| Objective To investigate the current situation of stages of change in dietary behavior among type 2 diabetic patients and its related influencing factors.To analyze the patients’ real experience and demands for diet self-management in different stages of eating behavior,so that personalized scheme for diet self-management can be provided for clinical and community nurses.Methods This cross-sectional survey was conducted from January 2017 to August 2017 in Jiangsu Province Hospital of Traditional Chinese Medicine and Jiangsu Province Official Hospital.A convenience sample of 312 type 2 diabetic patients who met inclusion and exclusion criteria were recruited from the endocrinology departments.Measures such as General information questionnaire,Stage of Dietary Behavior,Diabetes Self-efficacy Scale,Decision-making Scale,Social Support Rating Scale and Self-rating Depression Scale were used.Besides,patients who had different characteristic features,different disease conditions and different stages of change from the cross-sectional survey were chosen to have interviews.The number of the patients was on the basis of saturated texts.Results(1)Of the 312 diabetic patients,38(12.2%)patients were at the precontemplation stage,71(22.8%)patients were at the contemplation stage,87(27.9%)patients were at the preparation stage,47(15.0%)patients were at the action stage,69(22.1%)patients were at the maintenance stage and patients at the preaction stage were 62.9%.(2)The results of univariate analysis showed that the gender,age,occupation,duration of diabetes,complication and diabetes education were differed across stages(P<0.05);while the nation,religion,marriage,education level,forms of hospitalized costs,BMI and family heredity won’t differed across stages(P>0.05).The score of self-efficacy,decisional balance,subjective support,support utilization and depressive symptoms were also differed across stages(P<0.05);while no significant difference was observed in the score of objective support among stages(P>0.05).(3)The results of Logistic analysis revealed that the age,occupation,self-efficacy,decisional balance,support utilization and depression were important factors affecting the stage of dietary behavior.Compared with the stage of precontemplation,the patients who were 60-75 years old were more likely at the latter three stages of dietary behavior than those who were 45～59 years old.The patients employed were more likely at the contemplation stage.The patients who had higher self-efficacy and perceived benefits were more likely at the latter four stages and who had lower perceived barriers and depression were more likely at the latter three stages of dietary behavior.The patients having more scores of support utilization were more properly at the preparation stage.(4)Qualitative analysis showed that most patients didn’t have enough cognition to diabetes diet,mainly about fuzzy knowledge,misunderstanding and less professional access.They were eager to get more professional dietary guidance.The patients at the preaction stage had kinds of unhealthy mental phenomenon,faced with poor self-control,bad eating habits,hunger,insufficient family support and they aspired more supervision and help from family.Conclusion The status of dietary behavior of the patients was unsatisfactory because most patients have yet to control their diet.The age,occupation,self-efficacy,decisional balance,support utilization and depression were important factors affecting the stage of dietary behavior.In addition,most patients had not enough cognition to diabetes diet,kinds of unhealthy psychology and barriers were still existed.They were eager to multiple support from hospitals,communities and families.Therefore,stage of change should be assessed and individualized interventions provided based on the patients’ features at different stages to effectively promote the periodic change of dietary behavior. |
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