Rana Divya, Kumar Rajesh, Kant Ravi
College of Nursing, Division of Diabetes and Metabolism, All India Institute of Medical Sciences (AIIMS), Rishikesh, Uttarakhand, India.
Internal Medicine, Division of Diabetes and Metabolism, All India Institute of Medical Sciences (AIIMS), Rishikesh, Uttarakhand, India.
Indian J Endocrinol Metab. 2022 Nov-Dec;26(6):558-564. doi: 10.4103/ijem.ijem_116_22. Epub 2023 Feb 7.
Patients with type 2 diabetes mellitus (T2DM) need a high degree of self-care behavior, treatment adherence, and good psychological health. Psychological health play a vital role in adherence to treatment regimen and self-management of diabetes. This study aims to identify the psychological predictors of self-care behaviors among patients with T2DM.
A descriptive cross-sectional survey was conducted at a diabetic clinic at a tertiary care hospital in North India. Structured pre-tested personal and clinical profile and self-efficacy, diabetes distress, depression and anxiety, and complications and fear of developing hypoglycaemia due to diabetes mellitus in the future are measured through standardized questionnaires.
The mean age of the participants was 53.5 (±3.68) years, and 41.4% were in the overweight (BMI: 25.0-29.9) and obese (16.7%, BMI > 30) category. Self-care behaviours found significant association with self-efficacy (r = 0.34, < 0.001), anxiety (r = -0.28, < 0.001), depression (r = -0.28, < 0.001) and diabetes-related distress (r = -0.30, < 0.001). Further, self-efficacy ( = 0.001), diabetes distress ( < 0.001) and fear of developing hypoglycaemia ( < 0.001) were reported independent predictors of self-care behaviour in patients with T2DM.
The current study suggests that self-efficacy, fear of hypoglycaemia and emotional state played an important role in adherence to self-care behaviour in T2DM management. Patients with diabetes mellitus should be routinely screened for psychological factors at diabetes clinics. Thus, developing tailored interventions to raise belief and self-efficacy might be a useful way to increase the involvement of patients in treatment.
2型糖尿病（T2DM）患者需要高度的自我护理行为、治疗依从性和良好的心理健康。心理健康在糖尿病治疗方案的依从性和自我管理中起着至关重要的作用。本研究旨在确定T2DM患者自我护理行为的心理预测因素。
在印度北部一家三级护理医院的糖尿病诊所进行了一项描述性横断面调查。通过标准化问卷测量经过预测试的结构化个人和临床资料、自我效能感、糖尿病困扰、抑郁和焦虑，以及糖尿病并发症和对未来发生低血糖的恐惧。
参与者的平均年龄为53.5（±3.68）岁，41.4%属于超重（BMI：25.0 - 29.9）和肥胖（16.7%，BMI > 30）类别。自我护理行为与自我效能感（r = 0.34，< 0.001）、焦虑（r = -0.28，< 0.001）、抑郁（r = -0.28，< 0.001）和糖尿病相关困扰（r = -0.30，< 0.001）存在显著关联。此外，自我效能感（= 0.001）、糖尿病困扰（< 0.001）和对发生低血糖的恐惧（< 0.001）被报告为T2DM患者自我护理行为的独立预测因素。
当前研究表明，自我效能感、对低血糖的恐惧和情绪状态在T2DM管理中对自我护理行为的依从性起着重要作用。糖尿病诊所应常规筛查糖尿病患者的心理因素。因此，制定针对性的干预措施以增强信念和自我效能感可能是提高患者治疗参与度的有效方法。
