2型糖尿病患者低碳水化合物饮食管理依从性影响因素的质性研究

目的了解影响2型糖尿病患者实施低碳水化合物饮食(LCD)管理依从性的因素,为提高患者饮食依从性提供依据。方法采用目的抽样法,选取2019年5—9月于苏州大学附属第二医院内分泌科住院并参与完成3个月LCD干预课题的16例2型糖尿病患者为访谈对象,对其进行半结构式访谈,运用Colaizzi分析程序对访谈资料进行整理和分析。结果共提炼出促进因素和阻碍因素2个主题。其中促进因素包括益处感知、正性心理作用、多元社会支持、饮食和血糖管理得以强化和饮食方案可操作5个因子;阻碍因素包括未觉获益、饮食知识与实际需求存在差距、饮食习惯遭遇挑战、社会角色压力增加和饮食方案难以操作5个因子。结论2型糖尿病患者低碳水化合物饮食管理依从性受到多重因素影响,未来应考虑将患者、家属及医护人员共同纳入糖尿病患者低碳水化合物饮食的综合管理中。

A qualitative research on influencing factors of low carbohydrate diet management compliance in patients with type 2 diabetes mellitus

Objective To explore the influencing factors of low carbohydrate diet(LCD)management compliance in patients with type 2 diabetes mellitus(T2DM)so as to provide a basis for improving diet compliance of patients.Methods From May to September 2019,we selected 16 T2DM patients participating in LCD project for three months in Department of Endocrinology of the Second Affiliated Hospital of Soochow University as interviewees by purposive sampling.The semi-structured interview was carried out for them,and Colaizzi analysis was used to interview data sorting and analysis.Results A total of two themes were extracted,the promoting factors and obstructing factors.The promoting factors included the perceived benefits,positive psychological effect,multiplex social support,strengthening diet and blood glucose management as well as operational diet plan;the obstructing factors involved the perceived no benefits,difference between diet knowledge and actual demand,diet habit facing a challenge,increasing social role stress,difficulty carrying out diet plan.Conclusions LCD management compliance of T2DM patients have many influencing factors.Patients,family members and medical staff should be paid attention to integrated management of LCD for diabetic patients in future.