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糖尿病前期患者自我管理的认知与体验:一项中国的定性研究

Perceptions and Experiences of Self-Management in Patients with Prediabetes: A Qualitative Study in China.

作者信息

Jiang Jinfeng, Feng Qiongyao, Yan Lihua, Guo Yingchao, Yang Qiu

机构信息

Endocrinology, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan, People's Republic of China.

Faculty of Nursing, North Sichuan Medical College, Nanchong, Sichuan, People's Republic of China.

出版信息

Patient Prefer Adherence. 2025 May 3;19:1283-1293. doi: 10.2147/PPA.S513389. eCollection 2025.

Abstract

PURPOSE

This study aimed to investigate self-management experiences among individuals with prediabetes and analyze their potential self-management needs, thereby informing strategies to enhance self-management efficacy and facilitate the development of evidence-based, personalized interventions.

PATIENTS AND METHODS

Twelve prediabetes patients from a physical examination center in Nanchong, China, were recruited using purposive sampling. An interpretive phenomenological research method was employed. Semi-structured, in-depth interviews were conducted to explore patients' self-management experiences. The interviews were audio-recorded, transcribed, and analyzed thematically to develop the results. In addition, web-based information support and peer support facilitated patient self-management.

RESULTS

Four overarching themes emerged: (1) cognitive limitations, (2) intrinsic motivation, (3) hurdles to overcome, (4) perceived social support. Revealed the debilitating effect of non-medical terminology expression on the potential harm of the disease, neglect of diagnosis and health education by healthcare providers exacerbated the lack of awareness of prediabetes among patients. The complex social environment (unhealthy food environment, heavy work pressure, etc.) confronts prediabetes with self-management dilemmas. It was also revealed that patients' behavioral change motivation was "threat-benefit" dual-driven and was strongly influenced by family ethics, with family culture significantly influencing health decision-making. In addition, web-based information support and peer support facilitate patient self-management.

CONCLUSION

This study investigated the perceptions and self-management experiences of individuals with prediabetes, proposing targeted intervention strategies. Key recommendations include: (1) Healthcare providers' perceptions and attitudes toward prediabetes significantly influence patient engagement, necessitating standardized diagnostic and treatment protocols that emphasize disease progression risks during initial diagnosis to enhance clinical awareness; (2) Implementation of motivational interviewing (MI) techniques could effectively strengthen patients' intrinsic motivation for behavioral modification; (3) Multidimensional support systems should be established through AI-powered medical question-answering systems, standardized nutritional labeling regulations, family-involved health education programs, and peer-led "health coach" initiatives. These strategies provide a framework for developing comprehensive prediabetes management interventions aimed at improving self-management ability.

摘要

目的

本研究旨在调查糖尿病前期患者的自我管理经历,并分析他们潜在的自我管理需求,从而为提高自我管理效能的策略提供信息,并促进基于证据的个性化干预措施的制定。

患者与方法

采用目的抽样法,从中国南充某体检中心招募了12名糖尿病前期患者。采用解释性现象学研究方法。进行半结构化的深入访谈,以探索患者的自我管理经历。访谈进行了录音、转录,并进行主题分析以得出结果。此外,基于网络的信息支持和同伴支持促进了患者的自我管理。

结果

出现了四个总体主题:(1)认知局限;(2)内在动机;(3)需克服的障碍;(4)感知到的社会支持。揭示了非医学术语表达对疾病潜在危害的削弱作用,医疗服务提供者对诊断和健康教育的忽视加剧了患者对糖尿病前期认识的不足。复杂的社会环境(不健康的食物环境、沉重的工作压力等)使糖尿病前期患者面临自我管理困境。还发现患者的行为改变动机是“威胁-益处”双重驱动的,并且受到家庭伦理的强烈影响,家庭文化对健康决策有显著影响。此外,基于网络的信息支持和同伴支持促进了患者的自我管理。

结论

本研究调查了糖尿病前期患者的认知和自我管理经历,提出了有针对性的干预策略。主要建议包括:(1)医疗服务提供者对糖尿病前期的认知和态度显著影响患者的参与度,需要标准化的诊断和治疗方案,在初次诊断时强调疾病进展风险以提高临床认识;(2)实施动机性访谈(MI)技术可以有效地增强患者行为改变的内在动机;(3)应通过人工智能驱动的医学问答系统、标准化的营养标签规定、家庭参与的健康教育项目以及同伴主导的“健康教练”倡议建立多维支持系统。这些策略为制定旨在提高自我管理能力的全面糖尿病前期管理干预措施提供了框架。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c51c/12057631/d503030f34e1/PPA-19-1283-g0001.jpg

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