关键词: 空巢老年人, 糖尿病, 用药偏差, 贝叶斯网络, 延续性护理

Abstract:

Objective This study aims to explore the influencing factors and interaction mechanisms of medication discrepancy in elderly patients with diabetes living in empty-nest conditions，thereby providing a foundation for the development of targeted intervention strategies. Methods By the convenience sampling method，400 elderly empty-nest diabetic patients who were hospitalized in the endocrinology department of a tertiary grade A hospital in Zhuzhou City from February to May，2025 were selected as survey subjects. Baseline data were collected prior to discharge. 2 months post-discharge，patients were surveyed using the General Information Questionnaire，the Self-Efficacy for Appropriate Medication Use Scale，the Summary of Diabetes Self-Care Activity，the Financial Toxicity In Chronic Disease Scale，and the Medication Discrepancy Tool. Potential predictive variables were initially screened through univariate analysis. Significant variables were subsequently analyzed using binary logistic regression，while dependencies and pathways among the variables were explored using a Bayesian network model. Results A total of 400 questionnaires were distributed and 376 valid questionnaires were retrieved. The incidence rate of medication discrepancy among elderly diabetic patients in empty-nest families is 57.71%. The Bayesian network model demonstrated that medication frequency，self-efficacy in rational medication use，diabetes self-management status，and frequency of communication with children are directly correlated with medication discrepancy. In contrast，age，education level，sleep duration，triglyceride glucose index，number of comorbid chronic diseases，and types of medications exhibit indirect relationships with medication discrepancy. Notably，the risk of medication discrepancy is highest（99.7%） among elderly diabetic patients living alone who take medication 3 or more times per day，exhibit poor diabetes self-management，possess low self-efficacy in rational medication use，and do not communicate with their children. Conclusion The incidence of medication discrepancy among elderly diabetic patients living in empty-nest situations is notably high，attributed to the interplay of multiple factors. This issue is influenced by various dimensions，including medication complexity，psychological behavior，and social support. Therefore，clinical medical staff need to adopt systematic strategies to build a multi-level and precise prevention and control system.

Key words: Empty-Nest Elders, Diabetes, Medication Discrepancy, Bayesian Network, Continuing Nursing Care