探討第二型糖尿病患者轉換胰島素注射治療過程之促進與阻礙因素

An Exploration of Facilitators and Inhibitors in Relation to Switching to Insulin Injection by Patients with Type 2 Diabetes

10.6225/JEBN.2.1.14

吳淑華(Shwu-Hwa Wu)；陳清惠(Ching-Huey Chen)；顏妙芬(Miao-Fen Yen)

胰島素注射治療 ； 促進因素 ； 阻礙因素 ； insulin injection ； inhibiting factors ； facilitating factors

實證護理

2卷1期（2006 / 03 / 01）

14 - 23

繁體中文

本研究為回溯性描述性研究，探討第二型糖尿病患者轉換胰島素注射治療過程中的阻礙因素與促進因素。採方便取樣方式，選取南台灣某一地區醫院24位已轉換為胰島素注射之患者參與研究，以半結構式問卷進行一對一的訪談，收集質性資料，並以內容分析法(content analysis)進行分析。結果顯示，轉換胰島素注射治療之阻礙因素包括認知、態度、能力、心理／社會障礙及其他慢性病症狀干擾。促進因素包括注射必要性的自覺、注射執行無礙及信任的醫病關係。阻礙因素在個案執行注射前後會有些不同，注射前主要障礙來自認知與態度之偏差，注射後則多為實際操作上出現的問題。研究結果顯示，衛教時應同時掌握個案對胰島素注射治療之「理性」的知道與「感性」的接受層面，去除個人內外在阻礙因素，營造無障礙之注射環境，才能確保胰島素注射治療的成功。

The purpose of this retrospective study was to explore the factors that inhibit and the factors that facilitate switching to insulin injection on the part of type 2 diabetes patients. Twenty-four diabetic patients who had switched to insulin injections were recruited from one of the teaching hospitals in southern Taiwan. A semi-structured questionnaire and face-to-face interviews were used to collect qualitative data. These data were analyzed by content analysis. The findings show that inhibiting factors include barriers to cognition, attitude, operating ability, and the interference of other chronic diseases. Facilitating factors include self-awareness in relation to the necessity of injection, lack of difficulties with injections, and a relationship of trust between doctor and patient. The results indicate that subjects reported different inhibitors before and after insuline injections. Before injections, cognitive misunderstanding was the most common inhibitor. However, after injections, inhibitors shifted to those restraints of life that are caused by injections. To help patients in switching to insulin injections, primary health care providers should assess both their cognitive reasoning and sensual acceptance of injections. In order to ensure the success of insulin injections, an injection-friendly environment-one without any obstacles to injections must be established by removing all obstacles, be they intrinsic or extrinsic to the patient.