目的 探讨合理用药自我效能、药物自我管理在老年2型糖尿病患者药物素养对衰弱影响机制中的多重中介作用。方法 便利选取2024年8—11月在山西省某三级甲等医院内分泌科住院的330例老年2型糖尿病患者为研究对象,使用一般资料调查表、药物素养调查问卷、合理用药自我效能量表、慢性病老年人药物自我管理行为量表及Tilburg衰弱量表对其进行调查,构建并检验链式中介模型。结果 本组老年2型糖尿病患者药物素养总分为5.00（4.00,6.00）分,合理用药自我效能总分为（30.02±2.69）分,药物自我管理总分为（74.17±8.06）分,衰弱总分为4.00（3.00,6.00）分。老年2型糖尿病患者衰弱与药物素养、合理用药自我效能、药物自我管理均呈负相关（均P<0.001）。老年2型糖尿病患者药物素养对衰弱的间接效应成立,总间接效应为-0.125;合理用药自我效能的特定中介效应占总间接效应的45.6%;药物自我管理的特定中介效应占总间接效应的40.0%;合理用药自我效能和药物自我管理在老年2型糖尿病患者药物素养与衰弱间的链式中介效应占总间接效应的14.4%。结论 合理用药自我效能、药物自我管理在老年2型糖尿病患者药物素养与衰弱间的链式中介效应成立。建议医护人员应采取措施提高老年2型糖尿病患者的药物素养水平,同时增强其合理用药自我效能和药物自我管理能力,从而改善患者的衰弱状况。
Abstract
Objective To explore the multiple mediating roles of rational medication self-efficacy and medication self-management in the effects of medication literacy on frailty in elderly patients with type 2 diabetes mellitus. Methods Three hundred and thirty elderly patients with type 2 diabetes mellitus who were hospitalized in the endocrinology department of a tertiary grade-A hospital in Shanxi Province from August to November 2024 were conveniently selected as study subjects. General Information Questionnaire, Medication Literacy Questionnaire, Self-efficacy for Appropriate Medication Use Scale, Medication Self-Management Behavior Scale for the Elderly with Chronic Diseases, and Tilburg Frailty Indicator were used to conduct the investigation, and the chain mediation model was constructed and tested. Results The scores of medication literacy, rational medication self-efficacy, medication self-management, and frailty in elderly patients with type 2 diabetes mellitus were 5.00(4.00, 6.00), 30.02±2.69, 74.17±8.06, and 4.00(3.00, 6.00) respectively. Frailty was negatively associated with medication literacy, rational medication self-efficacy, and medication self-management in elderly patients with type 2 diabetes mellitus (all P<0.001). The indirect effect of medication literacy on frailty was established, with a total indirect effect of -0.125; the specific mediating effect of rational medication self-efficacy accounted for 45.6% of the total indirect effect, and that of medication self-management accounted for 40.0% of the total indirect effect. The chain-mediated effects of rational medication self-efficacy and medication self-management between medication literacy and frailty in elderly patients with type 2 diabetes mellitus accounted for 14.4% of the total indirect effects. Conclusion The chain mediating effect of rational medication self-efficacy and medication self-management between medication literacy and frailty in elderly patients with type 2 diabetes mellitus is established. It is recommended that healthcare professionals take measures to improve medication literacy in elderly patients with type 2 diabetes mellitus, and enhance their rational medication self-efficacy and medication self-management, thereby improving their frailty.
关键词
老年人 /
2型糖尿病 /
药物素养 /
衰弱 /
自我效能 /
自我管理
Key words
aged /
type 2 diabetes mellitus /
medication literacy /
frailty /
self-efficacy /
self-management
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