基于大五人格特质的2型糖尿病患者健康教育偏好

Health education preferences in patients with type 2 diabetes mellitus based on Big Five personality traits

摘要

目的：探讨老年2型糖尿病（type 2 diabetes mellitus，T2DM）患者大五人格特质在人口学特征及健康教育偏好上的差异，为个性化健康教育提供依据。方法：于2023年9月采用整群抽样的方法，抽取山东省7个社区卫生服务中心的 T2DM 患者，采用简版大五人格量表和自行设计的健康教育偏好问卷进行测量，基于大五人格特质得分使用潜剖面分析来识别患者的人格分类，通过卡方检验和分层二元 Logistic 回归分析人格分类与健康教育偏好的关联。结果：纳入的 612 例患者可分为 3 种人格分类：常规平衡型（69.8%）、内向敏感型（6.4%）和积极适应型（23.8%）。在单因素分析中，积极适应型患者希望糖尿病病友是健康教育提供者的比例低于其他人格分类（χ²=6.123, P=0.047) ，内向敏感型患者希望包含心理疏导内容的比例高于其他人格分类（χ²=8.566, P=0.014）。在Logistic 回归分析中，以常规平衡型为参照，在健康教育提供者方面，积极适应型患者更不倾向于选择糖尿病病友作为提供者（$\mathit{O}\mathit{R}=0.491,\text{ }95\mathrm{\%}\text{ }\mathit{C}\mathit{I}:0.279\sim 0.866,\text{ }\mathit{P}=0.014$）；在健康教育内容方面，积极适应型患者对研究前沿内容的偏好较低（$\mathit{O}\mathit{R}=0.565,\text{ }95\mathrm{\%}\mathit{C}\mathit{I}:0.376\sim 0.848,\text{ }\mathit{P}=0.006$）；在健康教育地点方面，内向敏感型患者不倾向于选择手机应用程序作为健康教育获取途径（$\mathit{O}\mathit{R}=\mathrm{0.374,95}\mathrm{\%}\mathit{C}\mathit{I}:0.165\sim 0.848,\mathit{P}=0.019$）。以积极适应型为参照，在健康教育内容方面，内向敏感型患者对心理疏导的偏好更高（$\mathit{O}\mathit{R}=\mathrm{2.122,95}\mathrm{\%}\mathit{C}\mathit{I}:1.029\sim 4.380,\mathit{P}=0.042$）。结论：老年 T2DM 患者存在明显的人格特质异质性，不同人格分类的患者在健康教育偏好上存在差异；在对 T2DM 患者开展健康教育时，可将人格特质作为制定个体化干预策略的重要参考因素之一，但其实际干预效果仍有待进一步研究验证。

Abstract

Objective：To explore differences in the Big Five personality traits among patients with type 2 diabetes mellitus（T2DM）in relation to demographic characteristics and health education preferences and to provide evidence for personalized health education strategies. Methods：In September 2023，a cluster sampling method was used to recruit patients with T2DM from seven community health service cen- ters in Shandong Province，China.Data were collected using a questionnaire survey.The 10-item Big Five Inventory（BFI-10）and a self-developed health education preference questionnaire were used for the assessment.Latent profile analysis（LPA）was conducted to identify personality classifications among the patients.Chi-square tests were applied to compare differences in health education preferences across per- sonality groups，and stratified binary Logistic regression analysis was performed to examine the association between personality classification and health education preferences. Results：A total of 612 patients were included and categorized into three personality groups：Regular-balanced type（69.8％），introverted- sensitive type（6.4％），and proactive-adaptive type（23.8％）.In the univariate analysis，the propor- tion of patients in the proactive-adaptive group who preferred peer patients as health education providers was significantly lower than that in other personality groups (χ²=6.123,P=0.047).In contrast，pa- tients in the introverted-sensitive group showed a significantly higher preference for health education con- tent that included psychological support than other personality groups (χ²=8.566,P=0.014).In the Logistic regression analysis，using the regular-balanced type as the reference group，proactive-adaptive patients were less likely to prefer peer patients with diabetes as health education providers（OR=0.491 ， 95％CI:0.279-0.866,P=0.014）.Regarding health education content，proactive-adaptive patients demonstrated a lower preference for research-frontier information $(\mathit{O}\mathit{R}=\mathrm{0.565,95}\mathrm{\%}\mathit{C}\mathit{I}:0.376-0.848$ ， P=0.006).In terms of educational delivery settings，introverted-sensitive patients were less likely to prefer mobile applications as a means of receiving health education (OR=0.374,95\%CI:0.165- 0.848,P=0.019）.When the proactive-adaptive type as the reference group，introverted-sensitive pa- tients showed a significantly higher preference for psychological support content (OR=2.122,95\%CI ： 1.029-4.380,P=0.042）. Conclusion：Personality traits exhibit substantial heterogeneity among pa- tients with T2DM，and different personality classifications are associated with distinct health education preferences.Personality traits may serve as an important reference for developing individualized health education strategies；however，their effectiveness in improving intervention outcomes requires further vali- dation through future studies.

关键词

糖尿病，2型 / 人格 / 健康教育 / 病人意愿 / 潜剖面分析

Key words

Diabetes mellitus，type 2 / Personality / Health education / Patient preference / Latent pro-file analysis

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基金资助

国家自然科学基金(72174008)