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老年 2 型糖尿病患者的自我护理行为、药物依从性状况及其相关因素。

Self-care behaviors, medication adherence status, and associated factors among elderly individuals with type 2 diabetes.

机构信息

Metabolic Diseases Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran.

Social Determinants of Health Research Center, Research Institute for Prevention of Non Communicable Diseases, Qazvin University of Medical Science, Qazvin, Iran.

出版信息

Sci Rep. 2024 Aug 18;14(1):19118. doi: 10.1038/s41598-024-70000-w.

Abstract

Elderly individuals face an increased likelihood of developing chronic diseases such as diabetes. Self-care practices and medication adherence play crucial roles in preventing complications and adverse effects of this condition. Therefore, this study aimed to determine self-care behaviors, medication adherence status, and related factors among elderly patients with type 2 diabetes. This descriptive-analytical study was conducted on 374 elderly patients with type 2 diabetes who visited educational healthcare centers in Qazvin, Iran, during 2023 (March-September). Sampling was performed using the convenience method. Data collection instruments included a demographic characteristics checklist, the summary of diabetes self-care activities questionnaire, and the Morisky medication adherence scale. Data analysis was conducted using SPSS-22 software, employing the Kolmogorov-Smirnov test, mean, standard deviation, univariate and multivariate regression analyses. The significance level was set at p ≤ 0.05. The mean age of participants was 67.56 ± 5.93 years. In the self-care questionnaire, the highest score pertained to adherence to the diet recommended by the treating physician (3.16 ± 1.87). In contrast, the lowest scores were related to the frequency of checking inside shoes (0.17 ± 0.93) and foot examination (0.31 ± 1.07), respectively. Furthermore, results in self-care behaviors indicated that with increasing education levels, self-monitoring of blood glucose (SMBG) significantly decreased (P = 0.048). This variable was considerably higher in rural residents than in urban dwellers (P = 0.016). Additionally, the frequency of blood glucose measurements was significantly higher in urban residents than in rural inhabitants (p = 0.006). Based on the results, the mean score for medication adherence among patients was 5.53 ± 1.65. Based on our findings, the level of self-care in physical activity, SMBG, and foot care among the elderly is below average. Furthermore, medication adherence in these patients is poor. We expect that managers and policymakers take steps to reduce complications and improve these two variables by developing educational programs on self-care and emphasizing the importance of treatment adherence for these patients.

摘要

老年人更容易患上糖尿病等慢性疾病。自我护理行为和药物依从性在预防这种疾病的并发症和不良反应方面起着至关重要的作用。因此,本研究旨在确定老年 2 型糖尿病患者的自我护理行为、药物依从性状况及其相关因素。本描述性分析研究于 2023 年(3 月至 9 月)在伊朗卡兹温的教育保健中心对 374 名老年 2 型糖尿病患者进行。采用便利抽样法进行抽样。数据收集工具包括人口统计学特征检查表、糖尿病自我护理活动问卷摘要和 Morisky 药物依从性量表。使用 SPSS-22 软件进行数据分析,采用 Kolmogorov-Smirnov 检验、均值、标准差、单变量和多变量回归分析。显著性水平设置为 p≤0.05。参与者的平均年龄为 67.56±5.93 岁。在自我护理问卷中,得分最高的是遵守治疗医生推荐的饮食(3.16±1.87)。相比之下,得分最低的是检查鞋内的频率(0.17±0.93)和足部检查(0.31±1.07)。此外,自我护理行为的结果表明,随着教育水平的提高,血糖自我监测(SMBG)显著下降(P=0.048)。农村居民的这一变量明显高于城市居民(P=0.016)。此外,城市居民的血糖测量频率明显高于农村居民(p=0.006)。根据结果,患者的药物依从性平均得分为 5.53±1.65。根据我们的发现,老年人在体育活动、SMBG 和足部护理方面的自我护理水平低于平均水平。此外,这些患者的药物依从性较差。我们希望管理者和政策制定者采取措施,通过开展自我护理教育计划并强调治疗依从性对这些患者的重要性,来减少并发症并改善这两个变量。

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