A follow-up study of treatment beliefs to insulin of patient with failure to oral hypoglycemic agents
Date Issued
2015
Date
2015
Author(s)
Shen, Wan-Ching
Abstract
In order to learn about the difference in the treatment beliefs of patients to insulin before and after insulin treatment, the study conducted a follow-up survey on 101 outpatients in a medical center, who were the research subjects in the Illness Perceptions, Treatment Beliefs to Insulin, and Intention to Insulin Therapy of Patients with Failure to Oral Drugs written by doctor Huey-Fen Wang in 2013. About two years after the former study, the present study performed the follow-up survey of 70 cases in the outpatient department of the same hospital. A questionnaire survey was made using Insulin Treatment Appraisal Scale (ITAS), and the ITAS score of each subject was compared with that in the study of Wang to explore the changes in the treatment beliefs to insulin of the same patients before and after insulin treatment. The present study found that after the study of Wang, some subjects successively received insulin treatment (acceptance group), while other subjects had not begun to receive insulin treatment (resistance group). Observation on the positive beliefs of subjects to insulin treatment found that neither the acceptance group nor the resistance group showed significant changes of positive beliefs in the former and later survey. Observation on the changes of negative beliefs found that the negative beliefs of two groups showed no significant difference in the study of Wang, while in the present study, the acceptance group showed significantly reduced and lower negative beliefs compared with the resistance group, but the resistance group showed no significant changes of negative beliefs. With the covariates that may influence the treatment beliefs to insulin of cases excluded by covariance analysis, the negative beliefs in the present study were still significantly lower in the acceptance group than in the resistance group. In addition, comparison of the mean of the positive and negative beliefs in each group found that the positive and negative beliefs of the acceptance group showed no difference in the former study, while the positive beliefs were significantly larger than the negative beliefs in the present study. Cross-group comparison of the difference in positive and negative beliefs found that with the positive and negative beliefs offset mutually, the rest of positive beliefs in the acceptance group were significantly larger than those in the resistance group. In conclusion, the present study found that for the patients with failure to oral hypoglycemic agents who require insulin treatment, if they can experience the insulin treatment by themselves, there is the possibility that their negative beliefs to insulin treatment will be reduced, and their positive beliefs also could be larger than the negative beliefs. With the positive and negative beliefs to insulin treatment offset mutually, there are still more positive beliefs supporting the patients to continue the insulin treatment. The present study summarized the reasons of cases for refusing insulin treatment using a self-made questionnaire, including misconceptions of cases to the relationship of insulin treatment and blood glucose control with the disease, as well as their worries about the operations in the insulin treatment. It is suggested that besides providing correct knowledge of diabetes and insulin, the diabetes education should also allow the patients to experience insulin injection by themselves, so as to reduce the negative beliefs of patients to insulin treatment. In addition, it is suggested that interventional studies can be made in the future to learn about the effects of changing the beliefs of patients to insulin on their acceptance for insulin treatment.
Subjects
Type 2 diabetes
Insulin Treatment Appraisal Scale (ITAS)
treatment beliefs to insulin
failure to oral hypoglycemic agents
SDGs
Type
thesis
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