• 中国精品科技期刊
  • 《中文核心期刊要目总览》收录期刊
  • RCCSE 中国核心期刊(5/114,A+)
  • Scopus收录期刊
  • 美国《化学文摘》(CA)收录期刊
  • WHO 西太平洋地区医学索引(WPRIM)收录期刊
  • 《中国科学引文数据库(CSCD)》核心库期刊 (C)
  • 中国科技核心期刊
  • 中国科技论文统计源期刊
  • 《日本科学技术振兴机构数据库(中国)》(JSTChina)收录期刊
  • 美国《乌利希期刊指南》(UIrichsweb)收录期刊
  • 中华预防医学会系列杂志优秀期刊(2019年)

留言板

尊敬的读者、作者、审稿人, 关于本刊的投稿、审稿、编辑和出版的任何问题, 您可以本页添加留言。我们将尽快给您答复。谢谢您的支持!

姓名
邮箱
手机号码
标题
留言内容
验证码

2型糖尿病患者的用药依从性与生存质量的关系及自我效能的调节作用

于业波 黄镇 吴一波 孙昕霙

于业波, 黄镇, 吴一波, 孙昕霙. 2型糖尿病患者的用药依从性与生存质量的关系及自我效能的调节作用[J]. 中华疾病控制杂志, 2024, 28(2): 228-232. doi: 10.16462/j.cnki.zhjbkz.2024.02.016
引用本文: 于业波, 黄镇, 吴一波, 孙昕霙. 2型糖尿病患者的用药依从性与生存质量的关系及自我效能的调节作用[J]. 中华疾病控制杂志, 2024, 28(2): 228-232. doi: 10.16462/j.cnki.zhjbkz.2024.02.016
YU Yebo, HUANG Zhen, WU Yibo, SUN Xinying. Self-efficacy as a moderator in relationship between medication adherence and quality of life among patients with type 2 diabetes[J]. CHINESE JOURNAL OF DISEASE CONTROL & PREVENTION, 2024, 28(2): 228-232. doi: 10.16462/j.cnki.zhjbkz.2024.02.016
Citation: YU Yebo, HUANG Zhen, WU Yibo, SUN Xinying. Self-efficacy as a moderator in relationship between medication adherence and quality of life among patients with type 2 diabetes[J]. CHINESE JOURNAL OF DISEASE CONTROL & PREVENTION, 2024, 28(2): 228-232. doi: 10.16462/j.cnki.zhjbkz.2024.02.016

2型糖尿病患者的用药依从性与生存质量的关系及自我效能的调节作用

doi: 10.16462/j.cnki.zhjbkz.2024.02.016
基金项目: 

北京市卫生与健康委首都卫生发展科研专项 2022-1G-4252

详细信息
    通讯作者:

    孙昕霙,E-mail: xysun@bjmu.edu.cn

  • 中图分类号: R193.3

Self-efficacy as a moderator in relationship between medication adherence and quality of life among patients with type 2 diabetes

Funds: 

Beijing Health Commission Capital Health Development Research Project 2022-1G-4252

More Information
  • 摘要:   目的  探究2型糖尿病患者用药依从性与生存质量的关联及自我效能在两者关系中的调节作用。  方法  选取符合条件的2型糖尿病患者728人,采用8条目Morisky用药依从性量表、糖尿病特异性生存质量量表和自编糖尿病自我效能量表收集数据。利用多元线性回归分析模型分析药物依从性与生活质量之间的关系,并进一步探讨自我效能的调节作用。  结果  用药依从性好的患者仅125人(占17.2%)。与基线相比,随访9个月后生存质量的社会维度得分显著上升(t=-3.668, P=0.001)。基线用药依从性与基线生存质量总分(β=-0.161, P < 0.001)和第9个月生存质量总分(β=-0.148, P=0.002)负向相关。较高的自我效能会增强用药依从性与第9个月治疗维度生存质量(β=0.150, P=0.010)和总生存质量(β=0.110, P=0.044)间的关系。  结论  2型糖尿病患者的用药依从性与未来短期生存质量有显著关联;提高自我效能能够增强用药依从性对生存质量的正向影响,尤其是疾病治疗维度的生存质量。
  • 表  1  基线不同人口学特征患者的用药依从性比较

