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目的 :评价不同心理社会因素对胰岛素治疗依从性的影响。方法 :调查 60 4例具有胰岛素治疗指征的糖尿病患者 ,根据对其胰岛素治疗依从性影响最大的一项社会因素及决定不依从或延迟不依从影响最大的一项心理因素分别分组计数 ,比较各组的构成比 ,计算依从率。结果 :本组病例总体依从率为 2 7 5 % ,家属及医务人员对患者依从性影响较大 ,依从率低于总体依从率 (u =1 85 1,P <0 0 5 ;u =3 60 2 ,P <0 0 1) ,媒体对患者依从性影响最小 ,依从率显著高于总体依从率 (u =7 93 8,P <0 0 1) ;担心成瘾是糖尿病患者决定不依从或延迟不依从的最主要心理因素 ,占 63 5 % ,其次为恐惧低血糖 ,占 2 1 7%。结论 :糖尿病患者对胰岛素治疗的依从性主要受家属及医务人员的影响 ,担心成瘾及恐惧低血糖是降低胰岛素治疗依从率的主要心理因素 ,加大媒体宣传力度是提高胰岛素治疗依从率的有效途径。
Objective: To evaluate the influence of different psychosocial factors on insulin treatment compliance. Methods: A total of 604 diabetic patients with indications of insulin therapy were enrolled and divided into groups according to a social factor that has the greatest influence on insulin treatment compliance and a psychological factor that decided to not comply with or delayed non-compliance. Composition ratio of the group to calculate the compliance rate. Results: The overall compliance rate of this group was 27.5%. The dependency of family members and medical personnel on patients was greater than that of the compliance group (u = 1 851, P <0 05; u = 3 60 2, P <0.01). The media had the least impact on patient compliance and the compliance rate was significantly higher than the overall compliance rate (u = 7 93 8, P <0.01). The fear of addiction was due to non-adherence or delay The main psychological factors of non-compliance, 63 5%, followed by fear of hypoglycemia, accounting for 21.7%. Conclusion: The adherence of diabetic patients to insulin therapy is mainly affected by their family members and medical staffs. They are concerned that addiction and fear of hypoglycemia are the main psychological factors that reduce the compliance rate of insulin treatment. Increasing the intensity of media propaganda is effective in improving adherence rate of insulin therapy way.