Wu Yuanhong, Xu Huijing, Wang Yuxin, Wang Xiaohui, Wu Shanyu
College of Nursing, Yanbian University, Yanji, People's Republic of China.
College of Nursing, Seoul National University, Seoul, South Korea.
Patient Prefer Adherence. 2024 Dec 25;18:2647-2655. doi: 10.2147/PPA.S489408. eCollection 2024.
To investigate the characteristics of psychological insulin resistance and dyadic coping in elderly diabetic patients and their spouses, and their association with insulin medication adherence.
Observational, cross-sectional study.
A convenience sampling method selected 300 elderly diabetic patient-spouse pairs from a community. Data were collected using general information questionnaires, the My Views on Insulin questionnaire, Dyadic Coping questionnaire, and ARMS refill and medication adherence questionnaire. Latent Profile Analysis (LPA) was used to categorize the "psychological-coping" patterns of psychological insulin resistance and dyadic coping among these pairs. Multiple linear regression analysis identified factors influencing insulin medication adherence.
Four latent classes were identified: patients and spouses with low resistance-high coping (30.3%), patients with low resistance-moderate coping and spouses with high resistance-low coping (16.3%), patients with high resistance-moderate coping and spouses with moderate resistance-high coping (33.7%), patients and spouses with high resistance-low coping (19.7%). Multiple linear regression analysis showed that the number of chronic diseases a patient has, the use of oral hypoglycemic agents, family per capita monthly income, and latent classes of psychological insulin resistance and dyadic coping significantly affected insulin medication adherence (<0.05).
It is crucial to consider the psychological insulin resistance and dyadic coping of both patients and their spouses, include both in health plans, and develop comprehensive intervention strategies that address the couple as a unit.
IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE: This study informs healthcare professionals by raising awareness of the different "psychological-coping" characteristics between elderly diabetic patients and their spouses, with insulin medication adherence and reducing the likelihood of readmission.
探讨老年糖尿病患者及其配偶的心理性胰岛素抵抗和二元应对的特点，以及它们与胰岛素治疗依从性的关联。
观察性横断面研究。
采用便利抽样法从一个社区选取300对老年糖尿病患者-配偶对。使用一般信息问卷、“我对胰岛素的看法”问卷、二元应对问卷以及ARMS再填充和药物治疗依从性问卷收集数据。潜在剖面分析（LPA）用于对这些配对中的心 理性胰岛素抵抗和二元应对的“心理-应对”模式进行分类。多元线性回归分析确定影响胰岛素治疗依从性的因素。
确定了四个潜在类别：低抵抗-高应对的患者及其配偶（30.3%）、低抵抗-中等应对的患者及高抵抗-低应对的配偶（16.3%）、高抵抗-中等应对的患者及中等抵抗-高应对的配偶（33.7%）、高抵抗-低应对的患者及其配偶（19.7%）。多元线性回归分析表明，患者患慢性病的数量、口服降糖药的使用、家庭人均月收入以及心理性胰岛素抵抗和二元应对的潜在类别显著影响胰岛素治疗依从性（<0.05）。
考虑患者及其配偶的心理性胰岛素抵抗和二元应对、将两者纳入健康计划并制定以夫妻为单位的综合干预策略至关重要。
对专业和/或患者护理的启示：本研究提高了医疗保健专业人员对老年糖尿病患者及其配偶之间不同“心理-应对”特征的认识，有助于改善胰岛素治疗依从性并降低再入院可能性，从而为他们提供了参考。
