Berkoh Dorice A, Owiredu William B K A, Gyasi Samuel F, Donkoh Emmanuel T, Ngala Robert A
Department of Basic and Applied Biology, University of Energy & Natural Resources, Sunyani.
Department of Molecular Medicine, School of Medicine and Dentistry, Kwame Nkrumah University of Science & Technology, Kumasi, Ghana.
Porto Biomed J. 2022 Jun 17;7(3):e148. doi: 10.1097/j.pbj.0000000000000148. eCollection 2022 May-Jun.
Failure to achieve adequate glycemic control can lead to debilitating complications for diabetics. Strict compliance to prescribed diet, lifestyle, and medication can prevent complications.
In order to examine factors accompanying noncompliance behavior to diabetes medication in a rapidly urbanizing region of Ghana, a mixed approach was adopted. Study subjects (N: 160, mean age: 58.3) were interviewed at the diabetic clinic of the Brong-Ahafo Regional Hospital, Sunyani. Compliance to diabetes treatment was evaluated with an adapted Morisky Medication Adherence Scale (MMAS). Face-to-face interviews of 20 subjects allowed for more personalized exploration of psychosocial aspects of noncompliance. The interviews were audio recorded, transcribed verbatim, and coded using the Nvivo software. Qualitative data was processed and subjected to inductive thematic analysis.
Majority of study participants reported an optimum (n = 121, 75.6%) level of compliance to diabetes medication, although some also reported poor compliance (n = 39, 24.4%). Qualitative responses received during interviews suggest that poor compliance may be attributable to misconceptions about religious beliefs and practices. Psychosocial factors relating to felt stress, the inevitability of fate, and compliance fatigue were also discovered to undermine compliance. Noncompliance behavior was also explained by socioeconomic status and barriers to health-seeking behavior.
Reported medication compliance was among the highest in out-patient settings in Ghana. However, contextual determinants of noncompliance have to be addressed. Efforts to improve compliance to diabetic medication could benefit from interventions that address superstition, target psychological aspects of chronic disease management, and remove operational barriers to healthcare delivery such as transportation costs and long waiting times.
血糖控制不佳会导致糖尿病患者出现使人衰弱的并发症。严格遵守规定的饮食、生活方式和药物治疗可预防并发症。
为了研究加纳一个快速城市化地区糖尿病药物治疗不依从行为的相关因素，采用了混合研究方法。研究对象（N = 160，平均年龄：58.3岁）在孙亚尼布朗阿哈福地区医院的糖尿病诊所接受访谈。使用改编后的莫利斯基药物依从性量表（MMAS）评估糖尿病治疗的依从性。对20名受试者进行面对面访谈，以便更个性化地探究不依从行为的心理社会方面。访谈进行了录音，逐字转录，并使用Nvivo软件进行编码。对定性数据进行处理并进行归纳主题分析。
大多数研究参与者报告对糖尿病药物治疗的依从性处于最佳水平（n = 121，75.6%），不过也有一些人报告依从性较差（n = 39，24.4%）。访谈中获得的定性回答表明，依从性差可能归因于对宗教信仰和习俗的误解。还发现与感知压力、命运的不可避免性以及依从性疲劳相关的心理社会因素会削弱依从性。社会经济地位和寻求医疗行为的障碍也解释了不依从行为。
在加纳的门诊环境中，报告的药物治疗依从性处于较高水平。然而，必须解决不依从行为的背景决定因素。改善糖尿病药物治疗依从性的努力可受益于解决迷信问题、针对慢性病管理心理方面以及消除医疗服务提供中的操作障碍（如交通成本和长时间等待）的干预措施。