    Table  1.   Baseline characteristics of respondents by medication adherence

    变量  Variable 人数
    Number of people
    用药依从性人数(构成比/%)
    Medication adherence [Number of people (proportion/%)]
    χ2
    value
    P
    value
    好  Good 中等  Moderate 差  Worse
    糖化血红蛋白/%  HemoglobinA1c/% 7.17±1.25 0.228 0.892
         < 6.5 214(29.4) 35(16.4) 88(41.1) 91(42.5)
        ≥6.5 514(70.6) 90(17.5) 214(41.6) 210(40.9)
    年龄组/岁  Age group/years 59.72±7.47 14.028 0.007
        ≤50 75(10.3) 12(16.0) 24(32.0) 39(52.0)
        >50~60 266(36.5) 42(15.8) 98(36.8) 126(47.4)
        >60 387(53.2) 71(18.4) 180(46.5) 136(35.1)
    性别  Gender 2.781 0.249
        男性  Male 346(47.5) 51(14.7) 149(43.1) 146(42.2)
        女性  Female 382(52.5) 74(19.4) 153(40.0) 155(40.6)
    受教育程度  Educational level 10.723 0.030
        小学  Primary school 82(11.3) 19(23.2) 38(46.3) 25(30.5)
        中学  Middle school 517(71.0) 93(18.0) 212(41.0) 212(41.0)
        大学及以上  University/college or above 129(17.7) 13(10.1) 52(40.3) 64(49.6)
    婚姻状态  Marital status 0.536 0.765
        已婚 Married 648(94.0) 119(17.4) 284(41.5) 281(41.1)
        其他  Other 44(6.0) 6(13.6) 18(40.9) 20(45.5)
    人均月收入/元  Personal monthly income/yuan 10.270 0.114
        <3 000 216(29.7) 49(22.7) 89(41.2) 78(36.1)
        3 000~<5 000 307(42.2) 49(16.0) 133(43.3) 125(40.7)
        5 000~<100 000 152(20.9) 19(12.5) 60(39.5) 73(48.0)
        ≥100 000 53(7.3) 8(15.1) 20(37.7) 25(47.2)
    病程/年  Course of disease/years 1.416 0.841
        ≤5 500(68.7) 86(17.2) 203(40.6) 211(42.2)
        6~10 189(26.0) 34(18.0) 80(42.3) 75(39.7)
        ≥11 39(5.4) 5(12.8) 19(48.7) 15(38.5)
    并发症  Complication 0.610 0.737
        否  No 135(18.5) 24(17.8) 52(38.5) 59(43.7)
        是  Yes 593(81.5) 101(17.0) 250(42.2) 242(40.8)
    体质指数/(kg·m-2)  Body mass index/(kg·m-2) 13.551 0.035
        偏瘦 Thin 2(0.3) 2(100.0) 0(0.0) 0(0.0)
        正常  Normal 152(20.9) 32(21.1) 61(40.1) 59(38.8)
        超重  Overweight 324(44.5) 47(14.5) 134(41.4) 143(44.1)
        肥胖  Obesity 250(34.3) 44(17.6) 107(42.8) 99(39.6)
    注:①以人数(占比/%)或x±s表示。
    Note: ① Number of people(proportion/%) or x±s.
    下载: 导出CSV

    表  2  DSQL分量表得分及基线与第9个月随访后的得分比较

    Table  2.   Scores and paired t-test of DSQL subscales from baseline to month 9

    变量  Variable 基线 Baseline (n=728) 第9个月  Month 9 (n=476) t
    value
    P
    value
    x s x s
    DSQL总分  DSQL total 45.22 13.42 45.75 15.85 -1.692 0.091
    DSQL生理维度  DSQL physical dimension 21.47 7.51 21.79 8.85 -1.713 0.087
    DSQL心理维度  DSQL psychological dimension 13.30 5.06 13.11 5.47 -0.034 0.979
    DSQL社会维度  DSQL social dimension 5.86 2.20 6.23 2.36 -3.668 0.001
    DSQL治疗维度  DSQL therapeutic dimension 4.59 2.02 4.63 2.22 -0.430 0.667
    注:DSQL,糖尿病特异性生存质量量表。
    ①采用配对t检验。
    Note:DSQL,diabetes specific quality of life scale.
    ①Paired sample t test.
    下载: 导出CSV

    表  3  多元线性回归分析用药依从性、自我效能与生存质量之间的关系

    Table  3.   Multiple linear regression analysis for the relationship between MA, SE and DSQL

