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

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

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感的调节作用。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。

Objective To explore the association between medication adherence and quality of life among patients with type 2 diabetes and the moderating role of self-efficacy on the relationship above.Methods A total of 728 eligible patients with type 2 diabetes were included and data were collected based on the 8-item Morisky medication adherence scale(MMAS-8),diabetes specific quality of life scale(DSQL),and the self-administered diabetes self-efficacy scale.Multiple linear regression models were established to analyze the associations between medication adherence and quality of life and further explored the moderating effect of self-efficacy.Results Among them,125 patients(17.2%)had good medication adherence.Compared with baseline,scores of DSQL social dimension increased significantly after 9 months of follow-up(t=-3.668,P=0.001).Medication adherence was negatively associated with baseline total DSQL score(β=-0.161,P<0.001)and month 9 total DSQL score(β=-0.148,P=0.002).Higher self-efficacy enhanced the relationship between medication adherence and DSQL cure dimension(β=0.150,P=0.010)and overall DSQL(β=0.110,P=0.044)at month 9.Conclusions Medication adherence is significantly associated with short-term future quality of life of patients with type 2 diabetes.Improving self-efficacy enhances the positive effect of medication adherence on quality of life,especially on the cure dimension of life quality.