依从糖尿病患者护理:生化过程知识能够对患有1型糖尿病的青少年的血糖控制产生重大影响

Aim To evaluate the impact of patients’ understanding of biochemical processes involved in glucose regulation (causal‐biochemical knowledge) and of diabetes self‐management knowledge on adherence to treatment recommendations among adolescents with type 1 diabetes mellitus. Design A cross‐sectional study. Methods Adolescents with type 1 diabetes mellitus, aged 12–18 years and able to read and write in Hebrew or in Arabic were eligible. Participants were recruited between August 2016 – January 2018 during routine visits to the Paediatric Diabetes Clinic; informed consent was obtained as customary. Patients completed sociodemographic, clinical and type 1 diabetes mellitus self‐management and biochemical knowledge questionnaires. Adherence to treatment was assessed by patients’ serum HbA1c levels, collected from medical records. Results Ninety‐seven patients participated in the study. Mean HbA1c levels were 9.2% (1.9%) and only 24 (24.7%) patients met the recommended HbA1c ≤ 7.5%. Lower HbA1c levels were strongly associated with higher family income, older age at diagnosis and with better type 1 diabetes mellitus self‐management and causal‐biochemical knowledge. A regression model showed that causal‐biochemical knowledge contributed to the variance in HbA1c levels. Furthermore, causal‐biochemical knowledge, but not self‐management knowledge, was found to mediate the negative relationship between low family income and high HbA1c levels. Conclusions Causal‐biochemical knowledge is a valuable component for the adherence to diabetes care and glycaemic control. Impact Our study suggests that causal knowledge is a valuable component that should be included in nursing and healthcare educational programmes for adolescents with type 1 diabetes mellitus.