卢旺达Rwinkwavu地区医院2型糖尿病患者对推荐方案的依从性及其相关因素

Emmanuel Ufitamahoro, E. Rutayisire, Michael Habtu
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摘要

背景:2型糖尿病患者发生各种并发症和住院的主要危险因素是对所有推荐方案的依从性差。目的了解Rwinkwavu地区医院及其集水区2型糖尿病患者对推荐治疗方案的依从性及其相关因素。方法采用描述性横断面研究。采用系统随机抽样方法,选取307例2型糖尿病患者。通过问卷调查收集数据。描述性分析(频率和百分比)描述参与者的特征,卡方检验确定与推荐方案依从性相关的因素。然后使用多变量逻辑回归确定与推荐方案依从性独立相关的因素。结果85.7%、27.0%和38.8%的受访者对药物、饮食和运动的依从性较好。多变量分析显示未饮酒[aOR= 2.21;95%CI= 1.11-4.42],卫生保健服务可及性[aOR= 2.59;95%CI= 1.21-5.53],无药物副作用经历[aOR= 5.27;95%CI= 2.46-11.32]与高药物依从性相关。与高依从性推荐饮食相关的因素是:可获得医疗服务[aOR= 2.93;95%CI= 1.20-7.17],接受生活方式改变治疗[aOR= 3.56;95%CI= 1.02-12.46]和存在慢性合并症[aOR= 2.36;95% ci = 1.37 - -4.08)。此外,受教育程度越高[aOR= 2.64;95%CI= 1.05-6.67],卫生保健服务可及性[aOR= 2.83;95%CI= 1.31-6.09], 2型糖尿病确诊时间较短[aOR= 2.09;95%CI= 1.08-4.51]更有可能高度坚持推荐的运动。结论不同的个体和临床因素是2型糖尿病患者坚持推荐治疗方案的决定因素。因此,与健康促进有关的决策者将需要考虑如何改善获得压缩生活方式教育和保健服务的机会,以及提供副作用较小的药物。卢旺达医学与健康科学杂志2022;5(3):276-290
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Adherence to Recommended Regimen and Associated Factors among Type 2 Diabetes Mellitus Patients in Rwinkwavu District Hospital, Rwanda
Background The main risk factor for developing various complications and hospital admissions among type 2 diabetes is poor adherence to all recommended regimens. Objective To determine adherence to recommended regimen and associated factors among type 2 diabetes at Rwinkwavu District Hospital and its catchment area. Methods A descriptive cross-sectional study was employed. A total of 307 type 2 diabetes were selected using systematic random sampling. Data were collected using a questionnaire. Descriptive analysis (frequency and percentages) to describe the participants’ characteristics, and Chi-square test to establish associated factors with adherence to recommended regimen were performed. Then multivariable logistic regression was used to determine factors independently associated with adherence to recommended regimen. Results The result shows that 85.7%, 27.0% and 38.8% of the respondents had good adherence to medication, diet and exercise respectively. Multivariable analysis revealed that not taking alcohol [aOR= 2.21; 95%CI= 1.11-4.42], accessibility of healthcare services [aOR= 2.59; 95%CI= 1.21-5.53] and no experience of drug side effects [aOR= 5.27; 95%CI= 2.46-11.32] were associated with high medication adherence. Factors associated with high adherence level to recommended diet were accessibility to healthcare services [aOR= 2.93; 95%CI= 1.20-7.17], receiving lifestyle modification sessions [aOR= 3.56; 95%CI= 1.02-12.46] and presence of chronic comorbidities [aOR= 2.36; 95%CI= 1.37-4.08]. In addition, higher level of education [aOR= 2.64; 95%CI= 1.05-6.67], accessibility to healthcare services [aOR= 2.83; 95%CI= 1.31-6.09] and shorter time since diagnosis of type 2 diabetes [aOR= 2.09; 95%CI= 1.08-4.51] were more likely to have high adherence to recommended exercise. Conclusion Different individual and clinical factors were identified as determinants of adherence to recommended regimen among type 2 diabetes patients. Therefore, the policy makers concerned with health promotion will need to consider ways of improving access to compressive lifestyle education and healthcare services as well as availing drugs with less side effects. Rwanda J Med Health Sci 2022;5(3):276-290  
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