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基于健康信念模型的尼泊尔确诊糖尿病患者定期散瞳检查的依从性及其决定因素:单中心医院分析。

Adherence to Periodic Dilated Eye Examinations and Its Determinants Among Nepalese Patients With Diagnosed Diabetes: A Single-Center Hospital-Based Analysis Using Health Belief Model.

机构信息

Department of Ophthalmology BP Eye Foundation Hospital for Children Eye ENT Rehabilitation Services (CHEERS), Lokanthali, Bhaktapur, Nepal.

Department of Academics and Research BP Eye Foundation Hospital for Children Eye ENT Rehabilitation Services (CHEERS), Lokanthali, Bhaktapur, Nepal.

出版信息

Biomed Res Int. 2024 Jul 30;2024:3231341. doi: 10.1155/2024/3231341. eCollection 2024.

Abstract

To find the adherence rate to periodic dilated eye examinations (DEEs) and its determinants among patients with diagnosed diabetes. In this cross-sectional study of 165 participants with diagnosed diabetes (Type 1/2) attending a general hospital with a diabetes clinic, we explored perceptions of barriers and facilitators of DEE at the individual level using a framework adapted from the health belief model (HBM). Patients were compared using t tests for continuous data and chi-square tests for categorical data. The rate of adherence to DEE (as defined by DEE ) was 62.4% (95% confidence interval [CI] = 55.0%-69.8%). The mean age of the patients was 56.81 (±13.29) years. We found that the mean benefit score was significantly higher, and the mean barrier score was significantly lower in those adhering to DEE ( < 0.001); but the susceptibility, severity, and self-efficacy scores were not significantly different. Furthermore, those under treatment for diabetes mellitus (DM), those with diabetic retinopathy (DR) in them or their family member, and those with DM duration of 1 year or less were significantly likely to adhere to DEE ( < 0.005). Additionally, those who had received advice for eye screening from their physicians were about 25 times more likely to adhere to DEE (95% CI =6.80-92.05) than those who were not advised. A larger proportion of people with diabetes did not adhere to periodic DEE. Benefits and barriers were found to be determinants in this population. Further exploration in a larger population and the use of HBM to increase adherence to periodic DEE can be tested by targeting behavioral counseling along with other traditional approaches.

摘要

为了找到患有确诊糖尿病患者定期进行眼部扩张检查(DEE)的依从率及其决定因素。 在这项针对 165 名患有糖尿病(1/2 型)的参与者的横断面研究中,这些参与者在一家有糖尿病诊所的综合医院就诊,我们使用健康信念模型(HBM)改编的框架来探索个体层面上 DEE 的障碍和促进因素的看法。使用 t 检验对连续数据和卡方检验对分类数据进行患者比较。 DEE 的依从率(根据 DEE 定义)为 62.4%(95%置信区间[CI] = 55.0%-69.8%)。患者的平均年龄为 56.81(±13.29)岁。我们发现,在坚持 DEE 的患者中,平均收益评分明显更高,平均障碍评分明显更低(<0.001);但易感性,严重程度和自我效能评分无显着差异。此外,正在接受糖尿病治疗(DM)的患者,其糖尿病视网膜病变(DR)患者或其家庭成员,以及 DM 持续时间为 1 年或更短的患者,明显更有可能坚持 DEE(<0.005)。此外,那些从医生那里获得过眼部检查建议的人比没有得到建议的人更有可能坚持 DEE(95%CI=6.80-92.05),约为 25 倍。患有糖尿病的人群中,有较大比例的人没有定期进行 DEE。本研究发现利益和障碍是该人群的决定因素。通过针对行为咨询以及其他传统方法,可以在更大的人群中进一步探索并使用 HBM 来提高定期 DEE 的依从性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8734/11303040/2c8399da5069/BMRI2024-3231341.001.jpg

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