    变量  Variable 模型1基线DSQL总分
    Model 1 baseline DSQL
    模型2第9个月DSQL总分
    Model 2 month 9 DSQL
    β
    value
    βadj值value
    (95% CI)
    P
    value
    β
    value
    βadj值value
    (95% CI)
    P
    value
    基线用药依从性MA (baseline) -1.357 -0.161(-2.024~-0.690) < 0.001 -1.449 -0.148(-2.357~-0.541) 0.002
    基线自我效能SE (baseline) -0.297 -0.057(-0.709~0.116) 0.158 0.143 0.023(-0.412~0.697) 0.613
    基线DSQL总分DSQL baseline 0.516 0.419(0.413~0.620) < 0.001
    注:DSQL,糖尿病特异性生存质量量表。
    1.所有模型均纳入包括糖化血红蛋白、年龄、性别、教育程度、婚姻状态、人均月收入、病程、并发症、吸烟饮酒和体质指数在内的混杂变量。
    Note:DSQL,diabetes specific quality of life scale.
    1.Confounding variables including hemoglobinA1c, age groups, gender, education, marital status, personal monthly income, course of diseases, complications and body mass index were included in all models.
    下载: 导出CSV

    表  4  多元线性回归分析自我效能对用药依从性与生存质量之间关系的调节作用

    Table  4.   Multiple linear regression analysis for the relationship between medication adherence*self-efficacy and DSQL

    变量  Variable β
    value
    βadj值value
    (95% CI)
    P
    value
    模型1第9个月DSQL总分 Model 1 month 9 DSQL total
        基线用药依从性MA (baseline) -1.418 -0.145(-2.324~-0.512) 0.002
        基线自我效能SE (baseline) 0.573 0.094(-0.120~1.265) 0.105
        基线用药依从性×基线自我效能MA (baseline)*SE (baseline) 1.095 0.110(0.032~2.159) 0.044
    模型2第9个月DSQL治疗维度  Model 2 month 9 DSQL cure
        基线用药依从性MA (baseline) -0.231 -0.169(-0.366~-0.097) 0.001
        基线自我效能SE (baseline) 0.100 0.117(-0.003~0.203) 0.058
        基线用药依从性×基线自我效能MA (baseline)*SE (baseline) 0.210 0.150(0.051~0.369) 0.010
    注:MA,用药依从性;SE,自我效能;DSQL,糖尿病特异性生存质量量表。所有模型均纳入包括糖化血红蛋白、年龄、性别、教育程度、婚姻状态、人均月收入、病程、并发症、吸烟饮酒、体质指数和相应维度的基线DSQL得分。
    Note,MA,medication adherence;SE,self-efficacy;DSQL,diabetes specific quality of life scale. Confounding variables including hemoglobinA1c, age groups, gender, education, marital status, personal monthly income, course of diseases, complications, body mass index and corresponding baseline DSQL scores were included in all models.
    下载: 导出CSV
  • [1] Wang ZJ, Wu Y, Wu JH, et al. Trends in prevalence and incidence of type 2 diabetes among adults in Beijing, China, from 2008 to 2017 [J]. Diabet Med, 2021, 38(9): e14487. DOI: 10.1111/dme.14487.
    [2] Tatulashvili S, Fagherazzi G, Dow C, et al. Socioeconomic inequalities and type 2 diabetes complications: a systematic review [J]. Diabetes Metab, 2020, 46(2): 89-99. DOI: 10.1016/j.diabet.2019.11.001.
    [3] Golicki D, Dudzińska M, Zwolak A, et al. Quality of life in patients with type 2 diabetes in Poland - comparison with the general population using the EQ-5D questionnaire [J]. Adv Clin Exp Med, 2015, 24(1): 139-146. DOI: 10.17219/acem/38137
    [4] Saffari M, Lin CY, Chen H, et al. The role of religious coping and social support on medication adherence and quality of life among the elderly with type 2 diabetes [J]. Qual Life Res, 2019, 28(8): 2183-2193. DOI: 10.1007/s11136-019-02183-z.
    [5] Saleh F, Mumu SJ, Ara F, et al. Non-adherence to self-care practices & medication and health related quality of life among patients with type 2 diabetes: a cross-sectional study [J]. BMC Public Health, 2014, 14: 431. DOI: 10.1186/1471-2458-14-431.
    [6] Botas P, Delgado E, Castaño G, et al. Comparison of the diagnostic criteria for diabetes mellitus, WHO-1985, ADA-1997 and WHO-1999 in the adult population of Asturias (Spain) [J]. Diabet Med, 2003, 20(11): 904-908. DOI: 10.1046/j.1464-5491.2003.01006.x.
    [7] 中华医学会糖尿病学分会. 中国2型糖尿病防治指南(2020年版) [J]. 中华内分泌代谢杂志, 2021, 37(4): 311-98. DOI: 10.3760/cma.j.cn311282-20210304-00142.

