Barriers and Facilitators to Taking Medication in Newly Diagnosed Patients With Type 2 Diabetes: A Qualitative Study Based on the Transtheoretical Model.

Baolu Zhang, Arpaporn Powwattana, Jutatip Sillabutra, Gang Liu, Siyu Li, Surintorn Kalampakorn
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Abstract

PurposeThe purpose of this study was to explore the barriers and facilitators to taking medication in newly diagnosed patients with type 2 diabetes (T2DM) at each stage of change from the perspective of the Transtheoretical model.MethodsThis qualitative descriptive study used purposive sampling to select 32 newly diagnosed patients with T2DM, with 8 representing each of the 4 stages of change (precontemplation, contemplation, preparation, and action). Participants were recruited at a community health service center in Sichuan Province, China. Semistructured interviews were conducted, and data were transcribed and analyzed using qualitative content analysis.ResultsThis study identified barriers and facilitators related to the patient, medication, health care service, and sociocultural dimensions. At the precontemplation and contemplation stages, various barriers across different domains predominated (e.g., incomplete comprehension of the disease; gaps in medication knowledge regarding importance, benefits, and indications; limited access to care; preferred traditional and alternative medication approaches). At the preparation and action stages, although patient, medication, health care service, and sociocultural facilitators were more reported (e.g., awareness of medication benefits, health system financial support, peer medication experiences), medication-related barriers persisted (e.g., medication knowledge gaps regarding side effects, adverse reactions, administration procedures, and missed dose management).ConclusionsThe primary barriers to taking medication in newly diagnosed patients with T2DM are medication-related factors, with barriers and facilitators dynamically evolving across the stages of change. Future research should focus on developing and evaluating stage-matched interventions to promote medication-taking behavior and patient well-being.

新诊断2型糖尿病患者服药障碍与促进因素:基于跨理论模型的定性研究
目的本研究旨在从跨理论模型的角度探讨新诊断2型糖尿病(T2DM)患者在各个变化阶段的服药障碍和促进因素。方法采用有目的抽样的定性描述性研究方法,选择32例新诊断T2DM患者,其中8例分别代表4个变化阶段(预诊、预诊、准备和行动)。参与者是在中国四川省的一个社区卫生服务中心招募的。进行了半结构化访谈,并使用定性内容分析对数据进行转录和分析。结果本研究确定了与患者、药物、医疗服务和社会文化维度相关的障碍和促进因素。在预观和沉思阶段,跨越不同领域的各种障碍占主导地位(例如,对疾病的不完全理解;药物知识在重要性、益处和适应症方面存在差距;获得护理的机会有限;首选传统和替代药物治疗方法)。在准备和行动阶段,尽管患者、药物、卫生保健服务和社会文化促进因素得到了更多的报告(例如,对药物益处的认识、卫生系统的财政支持、同伴用药经验),但与药物相关的障碍仍然存在(例如,关于副作用、不良反应、给药程序和遗漏剂量管理的药物知识差距)。结论新诊断T2DM患者服药的主要障碍是药物相关因素,障碍和促进因素在不同的变化阶段是动态演变的。未来的研究应侧重于开发和评估阶段匹配的干预措施,以促进服药行为和患者福祉。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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