Seo Shinae, Kim Chun-Ja, Kang Hee Sun, Kim Dae Jung, Schlenk Elizabeth A
School of Nursing, University of Virginia, Charlottesville, Virginia.
College of Nursing and Research Institute of Nursing Science, Ajou University, Suwon, Korea.
Sci Diabetes Self Manag Care. 2025 Feb;51(1):100-109. doi: 10.1177/26350106241293120. Epub 2024 Nov 19.
The purpose was to identify trajectories of medication taking among patients with diabetes and investigate correlates of these trajectories using the information-motivation-behavioral skills (IMB) model.
This study employed a descriptive correlational, longitudinal design using convenience sampling. The participants were 96 adults with diabetes from an outpatient diabetes clinic at a university-affiliated hospital. Medication taking was assessed at 3 time points: baseline, 6 months, and 12 months. At baseline, study variables based on the IMB model were measured: medication knowledge (information), motivational readiness and social support (motivation), and medication self-efficacy (behavioral skills). Group-based trajectory modeling was used to identify medication-taking trajectories, and multinomial logistic regression was used to assess factors associated with medication-taking trajectories.
Three distinct medication-taking trajectory groups were identified: "high medication taking," "increasing medication taking," and "low medication taking." Higher medication knowledge was associated with the high and increasing medication-taking trajectory groups. Motivational readiness was associated with the high and increasing medication-taking groups. In contrast, higher medication self-efficacy was associated only with the high medication-taking group, not with the increasing and low medication-taking groups.
The findings suggest that knowledge, motivational readiness, and self-efficacy are essential in IMB model-based intervention strategies across dynamic medication-taking patterns to enhance medication taking. Health care providers can help patients with diabetes improve medication taking by understanding their medication-taking trajectories and their correlates. Strategies that enhance medication self-efficacy are essential for patients in the increasing and low medication-taking groups.
本研究旨在确定糖尿病患者的服药轨迹，并使用信息-动机-行为技能（IMB）模型调查这些轨迹的相关因素。
本研究采用描述性相关性纵向设计，采用便利抽样。研究对象为来自某大学附属医院门诊糖尿病诊所的96名成年糖尿病患者。在3个时间点评估服药情况：基线、6个月和12个月。在基线时，测量基于IMB模型的研究变量：用药知识（信息）、动机准备和社会支持（动机）以及用药自我效能感（行为技能）。基于组的轨迹模型用于确定服药轨迹，多项逻辑回归用于评估与服药轨迹相关的因素。
确定了三个不同的服药轨迹组：“高服药量”、“服药量增加”和“低服药量”。较高的用药知识与高服药量和服药量增加的轨迹组相关。动机准备与高服药量和服药量增加的组相关。相比之下，较高的用药自我效能感仅与高服药量组相关，与服药量增加和低服药量组无关。
研究结果表明，知识、动机准备和自我效能感在基于IMB模型的干预策略中对于跨越动态服药模式以提高服药依从性至关重要。医疗保健提供者可以通过了解糖尿病患者的服药轨迹及其相关因素来帮助他们改善服药情况。提高用药自我效能感的策略对于服药量增加和低服药量组的患者至关重要。