    Diabetics Branch of Chinese Medical Association. Guidelines for prevention and treatment of type 2 diabetes in China (2020 edition) [J]. Chinese Journal of Endocrinology and Metabolism, 2021, 37(4): 311-98. DOI: 10.3760/cma.j.cn311282-20210304-00142.
    [8] 翁艳君, 赵豫梅, 刘伟军, 等. 中文版8条目Morisky服药依从性量表在2型糖尿病患者中的信效度评价及应用研究[J]. 中华临床医师杂志(电子版), 2018, 12(8): 445-450. DOI: 10.3877/cma.j.issn.1674-0785.2018.08.004.

    Weng YJ, Zhao YM, Liu WJ, et al. Reliability and validity of Chinese version of 8-item Morisky medication adherence scale in patients with type 2 diabetes [J]. Chinese Journal of Clinicians(electronic edition), 2018, 12(8): 445-450. DOI: 10.3877/cma.j.issn.1674-0785.2018.08.004.
    [9] 李冬美, 马爱霞, 李洪超. 我国糖尿病特异性生存质量量表研究系统评价[J]. 中国药物经济学, 2012, 7(1): 45-52. DOI: 10.3969/j.issn.1673-5846.2012.01.011.

    Li DM, Ma AX, Li HC. A systematic review of the research on diabetes-specific quality of life scale in China [J]. China J Pharm Econ, 2012, 7(1): 45-52. DOI: 10.3969/j.issn.1673-5846.2012.01.011.
    [10] 温忠麟, 侯杰泰, 张雷. 调节效应与中介效应的比较和应用[J]. 心理学报, 2005, 37(2): 268-274. DOI: 10.3969/j.issn.1671-3710.2003.05.020.

    Wen ZL, Hou JT, Zhang L. A comparison of moderator and mediator and their applications [J]. Acta Psychol Sin, 2005, 37(2): 268-274. DOI: 10.3969/j.issn.1671-3710.2003.05.020.
    [11] 赵丽红, 张加生, 周卫国, 等. 苏州枫桥社区2型糖尿病患者生存质量影响因素分析[J]. 社区医学杂志, 2021, 19(1): 17-20. DOI: 10.19790/j.cnki.JCM.2021.01.05.

    Zhao LH, Zhang JS, Zhou WG, et al. Analysis of influencing factors on quality of life of type 2 diabetes patients in Fengqiao Community of Suzhou [J]. Journal of Community Medicine, 2021, 19(1): 17-20. DOI: 10.19790/j.cnki.JCM.2021.01.05.
    [12] 李洪超, 官海静, 刘国恩. 我国社区2型糖尿病患者用药依从性影响因素研究[J]. 中国药房, 2019, 30(24): 3448-3451.10.6039/j. issn. 1001-0408.2019.24.25. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGYA201924029.htm

    Li HC, Guan HJ, Liu GE. Study on influential factors of medication compliance among community patients with type 2 diabetes mellitus in China [J]. China Pharm, 2019, 30(24): 3448-3451.10.6039/j. issn. 1001-0408.2019.24.25. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGYA201924029.htm
    [13] Huang YM, Shiyanbola OO, Smith PD. Association of health literacy and medication self-efficacy with medication adherence and diabetes control [J]. Patient prefer Adherence, 2018, 12: 793-802. DOI: 10.2147/ppa.S153312.
    [14] 王冯彬, 高敏, 陈雪莹, 等. 社区2型糖尿病患者家庭支持与饮食行为的相关性研究[J]. 中国健康教育, 2020, 36(4): 300-304. DOI: 10.16168/j.cnki.issn.1002-9982.2020.04.003.

    Wang FB, Gao M, Chen XY, et al. Study on the correlation between family support and dietary behavior in patients with type 2 diabetes mellitus in community [J]. Chinese Journal of Health Education, 2020, 36(4): 300-304. DOI: 10.16168/j.cnki.issn.1002-9982.2020.04.003.
    [15] Jiang XJ, Jiang H, Li MZ, et al. The mediating role of self-efficacy in shaping self-management behaviors among adults with type 2 diabetes [J]. Worldviews on Evid Based Nurs, 2019, 16(2): 151-160. DOI: 10.1111/wvn.12354.
  • 加载中
表(4)
计量
  • 文章访问数:  28
  • HTML全文浏览量:  6
  • PDF下载量:  2
  • 被引次数: 0
出版历程
  • 收稿日期:  2023-02-24
  • 修回日期:  2023-06-13
  • 网络出版日期:  2024-03-30
  • 刊出日期:  2024-02-10

目录

    /

    返回文章
    返回