中青年2型糖尿病患者饮食行为依从性变化轨迹及影响因素分析

doi:10.3761/j.issn.0254-1769.2024.13.009

摘要/Abstract

摘要：

目的探讨中青年2型糖尿病患者饮食行为依从性变化轨迹的潜在类别及影响因素。方法采用便利抽样法，调查2022年9月—2023年3月在淮安市某三级甲等综合医院内分泌科住院的277例中青年2型糖尿病患者，采用一般资料调查表、2型糖尿病患者饮食行为依从性量表、糖尿病控制自我效能量表、糖尿病知识问卷、健康信念问卷、家庭关怀度指数问卷收集患者的基线资料，在患者出院前1 d（T0）、出院后1周（T1）、出院后1个月（T2）、出院后3个月（T3）评估患者的饮食行为依从性水平，采用潜变量增长混合模型识别轨迹类别，采用单因素及多元Logistic回归分析中青年2型糖尿病患者的饮食依从性轨迹的影响因素。结果共识别出3个中青年2型糖尿病患者饮食行为依从性变化轨迹类别，分别是低依从-波动起伏组（49.8%）、高依从-缓慢回落组（31.4%）、中依从-持续上升组（18.8%）；年龄、文化程度、自我效能、健康信念、家庭关怀度是中青年2型糖尿病患者饮食行为依从性潜在类别的影响因素。结论中青年2型糖尿病患者饮食行为依从性轨迹存在异质性，医护人员可根据轨迹类别的影响因素，制订针对性的干预措施，以提升其依从性水平。

关键词: 中青年, 2型糖尿病, 饮食行为, 依从性, 影响因素分析, 潜在类别, 护理

Abstract:

Objective To explore the potential categories and influencing factors of dietary behavioral adherence trajectories in young and middle-aged patients with type 2 diabetes mellitus. Methods A convenience sampling method was used to investigate 277 young and middle-aged patients with type 2 diabetes mellitus admitted to the Department of Endocrinology of a tertiary A hospital in Huai’an City，China，from September 2022 to March 2023. The baseline data were collected using a general information questionnaire，the Dietary Behavioral Compliance Scale for Patients with Type 2 Diabetes Mellitus，the Diabetes Self-Efficacy Scale，the Diabetes Knowledge Text，the Health Beliefs Questionnaire，and the Family APGAR Index Questionnaire. The baseline information was collected on the patients’ behavioral adherence trajectories a day prior to hospital discharge（T0），a week post-discharge（T1），a month post-discharge（T2），and 3 months post-discharge（T3） to assess the level of patients’ dietary behavioral adherence，using latent variable growth mixed models to identify trajectory categories，and univariate and multivariate logistic regression to analyze the influences on dietary adherence trajectories. Results A total of 3 trajectories of dietary behavior adherence in young and middle-aged patients with type 2 diabetes mellitus were identified，namely，low adherence-fluctuating group（49.8%），high adherence-slowly regressing group（31.4%），and medium adherence-continuously rising group（18.8%），and the results showed that age，literacy level，self-efficacy，health beliefs，and family caring were the factors influencing potential categories of dietary behavioral adherence for young and middle-aged patients with type 2 diabetes mellitus. Conclusion There is heterogeneity in the adherence trajectories of young and middle-aged patients with type 2 diabetes mellitus，and healthcare professionals can develop targeted interventions according to the influencing factors of the trajectory categories in order to improve their adherence.

Key words: Young and Middle-Aged, Type 2 Diabetes, Eating Behaviors, Adherence, Root Cause Analysis, Potential Category, Nursing Care

蔡佩萱, 梁怡青, 王晶晶, 赵松青, 张怡, 曹松梅. 中青年2型糖尿病患者饮食行为依从性变化轨迹及影响因素分析[J]. 中华护理杂志, 2024, 59(13): 1592-1599.

CAI Peixuan, LIANG Yiqing, WANG Jingjing, ZHAO Songqing, ZHANG Yi, CAO Songmei. Analysis of the trajectory of changes in dietary behavioral adherence in young and middle-aged patients with type 2 diabetes mellitus and the influencing factors[J]. Chinese Journal of Nursing, 2024, 59(13): 1592-1599.

图/表 6

表1 调查对象的一般资料（n=277）

Table 1 General information of the patients（n=277）

表2 中青年2型糖尿病患者饮食行为依从性潜在类别分析模型拟合结果

Table 2 Results of model fitting for analysis of potential categories of dietary behavior adherence in young and middle-aged patients with type 2 diabetes mellitus

图1 中青年2型糖尿病患者不同饮食行为依从性潜在类别发展轨迹图注：T0为出院前1 d，T1为出院后1周，T2为出院后1个月，T3为出院后3个月。

Figure 1 Trajectory of the development of potential categories of adherence to different dietary behaviors in young and middle-aged patients with type 2 diabetes mellitus

表3 中青年2型糖尿病患者饮食行为依从性轨迹潜在类别的单因素分析结果（n=277）

Table 3 Results of a univariate analysis of potential categories of dietary behavioral adherence trajectories in young and middle-aged patients with type 2 diabetes mellitus（n=277）

表4 分类变量赋值方式

Table 4 Categorical variables assignment method

表5 中青年2型糖尿病患者饮食行为依从性轨迹潜在类别的多元Logistic回归分析结果（n=277）

Table 5 Results of multivariate logistic regression analysis of potential categories of dietary behavioral adherence trajectories in young and middle-aged patients with type 2 diabetes（n=277）

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