Table 1. Score Distributions of the Questionnaire Asking about an Experience of Dropout from Regular Visits and Reasons in the J-DOIT2-LT.

From: Psychological and Situational Factors Affecting Dropout from Regular Visits in Diabetes Practice: The Japan Diabetes Outcome Intervention Trial-2 Large Scale Trial 004 (J-DOIT2-LT004)

Item Components       Score distributions
      None or no response Once Twice or more
1 Past experience of dropout     n 1,725   189 117
(%) 84.9   9.3 5.8
2 Duration of dropout (months)     Mean
14
(Standard deviation)
(23)
  Mean
6
(Interquartile range)
(3–18)
Item Components Mean Median Score distributions
0 1 2 3 4 5
3 Intrapersonal  Negative emotion-frustration 0.9 0 n 1,164 398 198 168 61 42
    (%) 57.3 19.6 9.7 8.3 3.0 2.1
4  Negative emotion-anger 0.2 0 n 1,732 181 63 33 10 12
    (%) 85.3 8.9 3.1 1.6 0.5 0.6
5  Negative emotion-discomfort 0.5 0 n 1,424 336 125 92 36 18
    (%) 70.1 16.5 6.2 4.5 1.8 0.9
6  Negative emotion-no improvement 1.0 0 n 1,036 417 208 247 81 42
    (%) 51.0 20.5 10.2 12.2 4.0 2.1
7  Negative physical state 0.4 0 n 1,507 293 129 75 17 10
    (%) 74.2 14.4 6.4 3.7 0.8 0.5
8  Positive emotional state 0.5 0 n 1,542 234 93 102 36 24
    (%) 75.9 11.5 4.6 5.0 1.8 1.2
9  Positive physical state 0.4 0 n 1,646 216 64 68 19 18
    (%) 81.0 10.6 3.2 3.3 0.9 0.9
10  Testing personal control 0.9 0 n 1,130 406 205 206 48 36
    (%) 55.6 20.0 10.1 10.1 2.4 1.8
11  Temptation 0.8 0 n 1,151 445 197 168 37 33
    (%) 56.7 21.9 9.7 8.3 1.8 1.6
 
12 Environmental  Weather 0.4 0 n 1,626 216 67 81 24 17
    (%) 80.1 10.6 3.3 4.0 1.2 0.8
13  Busyness 1.2 1 n 973 417 221 210 110 100
    (%) 47.9 20.5 10.9 10.3 5.4 4.9
14  Economic situation 0.4 0 n 1,670 173 65 58 37 28
    (%) 82.2 8.5 3.2 2.9 1.8 1.4
                     
15 Interpersonal  Conflict 0.2 0 n 1,828 126 28 35 10 4
    (%) 90.0 6.2 1.4 1.7 0.5 0.2
16  Social pressure (direct) 0.1 0 n 1,950 56 11 9 3 2
    (%) 96.0 2.8 0.5 0.4 0.1 0.1
17  Social pressure (indirect) 0.1 0 n 1,948 58 12 10 2 1
    (%) 95.9 2.9 0.6 0.5 0.1 0.0
18         Positive emotional state   0.3 0 n 1,684 209 58 61 11 8
        (%) 82.9 10.3 2.9 3.0 0.5 0.4
19  Positive physical state 0.1 0 n 1,849 122 27 28 3 2
    (%) 91.0 6.0 1.3 1.4 0.1 0.1   
Table 2. Exploratory Factor Analysis of a Four-Factor Solution Using a Varimax Rotation.

From: Psychological and Situational Factors Affecting Dropout from Regular Visits in Diabetes Practice: The Japan Diabetes Outcome Intervention Trial-2 Large Scale Trial 004 (J-DOIT2-LT004)

Item Components Factor 1 Factor 2 Factor 3 Factor 4
3 Intrapersonal
factors
Negative emotion-frustration 0.78 0.03 0.17 0.15
4 Negative emotion-anger 0.69 0.21 0.20 0.06
5 Negative emotion-discomfort 0.83 0.08 0.09 0.13
6 Negative emotion-no improvement 0.57 0.02 0.31 0.17
7 Negative physical state 0.65 0.14 0.03 0.13
8 Positive emotional state 0.48 0.18 0.50 0.02
9 Positive physical state 0.42 0.29 0.48 0.01
10 Testing personal control 0.08 0.06 0.90 0.13
11 Temptation 0.16 0.09 0.87 0.15
 
12 Environmental
factors
Weather 0.19 0.19 0.10 0.66
13 Busyness 0.16 0.01 0.22 0.77
14 Economic situation 0.26 0.22 0.13 0.46
 
15 Interpersonal
factors
Conflict 0.20 0.60 0.04 0.37
16 Social pressure (direct) 0.09 0.82 0.08 0.05
17 Social pressure (indirect) 0.08 0.83 0.11 0.12
18 Positive emotional state 0.05 0.35 0.13 0.66
19 Positive physical state 0.07 0.56 0.14 0.50
Labeled name Negative
perceptions
for regular
visits
Social
pressure
Lack of
perceived
necessity
Environmental
obstacles
Eigenvalues 5.66 2.01 1.36 1.12
Percentage of total variance 18.6 14.4 13.8 13.0
Number of test measures 4 2 2 3
Table 3. Description of the Extracted Factors and Their Composite Scores Detected in the Explanatory Factor Analysis.

