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新诊断2型糖尿病患者服药的障碍与促进因素:一项基于跨理论模型的定性研究

Barriers and Facilitators to Taking Medication in Newly Diagnosed Patients With Type 2 Diabetes: A Qualitative Study Based on the Transtheoretical Model.

作者信息

Zhang Baolu, Powwattana Arpaporn, Sillabutra Jutatip, Liu Gang, Li Siyu, Kalampakorn Surintorn

机构信息

School of Nursing, Southwest Medical University, Luzhou, China.

Department of Nursing, The Affiliated Hospital, Southwest Medical University, Luzhou, China.

出版信息

Sci Diabetes Self Manag Care. 2025 Apr;51(2):180-193. doi: 10.1177/26350106251319541. Epub 2025 Mar 13.

Abstract

PurposeThe purpose of this study was to explore the barriers and facilitators to taking medication in newly diagnosed patients with type 2 diabetes (T2DM) at each stage of change from the perspective of the Transtheoretical model.MethodsThis qualitative descriptive study used purposive sampling to select 32 newly diagnosed patients with T2DM, with 8 representing each of the 4 stages of change (precontemplation, contemplation, preparation, and action). Participants were recruited at a community health service center in Sichuan Province, China. Semistructured interviews were conducted, and data were transcribed and analyzed using qualitative content analysis.ResultsThis study identified barriers and facilitators related to the patient, medication, health care service, and sociocultural dimensions. At the precontemplation and contemplation stages, various barriers across different domains predominated (e.g., incomplete comprehension of the disease; gaps in medication knowledge regarding importance, benefits, and indications; limited access to care; preferred traditional and alternative medication approaches). At the preparation and action stages, although patient, medication, health care service, and sociocultural facilitators were more reported (e.g., awareness of medication benefits, health system financial support, peer medication experiences), medication-related barriers persisted (e.g., medication knowledge gaps regarding side effects, adverse reactions, administration procedures, and missed dose management).ConclusionsThe primary barriers to taking medication in newly diagnosed patients with T2DM are medication-related factors, with barriers and facilitators dynamically evolving across the stages of change. Future research should focus on developing and evaluating stage-matched interventions to promote medication-taking behavior and patient well-being.

摘要

目的

本研究的目的是从跨理论模型的角度,探讨新诊断的2型糖尿病(T2DM)患者在每个改变阶段服药的障碍和促进因素。

方法

本定性描述性研究采用目的抽样法,选取32例新诊断的T2DM患者,每个改变阶段(未打算、打算、准备和行动)各8例。研究对象在中国四川省的一个社区卫生服务中心招募。进行半结构化访谈,并使用定性内容分析法对数据进行转录和分析。

结果

本研究确定了与患者、药物、医疗服务和社会文化层面相关的障碍和促进因素。在未打算和打算阶段,不同领域的各种障碍占主导(例如,对疾病的理解不完整;在药物重要性、益处和适应症方面的知识差距;获得护理的机会有限;倾向于传统和替代药物治疗方法)。在准备和行动阶段,虽然更多地报告了患者、药物、医疗服务和社会文化促进因素(例如,对药物益处的认识、卫生系统的财政支持、同伴的用药经验),但与药物相关的障碍仍然存在(例如,在副作用、不良反应、给药程序和漏服管理方面的药物知识差距)。

结论

新诊断的T2DM患者服药的主要障碍是与药物相关的因素,障碍和促进因素在改变阶段中动态演变。未来的研究应侧重于开发和评估与阶段匹配的干预措施,以促进服药行为和患者健康。

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