Boyer B A, Lerman C, Shipley T E, McBrearty J, Quint A, Goren E
Diabetes Educ. 1996 Sep-Oct;22(5):493-9. doi: 10.1177/014572179602200509.
Glycolsylated hemoglobin (G Hb) levels and data on adherence and patient-provider discordance in beliefs about diabetes were collected from 42 insulin-requiring patients with diabetes. Discordance was calculated for both degree of discordance (absolute amount of disagreement) and direction of discordance (degree to which physician > patient or patient < physician). Patients generally agreed with physicians in perceptions of severity, costs of adherence, and immediate and long-term benefits of adherence. Significant differences were found between these dimensions. Only discordance on long-term benefits of adherence correlated with adherence, with greater discordance related to greater adherence. Discordance on the cost dimension correlated negatively with G Hb, suggesting better glycemic control with greater disagreement. Those who underestimate the cost of adherence show greater adherence. Adherence did not correlate significantly with glycemic control.
收集了42例需要胰岛素治疗的糖尿病患者的糖化血红蛋白（G Hb）水平，以及关于糖尿病信念的依从性和医患分歧的数据。计算了分歧程度（分歧的绝对量）和分歧方向（医生＞患者或患者＞医生的程度）。患者在疾病严重程度、依从成本以及依从的近期和长期益处的认知上通常与医生一致。在这些维度上发现了显著差异。只有在依从的长期益处方面的分歧与依从性相关，分歧越大，依从性越高。在成本维度上的分歧与G Hb呈负相关，表明分歧越大，血糖控制越好。那些低估依从成本的人表现出更高的依从性。依从性与血糖控制没有显著相关性。
