Garay-Sevilla M E, Malacara H J M, González-Parada F, Jordán-Ginés L
Instituto de Investigaciones Médicas, Universidad de Guanajuato, Leon, Mexico.
J Diabetes Complications. 1998 Sep-Oct;12(5):239-45. doi: 10.1016/s1056-8727(97)00075-5.
We investigated the role of belief in conventional medicine, the type of medical care, and familiar and socioeconomic factors on the adherence to treatment in non-insulin-dependent diabetes mellitus (NIDDM) patients. In a cross-sectional design, we selected 156 patients from two institutions, who agreed to fill out a questionnaire, which included general data, socioeconomic level, somatometric data, type of medical care, complications, if they had friends and relatives with diabetes, the family function, and a score on the belief in conventional medicine. Factors associated with adherence to diet and medication were analyzed. Patients had a mean age of 55.6 years and 8.9 years since diagnosis. A total of 51.3% of them were not covered by social security, and 62.8% received attention by a general physician. Patients under the care of a specialist had better adherence to diet and medication, and better belief in conventional medicine. The principal factor associated with adherence to medication and diet was the belief in conventional medicine (p < 0.001 in both). Adherence to diet was also associated with the socioeconomic level (p=0.001) and years since diagnosis (p=0.004). Adherence to medication was also associated with schooling (p=0.001). We concluded that belief in conventional medicine is strongly associated with adherence to treatment and other factors such as schooling, socioeconomic level, and medical care under a specialist; adherence to diet was better in patients with more years since diagnosis.
我们调查了对传统医学的信念、医疗护理类型、熟悉程度和社会经济因素对非胰岛素依赖型糖尿病（NIDDM）患者治疗依从性的作用。在一项横断面设计中，我们从两个机构选取了156名患者，他们同意填写一份问卷，问卷包括一般数据、社会经济水平、身体测量数据、医疗护理类型、并发症、是否有患糖尿病的朋友和亲属、家庭功能以及对传统医学的信念得分。分析了与饮食和药物治疗依从性相关的因素。患者的平均年龄为55.6岁，自诊断以来平均患病8.9年。其中共有51.3%的患者没有社会保障覆盖，62.8%的患者接受全科医生的诊治。由专科医生护理的患者对饮食和药物治疗的依从性更好，对传统医学的信念也更强。与药物和饮食治疗依从性相关的主要因素是对传统医学的信念（两者p均<0.001）。饮食治疗依从性还与社会经济水平（p=0.001）和诊断后的年限（p=0.004）有关。药物治疗依从性还与受教育程度有关（p=0.001）。我们得出结论，对传统医学的信念与治疗依从性密切相关，以及其他因素如受教育程度、社会经济水平和专科医生的医疗护理；诊断后年限越长的患者饮食治疗依从性越好。
