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2型糖尿病患者治疗中断与恢复的触发因素:一项叙述性横断面定性研究。

Triggers of treatment interruption and resumption among individuals with type 2 diabetes: a narrative cross-sectional qualitative study.

作者信息

Hidaka Tomoo, Suzuki Rieko, Hashimoto Katsue, Inoue Mariko, Endo Shota, Kakamu Takeyasu, Gunji Mariko, Abe Koichi, Fukushima Tetsuhito

机构信息

Department of Hygiene and Preventive Medicine, Fukushima Medical University, Fukushima, Japan.

Health Promotion Division, Koriyama City Public Health Center, Fukushima, Japan.

出版信息

Int J Qual Stud Health Well-being. 2025 Dec;20(1):2496181. doi: 10.1080/17482631.2025.2496181. Epub 2025 Apr 29.

Abstract

PURPOSE

Treatment interruption and resumption are common among people with type 2 diabetes mellitus (T2D), but the triggers of resumption, according to the reasons for interruption, remain underexplored. This study examined patterns of treatment interruption and resumption.

METHODS

Narratives from 13 T2D patients with a history of treatment interruption were analysed through semi-structured interviews.

RESULTS

Four patterns were identified: 1) "Economic rationality", where financial barriers caused interruptions, but resumption was facilitated by low-cost check-ups and updated patient mindsets to manage medical expenses within the constraints of a limited household budget; 2) "Proactive information seeking", where doubts about treatment effectiveness led to interruptions, followed by resumption through active health risk reassessment by the patient's self-directed efforts; 3) "Health professional-patient relationship", where conflicts with healthcare providers prompted interruptions, but trustful encounters encouraged resumption; and 4) "Sustained partnerships with community health professionals", where personal challenges caused interruptions, but non-coercive partnerships with community health professionals fostered resumption through strengthened patient commitment.

CONCLUSION

This study highlights the need for tailored medical support and local policy development for T2D patients, emphasizing subjective interpretations of their experiences on treatment interruption and resumption. Recognizing these patterns can guide resource allocation and the design of community-based diabetes care interventions.

摘要

目的

治疗中断和恢复在2型糖尿病(T2D)患者中很常见,但根据中断原因,恢复治疗的触发因素仍未得到充分研究。本研究调查了治疗中断和恢复的模式。

方法

通过半结构化访谈分析了13名有治疗中断史的T2D患者的叙述。

结果

确定了四种模式:1)“经济合理性”,即经济障碍导致治疗中断,但低成本检查以及患者在家庭预算有限的情况下管理医疗费用的心态转变促进了治疗的恢复;2)“积极寻求信息”,即对治疗效果的怀疑导致治疗中断,随后通过患者自主进行的积极健康风险重新评估实现恢复;3)“医护人员与患者的关系”,即与医疗服务提供者的冲突导致治疗中断,但信任的接触会促使治疗恢复;4)“与社区卫生专业人员的持续合作关系”,即个人挑战导致治疗中断,但与社区卫生专业人员的非强制性合作关系通过增强患者的信念促进了治疗的恢复。

结论

本研究强调需要为T糖尿病患者提供量身定制的医疗支持和制定地方政策,强调患者对治疗中断和恢复经历的主观解读。认识到这些模式可以指导资源分配以及基于社区的糖尿病护理干预措施的设计。

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