The Impact of Psychological Insulin Resistance and Dyadic Coping on Insulin Medication Adherence in Elderly Diabetes Patients and Their Spouses: A Latent Profile Analysis.

IF 2 3区 医学 Q2 MEDICINE, GENERAL & INTERNAL
Patient preference and adherence Pub Date : 2024-12-25 eCollection Date: 2024-01-01 DOI:10.2147/PPA.S489408
Yuanhong Wu, Huijing Xu, Yuxin Wang, Xiaohui Wang, Shanyu Wu
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Abstract

Aim: To investigate the characteristics of psychological insulin resistance and dyadic coping in elderly diabetic patients and their spouses, and their association with insulin medication adherence.

Design: Observational, cross-sectional study.

Methods: A convenience sampling method selected 300 elderly diabetic patient-spouse pairs from a community. Data were collected using general information questionnaires, the My Views on Insulin questionnaire, Dyadic Coping questionnaire, and ARMS refill and medication adherence questionnaire. Latent Profile Analysis (LPA) was used to categorize the "psychological-coping" patterns of psychological insulin resistance and dyadic coping among these pairs. Multiple linear regression analysis identified factors influencing insulin medication adherence.

Results: Four latent classes were identified: patients and spouses with low resistance-high coping (30.3%), patients with low resistance-moderate coping and spouses with high resistance-low coping (16.3%), patients with high resistance-moderate coping and spouses with moderate resistance-high coping (33.7%), patients and spouses with high resistance-low coping (19.7%). Multiple linear regression analysis showed that the number of chronic diseases a patient has, the use of oral hypoglycemic agents, family per capita monthly income, and latent classes of psychological insulin resistance and dyadic coping significantly affected insulin medication adherence (P<0.05).

Conclusion: It is crucial to consider the psychological insulin resistance and dyadic coping of both patients and their spouses, include both in health plans, and develop comprehensive intervention strategies that address the couple as a unit.

Implications for the profession and/or patient care: This study informs healthcare professionals by raising awareness of the different "psychological-coping" characteristics between elderly diabetic patients and their spouses, with insulin medication adherence and reducing the likelihood of readmission.

心理胰岛素抵抗和二元应对对老年糖尿病患者及其配偶胰岛素用药依从性的影响:一项潜在分析
目的:探讨老年糖尿病患者及其配偶心理胰岛素抵抗和二元应对的特点及其与胰岛素治疗依从性的关系。设计:观察性横断面研究。方法:采用方便抽样的方法,从某社区抽取300对老年糖尿病患者-配偶。采用一般信息问卷、胰岛素个人看法问卷、二元应对问卷和ARMS补充及药物依从性问卷收集数据。利用潜在剖面分析(LPA)对心理胰岛素抵抗的“心理-应对”模式和二元应对模式进行分类。多元线性回归分析确定影响胰岛素药物依从性的因素。结果:共鉴定出4个潜在类别:低阻力-高应对的患者及配偶(30.3%)、低阻力-中等应对的患者及配偶(16.3%)、高阻力-中等应对的患者及配偶(33.7%)、高阻力-低应对的患者及配偶(19.7%)。多元线性回归分析显示,患者慢性疾病数量、口服降糖药使用情况、家庭人均月收入、心理胰岛素抵抗潜在类别和二元应对对胰岛素依从性有显著影响(p)。考虑患者及其配偶的心理胰岛素抵抗和二元应对是至关重要的,包括在健康计划中,并制定全面的干预策略,以解决夫妻作为一个单位。对专业和/或患者护理的启示:本研究通过提高对老年糖尿病患者及其配偶之间不同“心理应对”特征的认识,以及胰岛素药物依从性和减少再入院的可能性,告知医疗保健专业人员。
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来源期刊
Patient preference and adherence
Patient preference and adherence MEDICINE, GENERAL & INTERNAL-
CiteScore
3.60
自引率
4.50%
发文量
354
审稿时长
6-12 weeks
期刊介绍: Patient Preference and Adherence is an international, peer reviewed, open access journal that focuses on the growing importance of patient preference and adherence throughout the therapeutic continuum. The journal is characterized by the rapid reporting of reviews, original research, modeling and clinical studies across all therapeutic areas. Patient satisfaction, acceptability, quality of life, compliance, persistence and their role in developing new therapeutic modalities and compounds to optimize clinical outcomes for existing disease states are major areas of interest for the journal. As of 1st April 2019, Patient Preference and Adherence will no longer consider meta-analyses for publication.
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