Bagheri Sajad, Salari Nader, Khoshay Ahmad, Abdi Alireza
Nursing and Midwifery School, Kermanshah University of Medical Sciences, Kermanshah, Iran.
J Diabetes Metab Disord. 2023 Oct 25;23(1):665-671. doi: 10.1007/s40200-023-01331-0. eCollection 2024 Jun.
According to the high prevalence of diabetes Mellitus (DM), as a harmful metabolic disease, the adoption of self-care (SC) behaviors along with modern medications seems necessary for diabetes Mellitus patients (DMPs). Since self-efficacy (SE) affects the quality of SC behaviors in DMPs to prevent limb amputation as one of the most common DM-related complications, the present study aimed to investigate the probable relationship between the effect of the Diabetes Management Self-Efficacy (DMSE) with limb amputation rate in DMPs.
DMPs with ages of 18-65 years were selected and divided into two groups of the case (DMPs with experiences of DM ≥ 4 years and limb amputation, n = 300), and control (DMPs with no experience of limb amputation, n = 600). Data were collected through demographics, clinical checklists, and the DMSES tool, and were analyzed using SPSS (v.25).
The mean age of DMPs was 55.2 ± 8.2 years, and 59.3% and 40.7% of patients had type I and type II DM, respectively. A significant relationship was found between the mean of DMSES in terms of groups of the case (Mean: 60.6) and control (mean 67.7) (P = 0.001), living place, education, family background in non-close relatives, underlying disease, high blood pressure, hyperlipidemia, and the type of DM. The odds ratio (OR) of amputation was also found higher in DMPs with a lower mean of DMSES OR = 1.03, CI 95%=1.01-1.04, P = 0.001).
In this study, DMSE had a significant relationship with reducing limb amputation rate in DMPs. Furthermore, The average self-efficacy score according to gender, place of residence, education, family history in non-close relatives, underlying disease, and type of diabetes was significantly difference. It is suggested, that self-efficacy would be enhanced through systematic education in diabetes clinics.
The online version contains supplementary material available at 10.1007/s40200-023-01331-0.
糖尿病（DM）作为一种有害的代谢性疾病，患病率较高，糖尿病患者（DMPs）采取自我护理（SC）行为并结合现代药物治疗似乎很有必要。由于自我效能感（SE）会影响DMPs自我护理行为的质量，而预防肢体截肢是最常见的糖尿病相关并发症之一，因此本研究旨在探讨糖尿病管理自我效能感（DMSE）与DMPs肢体截肢率之间可能存在的关系。
选取年龄在18 - 65岁的DMPs，分为两组，病例组（DM病程≥4年且有肢体截肢经历的DMPs，n = 300）和对照组（无肢体截肢经历的DMPs，n = 600）。通过人口统计学、临床检查表和DMSES工具收集数据，并使用SPSS（v.25）进行分析。
DMPs的平均年龄为55.2±8.2岁，59.3%和40.7%的患者分别患有I型和II型糖尿病。病例组（均值：60.6）和对照组（均值67.7）的DMSES均值之间、居住地点、教育程度、非近亲家族背景、基础疾病、高血压、高脂血症以及糖尿病类型之间存在显著关系。DMSES均值较低的DMPs截肢的优势比（OR）也更高（OR = 1.03，95%置信区间=1.01 - 1.04，P = 0.001）。
在本研究中，DMSE与降低DMPs的肢体截肢率存在显著关系。此外，根据性别、居住地点、教育程度、非近亲家族史、基础疾病和糖尿病类型划分的平均自我效能得分存在显著差异。建议通过糖尿病诊所的系统教育来提高自我效能感。
在线版本包含可在10.1007/s40200 - 023 - 01331 - 0获取的补充材料。
