胰島素治療的第二型糖尿病患者血糖控制不佳之阻礙因素：焦點團體訪談的探索性研究

Barriers of poorly controlled patients with type 2 diabetes using insulin therapy: An exploratory research on focused group interview

莊雅婷(Ya-Ting Chuang)；楊宜瑱(Yi-Sun Yang)；彭秀玲(Hsiu-Ling Peng)

第二型糖尿病 ； 胰島素治療 ； 血糖控制 ； 焦點團體訪談 ； T2DM ； insulin injection ； glycemic control ； focused group interview

中華團體心理治療

25卷3期（2019 / 09 / 30）

33 - 49

繁體中文

目的：本研究以焦點團體訪談探索第二型糖尿病患者使用胰島素後，血糖控制不佳的因素。方法：以中區某醫學中心的糖尿病病人為對象，先進行3個焦點團體的訪談（共35名，平均63歲），再以個別深度訪談（8位）補足團體難以收集的資料。結果：血糖控制過程中患者面臨內外不斷拉扯的改變歷程，阻礙因素包含：一、知識的窒礙難行。二、難以調節的負面情緒。三、生活習慣難以改變。四、難以棄之不顧的文化習俗。五、低血糖與其他不適的威脅。六、無立即性的血糖變化與併發症。七、缺乏支持與共同奮戰的戰友。結論：文化習俗對血糖控制確有影響，個人知識、抗拒改變、情緒以及危機感等心理因素亦形成阻礙。建議未來糖尿病衛教可針對阻礙因素逐一調整。

Objectives: This study explores barriers of poor glycemic control after insulin therapy in patients with type 2 diabetes from qualitative perspective. Methods: Patients with T2DM were recruited from the medical center in the middle of Taiwan. Firstly, we had focused group interviews with 35 patients (average 63yrs). Secondly, we use in-depth interview to compensate the limitation of focused group (8 members). Results: Results showed that 7 main factors are leading to poor glycemic control: 1) Difficult in executing the treatment plan. 2) Hardly to change the living habits. 3) Hard to get rid of cultures and customs. 4) No hypoglycemia and other physical discomforts. 5) No immediate glycemic change or complications. 6) Negative emotions that are difficult to adjust. 7) Lack of supportive and comrades to facing difficulties. Conclusions: It is recommended that the health education for the patients with T2DM can be adjusted based on the seven barriers. Suggestions to the medical practitioners were contending with cultural pressure, application of knowledge, regulating negative mood, and improving the sense of crisis.

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