各种自我护理行为的依从性，包括健康饮食（HE）和体育活动（PA）。然而，T1D 青少年和年轻成年人（AYAs）的饮食摄入和 PA 往往不符合推荐指南。本研究旨在深入了解在哈马德综合医院就诊的年龄在 17-24 岁之间的阿拉伯 AYAs 对 HE 和 PA 依从性的行为决定因素。
方法
对 20 名参与者进行了半结构化、面对面的个人访谈。访谈基于综合健康行为改变模型，即 I-Change 模型（ICM）。所有访谈均进行了录音、逐字转录，并使用框架方法进行了分析。
结果
更多的参与者报告了不依从，而不是依从。确定了几个与 HE 和 PA 依从性相关的动机决定因素。大多数参与者都意识到自己对 HE 和 PA 的行为。然而，有些人并没有将 HE 和 PA 的低依从性与 T1D 导致健康问题的风险增加联系起来。确定了一些促进依从性的因素，包括确信 HE 和 PA 的优势、获得支持和高度的自我效能感、高水平的意向以及良好的医疗保健系统。
结论
AYAs 在 HE 和 PA 方面的依从性不理想，需要引起更多关注。需要采取支持性行动，鼓励他们遵循健康的生活方式，以在血糖控制和整体健康结果方面获益，特别是针对青少年。需要采取干预措施，通过解决相关决定因素来激发动机，以促进 T1D 的 AYAs 对这两种行为的依从性。
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