Endale Agizew, Hundessa Fitsum, Tamru Eyasu, Nigussie Fetene, Hailu Minyahl
Department of Nursing, Debre Berhan Health Science College, Debre Berhan, Ethiopia.
Department of Midwifery, School of Nursing and Midwifery, Debre Berhan University, Debre Berhan, Ethiopia.
Front Clin Diabetes Healthc. 2025 May 9;6:1560907. doi: 10.3389/fcdhc.2025.1560907. eCollection 2025.
Adherence to diabetes self-care management is a lifestyle modification for people with diabetes.
To assess adherence to diabetic self-care management and associated factors among type 2 diabetic patients in North Shewa Zone public hospitals, Ethiopia, 2023.
The study employed a concurrent mixed-methods approach among 600 type 2 diabetic patients in North Shewa Zone public hospitals in Amhara, Ethiopia. The study was conducted from May 5 to May 20, 2023. The quantitative data were collected by using a semi-structured interview-administered questionnaire and chart review. Logistic regression was employed, and a p-value < 0.05 was considered statistically significant. Qualitative data were collected by in-depth interviews, and audio recordings were first transcribed verbatim and then translated to the English language by the first author and analyzed manually using a thematic approach.
Out of the total 600 type 2 diabetic patients, 262 (43.7%) with 95% CI: 40-47.8% of the study participants had good adherence to diabetes self-care practices. The multivariable analysis indicated that type 2 diabetic patients who lived in urban areas [AOR: 5.4, 95% CI: (1.05-8.7)] were 5.4 times more likely to have good diabetic self-care practice than those rural residents. Those who had a high school level of education [AOR: 2.9, 95% CI: (1.3-6.6)] were 2.9 times more likely to have good self-care practice, and those with college and above [AOR: 5, 95% CI (2-12):] were five times more likely to have good self-care practice. Regarding occupation, unemployed people were 66% less likely to have good self-care practices than employed people. Those who had no availability of healthcare services [AOR: 0.19, 95% CI: (0.09-0.37)] were less likely by 81% to have good self-care practice than those who had availability of healthcare services. These are significantly associated with diabetic self-care practice. The qualitative component clarified six themes: lack of education and awareness, financial affordability, accessibility, lack of family support, and having diabetic-related complications were identified as barriers.
This study indicated that adherence of patients with type 2 diabetes to the recommended self-care practices was considerably poor. Different factors included the respondents who had a high school level or higher level of education and those who lived in urban areas. This was supported by the results from the qualitative part and thus the endorsement to strengthen diabetes health education to patients and their families. So, diabetic patients require an integrated approach through treatment as well as health education, which will increase the health and well-being of the patient.
坚持糖尿病自我护理管理是糖尿病患者的一种生活方式改变。
评估2023年埃塞俄比亚北谢瓦地区公立医院2型糖尿病患者对糖尿病自我护理管理的依从性及相关因素。
该研究在埃塞俄比亚阿姆哈拉州北谢瓦地区公立医院的600名2型糖尿病患者中采用了同步混合方法。研究于2023年5月5日至5月20日进行。定量数据通过半结构化访谈问卷和病历审查收集。采用逻辑回归分析，p值<0.05被认为具有统计学意义。定性数据通过深入访谈收集，录音首先逐字转录，然后由第一作者翻译成英语，并采用主题方法进行人工分析。
在总共600名2型糖尿病患者中，262名（43.7%），95%置信区间为40 - 47.8%的研究参与者对糖尿病自我护理实践有良好的依从性。多变量分析表明，居住在城市地区的2型糖尿病患者[AOR：5.4，95%置信区间：（1.05 - 8.7）]进行良好糖尿病自我护理实践的可能性是农村居民的5.4倍。高中教育水平的患者[AOR：2.9，95%置信区间：（1.3 - 6.6）]进行良好自我护理实践的可能性是其他人的2.9倍，大学及以上学历的患者[AOR：5，95%置信区间（2 - 12）：]进行良好自我护理实践的可能性是其他人的5倍。在职业方面，失业者进行良好自我护理实践的可能性比就业者低66%。无法获得医疗服务的患者[AOR：0.19，95%置信区间：（0.09 - 0.37）]进行良好自我护理实践的可能性比能够获得医疗服务的患者低81%。这些因素与糖尿病自我护理实践显著相关。定性部分明确了六个主题：缺乏教育和意识、经济承受能力、可及性、缺乏家庭支持以及患有糖尿病相关并发症被确定为障碍。
本研究表明，2型糖尿病患者对推荐的自我护理实践的依从性相当差。不同因素包括高中及以上教育水平的受访者以及居住在城市地区的受访者。定性部分的结果支持了这一点，因此认可加强对患者及其家属的糖尿病健康教育。所以，糖尿病患者需要通过治疗以及健康教育的综合方法，这将提高患者的健康水平和幸福感。
