题名

糖尿病病人自我照護行為及相關因素研究

并列篇名

A Study on Self-Care Behaviors and Related Factors in Diabetes Patients

DOI

10.6224/JN.000009

作者

黃喬欣(Chiao-Hsin Huang);林碧珠(Pi-Chu Lin);張媚(Mei Chang Yeh);李碧霞(Pi-Hsia Lee)

关键词

健康信念模式 ; 糖尿病 ; 自我照護行為 ; 糖尿病共同照護網 ; health belief model ; diabetes ; self-care behavior ; diabetes shared care network

期刊名称

護理雜誌

卷期/出版年月

64卷1期(2017 / 02 / 01)

页次

61 - 69

内容语文

繁體中文

中文摘要

背景 糖尿病自我照護行為是糖尿病醫療照護中最重要的一環,然而,糖尿病共同照護網之糖尿病病人執行自我照護行為的研究却很少見。目的 以健康信念模式瞭解糖尿病病人執行自我照護行為與相關因素。方法 採橫斷式研究設計,以方便取樣,選取宜蘭縣某區域教學醫院165位糖尿病共同照護網之第2型糖尿病病人為研究對象。以糖尿病知識量表、糖尿病健康信念量表、糖尿病行動線索量表、糖尿病自我效能量表、糖尿病自我照護行為量表進行問卷調查。以皮爾森積差相關、複迴歸分析等進行統計分析。結果 糖尿病自我照護行為的得分百分比為62.93%,其中以藥物行為最好、血糖監測行為最差。糖尿病健康信念以行動利益性認知得分最高、行動障礙性認知得分最低。藥物治療方式、加入糖尿病共同照護網時間、糖尿病行動線索、年齡及糖尿病自我效能,是影響糖尿病自我照護行為的重要因素,解釋變異量為20.2 %。結論/實務應用 糖尿病衛教人員宜重視糖尿病共同照護網病人之自我照護行為及相關因素,本研究結果可提供醫護人員日後擬定糖尿病健康照護計畫及介入研究之參考。

英文摘要

Background: The self-care behaviors of patients with diabetes represent the most important part of diabetic healthcare. However, few studies have investigated the self-care behaviors of diabetes patients in the context of diabetes shared care networks. Purpose: The present study applied a health belief model to determine the self-care behaviors of diabetes patients and the related factors affecting those behaviors. Methods: A cross-sectional approach and convenience sampling were employed. A questionnaire survey was completed by 165 patients with type 2 diabetes in a diabetes shared care network of a teaching hospital in Yilan County, Taiwan. The questionnaire comprised scales including knowledge, health beliefs, cues to action, self-efficacy, and self-care behavior for diabetes. The collected data were analyzed using the Pearson product-moment correlation and multiple regression analysis. Results: The percentage of accomplishment of diabetes self-care behavior was 62.93%, with taking medication achieving the highest rate of compliance and monitoring blood sugar achieving the lowest rate of compliance. On the diabetes health belief scale, the perceived benefits of taking action scored the highest and the perceived barriers to taking action scored the lowest. Medical treatment, duration of joining the diabetes shared care network, cues to action, age, and self-efficacy were the most important factors of influence in self-care behavior, accounting for 20.2% of total variance. Conclusion / Implications for Practice: Diabetes health educators should pay attention to factors that affect the self-care behaviors of patients receiving diabetes shared care. The results of the present study provide healthcare professionals with information that may be used to develop better healthcare and suggests further research on diabetes interventions.

