接受專科或非專科醫師照護之第二型糖尿病患之生活品質比較

Quality of Life in Type 2 Diabetes Patients Cared by Specialists or Generalists

比較某醫學中心新陳代謝專科與非專科（家庭醫學科、一般內科）第二型糖尿病患者生活品質是否有所差異。本研究為橫斷性研究，在2006 年7 月至9 月間，於某醫學中心使用Diabetes Quality of Life （DQOL）問卷進行資料收集。202 位受訪者中，年齡介於18 歲至93 歲；女性（53％）稍多於男性（47％）；就診於新陳代謝專科患者（54％） 稍多於來自非專科 （46％）。在生活品質總分部份，兩種科別的患者無顯著差異（P=0.23）。然而在生活品質衝擊面向，專科就醫者顯著較低（P=0.028）；檢驗確實度的部分，高密度脂蛋白（HDL-C）、低密度脂蛋白（LDL-C）、糖尿病相關併發症篩檢確實度也以專科較確實（P<0.05）。控制其他干擾變因後，確實檢驗神經篩檢的患者其生活品質衝擊程度較小。HbA1c 數值較高、確實末梢血管病變檢查者顯示對生活品質衝擊較嚴重。研究發現，兩科別之照護品質雖有不同，糖尿病患生活品質比較，以就診於專科的患者衝擊程度較低。

The aim of this study was to compare the difference of quality of life (QOL) between patients with type 2 diabetes cared by specialists or generalists. In this cross-sectional study, the Diabetes Quality of Life scale (DQOL) was used in Taiwanese patients who recruited from a medical center from July 2006 to September 2006. In this 202 sample, respondents ranged in age from 18 to 93 years, and there were slightly more female (53%) than males (47%), little more patients from specialists (54%) than generalists (46%). In total QOL status, there was indifferent in patients from specialists or generalists (P=0.23). However, in impact domain, QOL of patients from specialists was lower than another group (P=0.028). Besides, the checks of high-density lipoprotein cholesterol (HDL-C), high-density lipoprotein cholesterol (LDL-C), and diabetes-related complications screenings in patients from specialists were more accurate than another group (P<0.05). After adjustments of confounding factors, patients with checked neuropathy screening certainly had lower impact scores. And patients with higher HbA1c level, checked peripheral vascular screening, showed more impact on QOL. Findings provided the distinction in care quality of life from specialists or generalists and a statistical difference in impact domain of QOL, the degree of impact in patients of specialists was lower than patients who cared by generalists.