共同照護介入對提升地二型糖尿病控制不良者自我照顧能力之成效

Promoting Self-Care Ability of Poor Controlled TypeⅡDiabetes Patients by Shared-Care Program

張世杰(Shih-Chieh Chang)；黃信揚(Hsin-Yang Huang)；曾輝鈺(Hui-Yu Tseng)；蔡玉純(Yu-Chun Tsai)；陳彥元(Yen-Yuan Chen)；賴良宗(Liarng-Zung Laih)

第二型糖尿病 ； 糖尿病共同照護 ； 自我照顧能力 ； Type 2 diabetes mellitus ； Diabetes Shared-Care Program (DSCP) ； Self-Care ability

若瑟醫護雜誌

7卷1期（2013 / 08 / 01）

6 - 17

繁體中文

Background and objectives: The serum glucose level of approximately 30% of patients with diabetes mellitus (DM) in Taiwan was poorly controlled, which means the value of glycosylated hemoglobin (HbA1C) is greater than 9%. Some studies have shown that the risk of cerebrovascular diseases and myocardial infarction will be reduced by 12%-16% if the HbA1C value decreases by 1%. Methods: A total of 35 type 2 DM patients with HbA1C greater than 9% participated in Diabetes Shared-Care Program (DSCP), a DM intervention program to provide frequent interactions between patients and healthcare providers, and multiple educational courses to patients. A structured questionnaire with a five-level Likert scale was used to evaluate the knowledge of DM self care. Paired t test was used to compare the before-DSCP with after-DSCP knowledge of DM self care by the questionnaire, and HbA1C. Result: Twenty-five (71.43%) of the participants were female. The time that the patient has DM ranged from one to 40 years, with an average of 12.26 years (± 8.08 years). Before the intervention of DSCP, the mean HbA1C was 10.08% (± 1.01%). After the intervention, a significant reduction of 0.74% in HbA1C was shown. According to the questionnaire, the after-DSCP knowledge of DM self care was 4.06 (± 0.44), which is significantly higher than the before-DSCP one (3.67 ± 0.51). Conclusion: This study found that, by the active intervention of Diabetes Shared-Care Program, type poorly controlled type 2 DM patients complied with self care skills, regular exercise, diet and drug control, and thus being able to improve HbA1C value, and also patient self-care abilities.

Background and objectives: The serum glucose level of approximately 30% of patients with diabetes mellitus (DM) in Taiwan was poorly controlled, which means the value of glycosylated hemoglobin (HbA1C) is greater than 9%. Some studies have shown that the risk of cerebrovascular diseases and myocardial infarction will be reduced by 12%-16% if the HbA1C value decreases by 1%. Methods: A total of 35 type 2 DM patients with HbA1C greater than 9% participated in Diabetes Shared-Care Program (DSCP), a DM intervention program to provide frequent interactions between patients and healthcare providers, and multiple educational courses to patients. A structured questionnaire with a five-level Likert scale was used to evaluate the knowledge of DM self care. Paired t test was used to compare the before-DSCP with after-DSCP knowledge of DM self care by the questionnaire, and HbA1C. Result: Twenty-five (71.43%) of the participants were female. The time that the patient has DM ranged from one to 40 years, with an average of 12.26 years (± 8.08 years). Before the intervention of DSCP, the mean HbA1C was 10.08% (± 1.01%). After the intervention, a significant reduction of 0.74% in HbA1C was shown. According to the questionnaire, the after-DSCP knowledge of DM self care was 4.06 (± 0.44), which is significantly higher than the before-DSCP one (3.67 ± 0.51). Conclusion: This study found that, by the active intervention of Diabetes Shared-Care Program, type poorly controlled type 2 DM patients complied with self care skills, regular exercise, diet and drug control, and thus being able to improve HbA1C value, and also patient self-care abilities.