제2형 당뇨병 성인 남성 환자의 약물치료 이행과 혈당 조절 수준 간에 치료 스트레스의 매개효과
The Mediating Effect of Regimen Distress in the Relationship between Medication Adherence and Glycemic Control in Men with Type 2 Diabetes Mellitus
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연구목적 : 본 연구는 제 2형 당뇨병 환자 중 성인 남성의 약물치료 이행, 혈당조절 수준, 치료스트레스의 정도를 확인하고 약물치료 이행과 혈당조절 수준간의 관계와 이들 관계에서 치료스트레스의 매개효과를 검증함으로써 대상자의 건강 증진을 위한 간호중재 마련의 기초자료로 활용하기 위하여 시행되었다. 연구방법: 제 2형 당뇨병을 가진 30세 이상의 성인 남성 116명을 대상으로 서술적 조사연구를 실시하였다. 자료는 2015년 10월부터 11월까지 연구 대상자와 직접면담을 통한 설문조사와 전자의무기록을 통해 수집하였다. 수집한 자료는 SPSS/WIN 18.0을 이용하여 분석하였으며 기술통계, t-test, ANOVA, Pearson correlation coefficient와 Baron과 Kenny의 3단계 매개효과 검증절차를 이용한 회귀분석으로 검정하였다. 연구결과 : 연구 결과 약물치료 이행 정도는 7점 만점에 평균 6.32점, 혈당조절수준은 HbA1c이 평균 7.47%였으며 치료스트레스는 5점 만점에 평균 2.37점이었다. 약물치료 이행, 치료스트레스와 혈당조절 수준 간에는 유의하게 상관관계가 있는 것으로 나타났으며, 약물치료 이행과 혈당조절 수준의 관계에서 치료 스트레스가 유의한 부분 매개 변인(β = .22, p = .005)으로 확인되었다(Sobel test: Z= 2.47, p =.013). 결론: 본 연구 결과를 근거로 제 2형 당뇨병을 가진 성인 남성 환자의 혈당 조절 수준을 향상시키기 위해서는 약물치료 이행을 촉진 시키는 방안 마련뿐만 아니라 치료 스트레스를 감소시키는 전략을 개발하여 적극적으로 적용할 것을 제언한다.
Abstract
Purpose: The purpose of this study was to examine the mediating effect of regimen distress in the relationship between medication adherence and glycemic control in men with type 2 diabetes. Methods: A total of 116 patients with type 2 diabetes was recruited for the cross-sectional survey design. Data were analyzed using descriptive statistics, independent t-test, ANOVA, Pearson’s correlation coefficient, and multiple regression using Baron and Kenny steps for mediation. Results: The mean score for medication adherence was 6.32, and the mean glycemic control level (HbA1c) was 7.47%. The mean score was 2.37 for regimen distress. There were significant correlations among medication adherence, regimen distress, and HbA1c. Regimen distress had a partial mediating effect (β=.22, p=.005) in the relationship between medication adherence and HbA1c (Sobel test: Z=2.47, p=.013). Conclusion: Regimen distress was found to be associated with glycemic control in men with type 2 diabetes. Based on the findings of this study, nursing intervention programs focusing on decreasing regimen distress are highly recommended to improve level of glycemic control in patients with type 2 diabetes.
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