Assessing Barriers and Adherence to Insulin Injection Technique in People With Diabetes: Development and Validation of New Assessment Tools.

IF 4.1 Q2 ENDOCRINOLOGY & METABOLISM Journal of Diabetes Science and Technology Pub Date : 2024-11-01 Epub Date: 2023-05-20 DOI:10.1177/19322968231175920
Dominic Ehrmann, Bernhard Kulzer, Inka Wienbarg, Jochen Sieber, Siegfried Weber, Thomas Haak, Norbert Hermanns
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Abstract

Background: The correct injection technique is crucial for people with insulin therapy. However, barriers to insulin injections exist, which can lead to problems with injections. In addition, injection behavior may deviate from recommendations leading to lower adherence to the correct injection technique. We developed two scales to assess barriers and adherence to the correct technique.

Methods: Two item pools were created to assess barriers to insulin injections (barriers scale) and adherence to the correct technique (adherence scale). In an evaluation study, participants completed the two newly created scales, as well as other questionnaires used for criterion validity. Exploratory factor analysis, correlational analysis, and receiver operating characteristics analysis were computed to analyze the validity of the scales.

Results: A total of 313 people with type 1 and type 2 diabetes using an insulin pen for insulin injections participated. For the barriers scale, 12 items were selected achieving a reliability of 0.74. The factor analysis revealed three factors namely emotional, cognitive, and behavioral barriers. For the adherence scale, nine items were selected achieving a reliability of 0.78. Both scales showed significant associations with diabetes self-management, diabetes distress, diabetes acceptance, and diabetes empowerment. Receiver operating characteristics analysis showed significant area under the curves for both scales in classifying people with current skin irritations.

Conclusions: Reliability and validity of the two scales assessing barriers and adherence to insulin injection technique were demonstrated. The two scales can be used in clinical practice to identify persons in need of education in insulin injection technique.

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评估糖尿病患者使用胰岛素注射技术的障碍和依从性:新评估工具的开发与验证。
背景:正确的注射技术对于接受胰岛素治疗的人来说至关重要。然而,胰岛素注射存在障碍,可能导致注射问题。此外,注射行为可能会偏离建议,导致对正确注射技术的依从性降低。我们开发了两个量表来评估障碍和对正确技术的依从性:我们创建了两个项目库,分别用于评估胰岛素注射障碍(障碍量表)和坚持正确注射技术(坚持量表)。在一项评估研究中,参与者完成了这两个新创建的量表以及用于标准效度的其他问卷。为了分析量表的有效性,我们计算了探索性因子分析、相关分析和接受者操作特征分析:共有 313 名使用胰岛素笔注射胰岛素的 1 型和 2 型糖尿病患者参加了调查。障碍量表选取了 12 个项目,信度为 0.74。因子分析显示了三个因子,即情绪障碍、认知障碍和行为障碍。在依从性量表中,选取了 9 个项目,信度为 0.78。两个量表均显示与糖尿病自我管理、糖尿病困扰、糖尿病接受度和糖尿病赋权有明显关联。受试者操作特征分析表明,两个量表在对当前皮肤过敏患者进行分类时,曲线下面积均有显著性:结论:评估胰岛素注射技术障碍和依从性的两个量表的可靠性和有效性得到了证实。这两个量表可用于临床实践,以识别需要接受胰岛素注射技术教育的人群。
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来源期刊
Journal of Diabetes Science and Technology
Journal of Diabetes Science and Technology Medicine-Internal Medicine
CiteScore
7.50
自引率
12.00%
发文量
148
期刊介绍: The Journal of Diabetes Science and Technology (JDST) is a bi-monthly, peer-reviewed scientific journal published by the Diabetes Technology Society. JDST covers scientific and clinical aspects of diabetes technology including glucose monitoring, insulin and metabolic peptide delivery, the artificial pancreas, digital health, precision medicine, social media, cybersecurity, software for modeling, physiologic monitoring, technology for managing obesity, and diagnostic tests of glycation. The journal also covers the development and use of mobile applications and wireless communication, as well as bioengineered tools such as MEMS, new biomaterials, and nanotechnology to develop new sensors. Articles in JDST cover both basic research and clinical applications of technologies being developed to help people with diabetes.
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