From: Psychological and Situational Factors Affecting Dropout from Regular Visits in Diabetes Practice: The Japan Diabetes Outcome Intervention Trial-2 Large Scale Trial 004 (J-DOIT2-LT004)

Detected
factor
Retained items Name Composite score Mean Median Score distributions
0 0< to 1 1< to 2 2< to 3 3<
1 3, 4, 5, and 7 Negative perceptions for
regular visits
Averaging the scores of
Items 3, 4, 5, and 7
0.5 0.25 n 978 705 242 76 30
(%) 48.2 34.7 11.9 3.7 1.5
2 16 and 17 Social pressure Averaging the scores of
Items 16 and 17
0.1 0 n 1,926 73 17 15 0
(%) 94.8 3.6 0.8 0.7 0
3 10 and 11 Lack of perceived
necessity
Averaging the scores of
Items 10 and 11
0.9 0.5 n 1,012 490 271 181 77
(%) 49.8 24.1 13.3 8.9 3.8
4 12, 13, and 18 Environmental obstacles Averaging the scores of
Items 12, 13, and 18
0.6 0.33 n 926 701 276 88 40
(%) 45.6 34.5 13.6 4.3 2.0
Table 4. Dropout Incidence Rates and Hazard Ratios According to the Extracted Factors.

From: Psychological and Situational Factors Affecting Dropout from Regular Visits in Diabetes Practice: The Japan Diabetes Outcome Intervention Trial-2 Large Scale Trial 004 (J-DOIT2-LT004)

The composite score
(0–5)
Number of
patients
Number
of
dropouts
Person-
years
Incidence rate
(per 1,000
person-years)
Crude
HR
(95% CI) Adjusted
HRa
(95% CI) Adjusted
HRb
(95% CI)
Median Range
Factor 1: Negative perceptions for regular visits
(Categorical)
Low 0 0 978 53 1017 52.1 1.00 ref 1.00 ref 1.00 ref
Intermediate 0.25 0.25–0.5 465 26 481 54.0 1.03 (0.65–1.65) 1.03 (0.64–1.66) 0.89 (0.55–1.45)
High 1.25 0.75–4.5 588 46 593 77.6 1.49 (1.00–2.21) 1.46 (0.97–2.18) 1.06 (0.68–1.65)
(Continuous)
One-point increase in the composite score
1.23 (1.01–1.50) 1.25 (1.02–1.54) 1.07 (0.85–1.35)
Factor 3: Lack of perceived necessity
(Categorical)
Low 0 0 1,012 45 1053 42.7 1.00 ref 1.00 ref 1.00 ref
Intermediate 1.0 0.5–1.0 490 32 506 63.3 1.4799 (0.94–2.33) 1.38 (0.87–2.18) 1.26 (0.79–2.02)
High 2.0 1.5–5.0 529 48 532 90.2 2.11 (1.41–3.17) 1.89 (1.25–2.88) 1.59 (1.00–2.51)
(Continuous)
One-point increase in the composite score
1.30 (1.15–1.48) 1.26 (1.10–1.44) 1.20 (1.04–1.39)
Factor 4: Environmental obstacles
(Categorical)
Low 0 0 926 38 965 39.4 1.00 ref 1.00 ref 1.00 ref
Intermediate 0.33 0.33–0.67 514 35 532 65.8 1.67 (1.05–2.64) 1.57 (0.99–2.50) 1.52 (0.95–2.43)
High 1.67 1.0–5.0 591 52 594 87.5 2.22 (1.46–3.38) 2.03 (1.32–3.12) 1.72 (1.08–2.74)
(Continuous)
One-point increase in the composite score
1.31 (1.11–1.56) 1.27 (1.06–1.52) 1.15 (0.94–1.40)
Table 5. Hazard Ratios of Dropout According to the Extracted Factors, Stratified by the J-DOIT2-LT Intervention.

From: Psychological and Situational Factors Affecting Dropout from Regular Visits in Diabetes Practice: The Japan Diabetes Outcome Intervention Trial-2 Large Scale Trial 004 (J-DOIT2-LT004)

Assinged to intervention group p for
interaction
Yes (n = 872) No (n = 1,159)
Adjusted
HR
(95% CI) Adjusted
HRa
(95% CI)
Facor 1: Negative perceptions for regular visits 0.504
Low 1.00 ref 1.00 ref
Intermediate 1.69 (0.66–4.32) 0.87 (0.50–1.52)
High 1.73 (0.69–4.36) 1.42 (0.90–2.22)
Factor 3: Lack of perceived necessity 0.499
Low 1.00 ref 1.00 ref
Intermediate 1.18 (0.39–3.57) 1.46 (0.88–2.43)
High 2.71 (1.12–6.60) 1.74 (1.08–2.81)
Factor 4: Environmental obstacles 0.724
Low 1.00 ref 1.00 ref
Intermediate 1.32 (0.45–3.87) 1.61 (0.96–2.70)
High 2.69 (1.08–6.73) 1.93 (1.18–3.14)
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