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Journal of Peking University (Health Sciences) ›› 2021, Vol. 53 ›› Issue (3): 530-535. doi: 10.19723/j.issn.1671-167X.2021.03.015

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To explore medication adherence of patients with type 2 diabetes mellitus using the latent profile analysis based on the Big Five personality theory

CHEN Ping1,LI Ze-ming1,GUO Yi1,SUN Xin-ying1,Δ(),Edwin B. FISHER2   

  1. 1. Department of Social Medicine and Health Education, Peking University School of Public Health, Beijing 100191, China
    2. Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina-Chapel Hill, North Carolina 27599-7440, USA
  • Received:2021-03-01 Online:2021-06-18 Published:2021-06-16
  • Contact: Xin-ying SUN E-mail:xysun@bjmu.edu.cn
  • Supported by:
    National Natural Science Foundation of China(71673009)

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Abstract:

Objective: To explore the personality portraits of patients with type 2 diabetes mellitus (T2DM), its relationship with medication adherence and the influencing factors of medication adherence. Methods: T2DM patients from 22 community health service stations of 4 community health service centers in Tongzhou district and Shunyi district in Beijing were selected as the research objects. A self-designed questionnaire was used to collect demographic information. The short version of Big Five personality scale was used to collect personality information, and latent profile analysis was used to explore their personality portraits. The medication adherence was evaluated by medication adherence scale, and the difference of medication adherence among the different personality portraits was explored by analysis of variance. The influencing factors of medication adherence were explored by the ordinal Logistic regression model. Results: In the study, 751 T2DM patients were included. Latent profile analysis showed that the T2DM patients in this study could be divided into four types of personality portraits, including introverted and stable type (42.7%), negative type (12.7%), anxiety type (15.3%) and active and responsible type (29.3%). Among them, 75 patients said that they did not use medicine or insulin, 5 patients were lack of data, and finally 671 patients with T2DM were included in the analysis about medication adherence. The analysis of variance showed that there was no significant difference in medication adherence between anxiety type (5.55±1.65) and negative type (5.94±1.53, P=0.089), but the medication adherence score of anxiety type was significantly lower than that of introverted and stable type (6.17±1.46, P=0.001) and active and responsible type (6.09±1.65, P=0.004). Anxiety type and negative type were seen as a whole in the ordinal Logistic regression model named anxiety and negative type. The results showed that compared with anxiety and negative type, the active and responsible type or introverted and stable type was the protective factor for good medication adherence (OR=1.567, 95%CI: 1.096-2.237; OR=1.774, 95%CI: 1.214-2.591), and the education level also affected the medication adherence. Conclusion: T2DM can be classified into four types of personality portraits based on Big Five personality theory. The anxiety and negative type after the combination of anxiety type and negative type is the independent risk factor for poor medication adherence. In addition, education level is also the influencing factor of medication compliance.

Key words: Type 2 diabetes mellitus, Personality portrait, Big Five personality theory, Medication adherence, Latent profile analysis

CLC Number: 

  • R195.4

Table 1

Latent profile analysis results of each index"

Number of profiles AIC BIC aBIC Entropy P value of LMRT
1 25 944.66 25 990.87 25 959.12
2 25 582.64 25 656.58 25 605.77 0.64 <0.001
3 25 392.42 25 494.09 25 424.23 0.70 0.243
4 25 284.08 25 413.48 25 324.57 0.72 0.002
5 25 231.59 25 388.72 25 280.76 0.73 0.168
6 25 191.82 25 376.68 25 249.67 0.75 0.480

Figure 1

Latent profile analysis of T2DM patients personality"

Table 2

Characteristics of different personality portraits in T2DM patients"

Items Introverted and stable
(n=321)		 Negative(n=95) Anxiety(n=115) Active and responsible
(n=220)		 F P
Gender, n(%) 0.558 0.643
Male 147 (45.8) 46 (48.4) 54 (47.0) 113 (51.4)
Female 174 (54.2) 49 (51.6) 61 (53.0) 107 (48.6)
Age/years, n(%) 6.246 <0.001
≤50 20 (6.2) 6 (6.3) 12 (10.4) 14 (6.4)
>50-60 81 (25.2) 27 (28.4) 52 (45.2) 64 (29.1)
>60 220 (68.6) 62 (65.3) 51 (44.4) 142 (64.5)
Education level, n(%) 3.450 0.016
Primary school 43 (13.4) 10 (10.5) 9 (7.8) 20 (9.1)
Middle school 145 (45.2) 51 (53.7) 54 (47.0) 93 (42.3)
High school 85 (26.4) 21 (22.1) 29 (25.2) 57 (26.0)
University/College 48 (15.0) 13 (13.7) 23 (20.0) 42 (19.1)
Graduate school 0 0 0 8 (3.5)
Course of disease/years, n(%) 0.825 0.480
≤5 219 (68.2) 66 (69.5) 79 (68.7) 161 (73.2)
>5-10 81 (25.2) 25 (26.3) 32 (27.8) 51 (23.2)
>10 21 (6.6) 4 (4.2) 4 (3.5) 8 (3.6)
Complications, n(%) 0.466 0.706
Yes 265 (82.6) 76 (80.0) 99 (86.1) 180 (81.8)
No 56 (17.4) 19 (20.0) 16 (13.9) 40 (18.2)
Medical insurance, n(%)
Urban employee 139 (43.3) 42 (44.2) 57 (49.6) 116 (52.7) 1.627 0.182
Urban resident 120 (37.4) 26 (27.4) 33 (28.7) 62 (28.2) 1.448 0.228
New rural cooperative 39 (12.2) 11 (11.6) 11 (9.6) 20 (9.1) 0.560 0.642
Public health care 9 (2.8) 3 (3.2) 2 (1.7) 6 (2.7) 0.161 0.923
Commercial 0 0 0 1 (0.5) 0.792 0.498
Others 2 (0.6) 3 (3.2) 3 (2.6) 5 (2.3) 1.409 0.239
Unclear 12 (3.7) 10 (10.4) 9 (7.8) 10 (4.5) 0.060 0.807
Noncompliance of medication, n(%) 41 (12.8) 8 (8.4) 12 (10.4) 14 (6.7) 1.822 0.142

Table 3

Medication adherence scores and adherence rates of four personality portraits"

Personality types Medication adherence score, $\bar{x} \pm s$ Medication adherence,n(%)
Good Moderate Worse
Introverted and stable (n=277) 6.17±1.46 51 (18.4) 124 (44.8) 102 (36.8)
Negative (n=86) 5.94±1.53 14 (16.3) 34 (39.5) 38 (44.2)
Anxiety (n=101) 5.55±1.65 7 (6.9) 42 (41.6) 52 (51.5)
Active and responsible (n=207) 6.09±1.65 44 (21.3) 88 (78.7) 75 (36.2)

Table 4

Logistic regression analysis of medication adherence"

Variables β SE P OR 95%CI
Gender
Male -0.111 0.148 0.455 0.895 0.670-1.197
Female
Age
>60 years old 0.181 0.154 0.241 1.198 0.886-1.623
≤60 years old
Education level
Middle school and lower 0.334 0.151 0.027 1.397 1.039-1.876
Higher than middle school
Course of disease
≤5 years -0.012 0.328 0.970 0.988 0.519-1.879
>5 years
Personality profile
Active and responsible 0.449 0.182 0.014 1.567 1.096-2.237
Introverted and stable 0.573 0.193 0.003 1.774 1.214-2.591
Negative and anxiety
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