Diabetes Self-Care Behaviors and Disease Control in Support Group Attenders and Nonattenders

參加與未參加糖尿病支持團體糖友的自我照顧行為與疾病控制

10.1097/jnr.0000000000000053

邱啟潤(Chii-Jun Chiou)

糖尿病支持團體 ； 自我照顧行為 ； 疾病控制 ； diabetes support groups ； self-care behavior ； disease control

The Journal of Nursing Research

22卷4期（2014 / 12 / 01）

231 - 241

英文

背景　糖尿病的盛行率與死亡率皆在逐年增加中，若控制不佳會帶來洗腎、截肢、心臟病、中風、視網膜病變、血管病變等併發症，對個人、家庭、國家的影響甚鉅。目的　比較有無參加糖尿病支持團體之糖友，其糖尿病的自我照顧行為與疾病控制。方法　本研究利用具信、效度的問卷進行橫斷性調查，由全國已成立兩年之糖尿病支持團體名冊進行隨機抽樣，請團體之輔導員收集該機構「參加」與「未參加」糖尿病支持團體糖友的問卷。實際可配合的團體共10家，回收糖友有效問卷於「參加」支持團體有147位，「未參加」支持團體有93位。結果　「參加」與「未參加」支持團體糖友的年齡、教育程度、罹病年數等變項皆無顯著差異，兩組是可比較的同質性團體。在「參加」支持團體糖友之自我照顧行為、疾病控制分數與糖尿病護照使用比率，皆高於「未參加」支持團體的糖友，兩組皆具統計上顯著差異。結論／實務應用　「參加」糖尿病支持團體糖友，較「未參加」者之糖尿病自我照顧行為和疾病控制是較理想的，建議政府應積極推動糖尿病支持團體的政策。

Background: The prevalence rate and mortality rate of diabetes continue to increase annually. Complications associated with poor control of diabetes include renal dialysis, amputation, heart disease, stroke, retinopathy, and vascular disease, all of which have an impact at the individual, family, and national level. Purpose: This study compares diabetes self-care behavior and disease control efficacy between attenders and nonattenders of a diabetes support group. Methods: We used a questionnaire with good validity and reliability to conduct a cross-sectional survey. Diabetes support groups have been established throughout Taiwan for around 2 years. Participants for this study were recruited randomly from a register of support group participants. Support group instructors were asked to collect questionnaires from those attending and not attending their support groups. Ten groups volunteered to participate in this study. We received 147 valid questionnaires from participants attending support groups (attenders) and 93 questionnaires from participants who did not (nonattenders). Results: There were no statistically significant differences between support group attenders and nonattenders in terms of age, educational level, or time since diagnosis of diabetes. Thus, we assumed these two groups as adequately similar to conduct statistical comparisons. Scores for diabetes self-care behavior, disease control, and use of the diabetes passport were all significantly higher among support group attenders than their nonattender peers. Conclusions/Implications for Practice: Results indicate that people attending diabetes support groups are more likely to have better self-care behavior and disease control than nonattenders. Therefore, we suggest that the government actively promote policies supportive of diabetes support groups.

