| Summary: | 碩士 === 長榮大學 === 護理學系碩士班 === 107 === Background: Dietary adherence is the most difficult self-care behaviors among patients with type 2 diabetes mellitus. It is lack of literature about the factors related to dietary adherence.
Objectives: The aim of the study was to explore the associated factors of dietary adherence in patients with type 2 diabetes.
Method: A cross-sectional study was conducted. The patients with type 2 diabetes were recruited from a medical center in southern Taiwan. Inclusion criteria included patients diagnosed as with type 2 diabetes without serious complications (hemodialysis, blindness, amputation, or being bed-ridden); being able to communicate with Mandarin or Taiwanese; aged 20 year; without mental illness. Exclusion criteria included patients with dementia or cognitive problems caused by brain damages. The participants were interviewed with the 58-item questionnaire, including healthy eating behavior, diet adherence, knowledge on dietary patterns for type 2 diabetes, attitude, self-efficacy, psychological factors, family and environment factors, and demographics. The sample size is estimated to be 160. The data was analyzed using SPSS version 22.0. Descriptive statistics analysis, t-test, correlation, ANOVA, and multiple regression were conducted.
Results: Men had significantly higher scores of healthy eating behavior than women (t=2.7, p<.05). Participants without other diseases had significantly higher scores of diet adherence than those with other diseases (t=-2.1, p<.05). Participants with college levels and above had significantly higher scores of diet adherence than those with high school education and below (F=4.6, p<.05). There was significantly positive correlations between age (r=.19, p <.05), attitude (r=.17, p <.05), diet-related self-efficacy (r=.35, p <.01) and healthy eating behavior. The study also showed a negative correlation between the environment factor (r=-.27, p <.01) and healthy eating behavior. There were significantly positive correlations between dietary knowledge (r=.17, p <.05), attitude (r=.35, p <.01), and self-efficacy (r=.38, p <.01), and diet adherence. The environmental factor was negatively associated with diet adherence (r=-.33, p <.01). The multiple regression analysis showed that gender (β=-.19, p <.05) and self-efficacy (β=.22, p <.05) were importantly associated factors of healthy eating behavior, explained 18.70% of the variances. The education level (β=.22, p <.01), attitude (β=.21, p <.05), self-efficacy (β=.26, p <.01), and the environmental factor (β=-.23, p <.01) were importantly associated factors of diet adherence, explaining 29.40% of the variances.
Conclusion: The results of the study could provide diabetes educators as a reference for health education specific to different gender and education levels. The education interventions for healthy eating behavior and diet adherence may focus on attitude, self-efficacy, and environmental factors in order to improve the efficacy of health education and management of diabetes.
Keywords: Type 2 diabetes, diet behavior, adherence, factor
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