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性别对2型糖尿病患者自我管理体验的影响:一项定性研究

Impact of Gender on Patient Experiences of Self-Management in Type 2 Diabetes: A Qualitative Study.

作者信息

Ramírez-Morros Anna, Berenguera Anna, Millaruelo Laura, Buil-Cosiales Pilar, Gomez Garcia Carmen, Cos Xavier, Ávila Lachica Luis, Artola Sara, Millaruelo Jose Manuel, Mauricio Didac, Franch-Nadal Josep

机构信息

DAP-Cat Group, Unitat de Suport a la Recerca de la Catalunya Central, Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Sant Fruitós de Bages, Spain.

Gerència Territorial de la Catalunya Central, Institut Català de la Salut, Sant Fruitós de Bages, Spain.

出版信息

Patient Prefer Adherence. 2024 Sep 13;18:1885-1896. doi: 10.2147/PPA.S466931. eCollection 2024.

Abstract

PURPOSE

This study aims to identify gender disparities in knowledge, attitudes and behaviors related to self-management and control of Type 2 diabetes Mellitus (T2DM) among primary care patients. The research was conducted across multiple Spanish cities.

PATIENTS AND METHODS

The study involved 8 Primary Care Centres located in four distinct regions of Spain: East (Barcelona), Centre (Madrid), North (Pamplona and Zumaia) and South (Vélez-Málaga and Málaga). A total of 111 individuals diagnosed with T2DM, comprising 52 women and 59 men, participated in 12 group discussions at these primary healthcare centers from February to June 2015. Participation was voluntary, and all participants provided informed consent by signing the consent form. A qualitative hermeneutic phenomenological study with a maximum variation sample was done. Participant profiles were defined based on gender, age, place of residence, type of treatment, years living with T2DM and the presence or absence of a cardiovascular event. Thematic analysis was used to analyze the data.

RESULTS

Participants were aware that diabetes is a chronic condition, with varied levels of concern regarding the diagnosis. Participants' locus of control influenced their perception of the disease's cause, with women attributing it to stress and emotional situations, while men linked it to risky behaviors. Self-management strategies were shaped by beliefs about diabetes, with both genders facing challenges in implementing recommended practices. Gender differences were also evident in caregiving roles, with men receiving more family support for diet adherence, while women prioritized family needs over their self-care. Participants expressed satisfaction with professional-patient interactions but highlighted the need for more accessible information and specialist care, suggesting support groups for women and clear health guidelines for men.

CONCLUSION

Gender differences significantly influence how patients perceive and manage type 2 diabetes, with women experiencing greater concern and care burden compared to men. Effective diabetes management requires tailored support that addresses these gender-specific challenges. Enhancing healthcare services with clear guidelines and support groups can improve self-management outcomes in both men and women.

摘要

目的

本研究旨在确定初级保健患者中与2型糖尿病(T2DM)自我管理和控制相关的知识、态度和行为方面的性别差异。该研究在西班牙多个城市开展。

患者与方法

该研究涉及位于西班牙四个不同地区的8个初级保健中心:东部(巴塞罗那)、中部(马德里)、北部(潘普洛纳和苏迈亚)和南部(韦莱斯-马拉加和马拉加)。2015年2月至6月,共有111名被诊断为T2DM的患者参与了这些初级保健中心的12次小组讨论,其中包括52名女性和5名男性。参与是自愿的,所有参与者都通过签署同意书提供了知情同意。进行了一项采用最大差异样本的定性诠释现象学研究。根据性别、年龄、居住地点、治疗类型、患T2DM的年限以及是否发生心血管事件来确定参与者的概况。采用主题分析法对数据进行分析。

结果

参与者意识到糖尿病是一种慢性病,对诊断的关注程度各不相同。参与者的控制点影响了他们对疾病病因的认知,女性将其归因于压力和情绪状况,而男性则将其与危险行为联系起来。自我管理策略受对糖尿病的信念影响,男女在实施推荐做法时都面临挑战。在照护角色方面也存在明显的性别差异,男性在饮食依从性方面得到更多家庭支持,而女性将家庭需求置于自我护理之上。参与者对医患互动表示满意,但强调需要更易获取的信息和专科护理,建议为女性设立支持小组,为男性制定明确的健康指南。

结论

性别差异显著影响患者对2型糖尿病的认知和管理方式,与男性相比,女性的担忧和护理负担更大。有效的糖尿病管理需要针对这些特定性别的挑战提供量身定制的支持。通过明确的指南和支持小组加强医疗服务,可以改善男性和女性的自我管理效果。

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