1. Ministry of Health and Welfare. (2012). 2011 cause of death statistics for Taiwan (disk ed.). Taipei, Taiwan, ROC: Author. (Original work published inChinese)
2. Weng, S. L. (2012). HbA1C levels in half of over 900 regularly monitored diabetic patients in Tainan City within "safe" range. China Daily News, Medical Network. Retrieved from http://blog.xuite.net/yun5624/twblog/140015597-%E5%85%8D%E7%96%AB%E7%96%BE%E7%97%85%E8%88%87%-E9%81%8E%E6%95%8F (Original work published in Chinese)
3. Chen, L. J. (n.d.). How to manage the difficulties of administering diabetes peer-support groups. Catholic Sanipax Socio-Medical Service & Education Foundation. Retrieved from http://www.tapd.tw/p2-2b.asp?nid=260 (Original work published in Chinese)
4. Huang, M. J. (2011). The operational model of the diabetes support groups. Supervisor training handouts by the Catholic Sanipax Socio-Medical Service & Education Foundation and Health Promotion Administration, Ministry of Health and Welfare. (Original work published in Chinese)。
5. Albright, T. L.,Parchman, M.,Burge, S. K.(2001).Predictors of self-care behavior in adults with type 2 diabetes: An RRNeST study.Family Medicine,33(5),354-360.
6. Brown, S. A.,Kouzekanani, K.,Garcia, A. A.,Hanis, C. I.(2002).Culturally competent diabetes self-management education for Mexican Americans: The Starr County border health initiative.Diabetes Care,25(2),259-268.
7. Brownson, C. A.,Heisler, M.(2009).The role of peer support in diabetes care and self-management.The Patient: Patient-Centered Outcomes Research,2(1),5-17.
8. Bureau of Health Promotion, Department of Health(2012)。Diabetes and me。Taipei, Taiwan, ROC:Author。
9. Bureau of National Health Insurance, Ministry of Health and Welfare(2011)。The international forum for the 2025 diabetes challenge。National Health Insurance，92，14-15。
10. Chaveepojnkamjorn, W.,Pichainarong, N.,Schelp, F. P.,Mahaweerawat, U.(2009).A randomized controlled trial to improve the quality of life of type 2 diabetic patients using a self-help group program.The Southeast Asian Journal of Tropical Medicine and Public Health,40(1),169-176.
11. Chiou, C. J.、Wang, R. H.、Lin, C. C.、Chang, S. H.、Chang, F. T.(2012)。,Kaohsiung, Taiwan, ROC:Kaohsiung Medical University。
12. Coleman, M. T.,Newton, K. S.(2005).Supporting self-management in patients with chronic illness.American Family Physician,72(8),1503-1510.
13. Collins, R.,Armitage, J.,Parish, S.,Sleigh, P.,Peto, R.,Heart Protection Study Collaborative Group(2003).MRC/BHF Heart protection study of cholesterol-lowering with simvastatin in 5963 people with diabetes: A randomised placebo-controlled trial.The Lancet,361(9374),2005-2016.
14. Deakin, T. A.,McShane, C. E.,Cade, J. E.,Williams, R.(2005).Group based training for self-management strategies in people with type 2 diabetes mellitus.Cochrane Database of Systematic Reviews,2005(2)
15. Hill-Briggs, F.(2003).Problem solving in diabetes self-management: A model of chronic illness self-management behavior.Annals of Behavioral Medicine: A Publication of the Society of Behavioral Medicine,25(3),182-193.
16. Hu, Y. F.、Lee, W. H.、Chen, P. J.、Tai, F. T.、Lin, W. S.(2009)。Effectiveness of integration service by applying community-oriented primary care to diabetic patient group in community。Show-Chwan Medical Journal，9(1-2)，9-19。
17. Huang, C. L.、Liu, M. J.、Tai, Y. K.、Chiou, C. J.、Hsiao, J. Y.(2010)。Implementation and evaluation of a proper dietary behavior program in diabetes support groups。The Journal of Nursing，57(1)，35-44。
