每日監控對改善獨居老年糖尿病患血糖控制及遵從行為之成效

The Effect of Daily Monitoring on Glycemic Control and Compliance Behaviors in Older People with Diabetes Mellitus Living Alone

目的：探討每日監控方案對促進獨居老年糖尿病患血糖控制及遵從行為之成效，以及遵從行為與血糖控制之關係。方法：為實驗性研究設計，樣本來自台北市十二轄區中十所衛生所列管及由台北市某一醫學中心診斷居住於台北市之獨居老年糖尿病患者。將符合研究條件之個案，依年齡、性別、教育程度、罹病時間加以配對，隨機分至實驗組（每日監測一次）與控制組（每週探視一次），每組各15人。結果：實驗組研究對象遵從行為顯著優於控制組，且研究對象遵從行為越好，糖尿病控制情形越好。結論：研究發現能每日到宅督促確實比僅每週到宅探視一次更能促進研究對象之遵從行為，且可以有效改善個案的血糖和體重，因此可推廣教導個案血糖自我監測及密集督促計劃，以促進獨居老年糖尿病患的遵從性。

The purposes of this study were to evaluate the effect of a daily monitoring nursing program on the glycemic control and the compliance behaviors in older people with diabetes mellitus who lived alone and to determine if their was a correlation between compliance behaviors and glycemic control. The design was experimental study. Thirty older persons who met the sampling criteria were recruited from a local medical center in Taipei and 10 of 12 district health centers in Taipei. The criteria for inclusion and matched groups were age, gender, education, and history of diabetes. Subjects were randomly assigned to an experimental group (one nurse visit per day, n=15) and a control group (one nurse visit per week, n=15). The results revealed that compliance behaviors and glycemic and body weight control in the experimental group were significantly improved when compared with the control group. Findings suggest that a daily visitation is better than visiting once per week and that daily monitoring increases patient compliance and can improve glycemic and body weight control for diabetes subjects. Instituting a daily monitoring program and teaching diabetic patients the technique of blood sugar self-monitoring are recommended.