主题分类 醫藥衛生 > 預防保健與衛生學
醫藥衛生 > 社會醫學
参考文献
  1. 衛生福利部統計處(2016).104 年主要死因統計結果分析.取自http://www.mohw.gov.tw/cht/DOS/Statistic.aspx?f_list_no=312&fod_list_no=6201[Department of Statistics, Ministry of Health and Welfare, Taiwan, ROC. (2016). Analysis of cause of death statistics, 2015. Retrieved from http://www.mohw.gov.tw/cht/DOS/Statistic.aspx?f_list_no=312&fod_list_no=6201]
  2. American Association of Diabetes Educators. (2011). Technical review: Diabetes Self-Management Education and Training (DSME/T) outcomes measures. Retrieved from http://www.diabeteseducator.org/ export/sites/aade/_resources/pdf/publications/Outcomes_Technical_Review_Aug.pdf
  3. 中央健康保險署(2012).糖尿病醫療給付改善方案.取自http://www.nhi.gov.tw/webdata/webdata.aspx?menu=20&Menu_id=712&webdata_id=3862&WD_ID=836[National Health Insurance Administration, Taiwan, ROC. (2012). National Health Insurance program to improve diabetes healthcare payments. Retrieved from http://www.nhi.gov.tw/webdata/webdata.aspx?menu=20&Menu_id=712&webdata_id=3862&WD_ID=836]
  4. Al-Khawaldeh, O. A.,Al-Hassan, M. A.,Froelicher, E. S.(2012).Self-efficacy, self-management, and glycemic control in adults with type 2 diabetes mellitus.Journal of Diabetes and Its Complications,26(1),10-16.
  5. American Diabetes Association.(2016).Standards of medical care in diabetes-2016.Diabetes Care,39(1, Suppl.),S4-S5.
  6. Bandura, A.(2004).Health promotion by social cognitive means.Health Education & Behavior,31(2),143-164.
  7. Becker, M. H.(1974).The health belief model and sick role behavior.Health Education Monographs,2(4),409-419.
  8. Bohanny, W.,Wu, S. F. V.,Liu, C. Y.,Yeh, S. H.,Tsay, S. L.,Wang, T. J.(2013).Health literacy, self‐efficacy, and self‐care behaviors in patients with type 2 diabetes mellitus.Journal of the American Association of Nurse Practitioners,25(9),495-502.
  9. Chang, T. J.,Jiang, Y. D.,Chang, C. H.,Chung, C. H.,Yu, N. C.,Chuang, L. M.(2012).Accountability, utilization and providers for diabetes management in Taiwan, 2000-2009: An analysis of the National Health Insurance database.Journal of the Formosan Medical Association,111(11),605-616.
  10. Chin, Y. F.,Huang, T. T.,Hsu, B. R. S.(2013).Impact of action cues, self‐efficacy and perceived barriers on daily foot exam practice in type 2 diabetes mellitus patients with peripheral neuropathy.Journal of Clinical Nursing,22(1-2),61-68.
  11. Faul, F.,Erdfelder, E.,Buchner, A.,Lang, A. G.(2009).Statistical power analyses using G* Power 3.1: Tests for correlation and regression analyses.Behavior Research Methods,41(4),1149-1160.
  12. Feil, E. G.,Glasgow, R. E.,Boles, S.,McKay, H. G.(2000).Who participates in internet-based self-management programs? A study among novice computer users in a primary care setting.The Diabetes Educator,26(5),806-811.
  13. Funnell, M. M.,Brown, T. L.,Childs, B. P.,Haas, L. B.,Hosey, G. M.,Jensen, B.,Weiss, M. A.(2012).National standards for diabetes self-management education.Diabetes Care,31(1, Suppl.),S101-S108.
  14. Genuth, S.(2008).The UKPDS and its global impact.Diabetic Medicine,25(2),57-62.
  15. Harvey, J. N.,Lawson, V. L.(2009).The importance of health belief models in determining self‐care behavior in diabetes.Diabetic Medicine,26(1),5-13.
  16. Kang, C. M.,Chang, S. C.,Chen, P. L.,Liu, P. F.,Liu, W. C.,Chang, C. C.,Chang, W. Y.(2010).Comparison of family partnership intervention care vs. conventional care in adult patients with poorly controlled type 2 diabetes in a community hospital: A randomized controlled trial.International Journal of Nursing Studies,47(11),1363-1373.
  17. Nam, S.,Chesla, C.,Stotts, N. A.,Kroon, L.,Janson, S. L.(2011).Barriers to diabetes management: Patient and provider factors.Diabetes Research and Clinical Practice,93(1),1-9.
  18. Orem, D. E.(1995).Nursing: Concepts of practice.St. Louis, MO:Mosby.
  19. Rosenstock, I. M.(1974).Historical origins of the health belief model.Health Education Monographs,2(4),328-335.
  20. Rosenstock, I. M.,Strecher, V. J.,Becker, M. H.(1988).Social learning theory and the health belief model.Health Education Quarterly,15(2),175-183.
  21. Sharoni, S. K. A.,Wu, S. F. V.(2012).Self‐efficacy and selfcare behavior of Malaysian patients with type 2 diabetes: A cross sectional survey.Nursing & Health Sciences,14(1),38-45.
  22. Shrivastava, S. R.,Shrivastava, P. S.,Ramasamy, J.(2013).Role of self-care in management of diabetes mellitus.Journal of Diabetes & Metabolic Disorders,12(1),14.
  23. Toobert, D. J.,Hampson, S. E.,Glasgow, R. E.(2000).The summary of diabetes self-care activities measure: Results from 7 studies and a revised scale.Diabetes Care,23(7),943-950.
  24. Wu, S. F. V.,Courtney, M.,Edwards, H.,McDowell, J.,Shortridge-Baggett, L. M.,Chang, P. J.(2008).Development and validation of the Chinese version of the Diabetes Management Self-Efficacy Scale.International Journal of Nursing Studies,45(4),534-542.
  25. Wu, S. F. V.,Courtney, M.,Edwards, H.,McDowell, J.,Shortridge‐Baggett, L. M.,Chang, P. J.(2007).Selfefficacy, outcome expectations and self‐care behavior in people with type 2 diabetes in Taiwan.Journal of Clinical Nursing,16(11c),250-257.
  26. 吳淑芳、蔡秀鸞(2009)。談糖尿病衛教演進與未來發展。源遠護理,3(2),5-14。
  27. 官蔚菁(2004)。臺南市=Tainan City, Taiwan, ROC.,國立成功大學護理學系=National Cheng Kung University。
  28. 邱馨誼(2002)。臺北市=Taipei City, Taiwan, ROC.,國立臺灣大學護理學研究所=National Taiwan University。
  29. 侯穎蕙、林士弼、邱于容、許雅蓉、鄭俐玲(2011)。糖尿病門診照護品質與就醫機構相關性探討。澄清醫護管理雜誌,7(1),32-41。
  30. 郝立智、趙建剛、趙海倫、洪靜如、王瑞祥、吳達仁、馬瀰嘉(2010)。某榮民醫院糖尿病患者代謝指標改善程度與認知行為關係之研究。中華民國糖尿病衛教學會會訊,6(3),11-20。
  31. 張媚(2009)。糖尿病個案管理。護理雜誌,56(2),22-27。
  32. 練淑靜(2007)。臺北市=Taipei City, Taiwan, ROC,國立臺灣師範大學衛生教育學系=National Taiwan Normal University。
被引用次数
  1. 陳盈妤(Ying-Yu Chen)(2022)。一位高血糖合併右臉蜂窩性組織炎個案之護理經驗。高雄護理雜誌。39(2)。165-177。