18. Kennedy, A.,Rogers, A.,Gately, C.(2005).Assessing the introduction of the expert patients programme into the NHS: A realistic evaluation of recruitment to a national lay-led self-care initiative.Primary Health Care Research and Development,6(2),137-148.
19. King, H.,Aubert, R. E.,Herman, W. H.(1998).Global burden of diabetes, 1995-2025: Prevalence, numerical estimates, and projections.Diabetes Care,21(9),1414-1431.
20. Kuo, C. C.、Wang, H. H.(2012)。Applying self-management intervention studies to patients with chronic illness: A systematic review。Journal of Nursing and Healthcare Research，8(1)，52-60。
21. Lee, Y. C.(2008)。Self-management of diabetes health in support groups。Counseling and Guidance，266，51-58。
22. Lorig, K. R.,Holman, H. R.(2003).Self-management education: History, definition, outcomes, and mechanisms.Annals of Behavioral Medicine,26(1),1-7.
23. Lorig, K. R.,Sobel, D. S.,Stewart, A. L.,Brown, B. W., Jr.,Bandura, A.,Ritter, P. L.,Holman, H. R.(1999).Evidence suggesting that a chronic disease self-management program can improve health status while reducing hospitalization: A randomized trial.Medical Care,37(1),5-14.
24. McEwen, M. M.,Pasvogel, A.,Gallegos, G.,Barrera, L.(2010).Type 2 diabetes self-management social support intervention at the U.S.-Mexico border.Public Health Nursing,27(4),310-319.
25. Mensing, C. R.,Norris, S. L.(2003).Group education in diabetes: Effectiveness and implementation.Diabetes Spectrum,16(2),96-103.
26. Minet, L. K. R.,Wagner, L.,Lønvig, E. M.,Hjelmborg, J.,Henriksen, J. E.(2011).The effect of motivational interviewing on glycaemic control and perceived competence of diabetes self-management in patients with type 1 and type 2 Diabetes Mellitus after attending a group education programme: A randomised controlled trial.Diabetologia,54(7),1620-1629.
27. Norris, S. L.,Engelgau, M. M.,Venkat Narayan, K. M.(2001).Effectiveness of self-management training in type 2 diabetes.Diabetes Care,24(3),561-587.
28. Stratton, I. M.,Adler, A. I.,Neil, H. A. W.,Matthews, D. R.,Manley, S. E.,Cull, C. A.(2000).Association of glycaemia with macrovascular and microvascular complications of type 2 diabetes (UKPDS 35): Prospective observational study.British Medical Journal,321(7258),405-412.
29. Tang, T. S.,Ayala, G. X.,Cherrington, A.,Rana, G.(2011).A review of volunteer-based peer support interventions in Diabetes.Diabetes Spectrum,24(2),85-98.
30. Tang, T. S.,Funnell, M. M.,Anderson, R. M.(2006).Group education strategies for diabetes self-management.Diabetes Spectrum,19(2),99-105.
31. Tang, T. S.,Sohal, P. S.,Garg, A. K.(2013).Evaluating a diabetes self-management support peer leader training programme for the English- and Punjabi-speaking South-Asian community in Vancouver.Diabetic Medicine,30(6),746-752.
32. Wild, S.,Roglic, C.,Green, A.,Sicree, R.,King, H.(2004).Global prevalence of diabetes: Estimates for the year 2000 and projections for 2030.Diabetes Care,27(5),1047-1053.

1. Wang, Ruey-Hsia,Lin, Ying-Chun,Huang, Hsiao-Ling,Chiou, Chii-Jun(2016).Developing and Psychometrically Testing the Functions of Diabetes Peer Support Group Scale.The Journal of Nursing Research,24(4),357-364.
2. WANG, Wenru,TAN, Cherry Chay Lee,SUM, Chee Fang,SHEW, Jasmine Sew Hong,HOLYDARD, Eleanor,CHENG, Karis Kin Fong(2018).Perceptions of Diabetes Self-Care Management Among Older Singaporeans With Type 2 Diabetes: A Qualitative Study.The Journalof Nursing Research,26(4),242-249.
3. Yeh, Shu-Ling,Shyu, Yea-Ing Lotus,Liu, Chien-Ying,Chen, Kang-Hua(2016).Living With Chronic Obstructive Pulmonary Disease: The Process of Self-Managing Chronic Obstructive Pulmonary Disease.The Journal of Nursing Research,24(3),262-271.
4. 侯惠娟,邱啟潤(2019)。參加「糖尿病支持團體」之第二型糖尿病患者自我照顧行為及相關因素。長期照護雜誌，23(2)，133-147。