伴隨糖尿病精神分裂患者衛教團體成效之初探

A Pilot Study of the Effectiveness of a Psychoeducational Group for Schizophrenic Patients with DM

精神分裂病患合併出現糖尿病時，由於其認知以及學習功能的退化，容易產生控制不良的情形。糖尿病衛教團體能協助病患獲得正確的知識及良好的自我照顧，然而有關精神分裂病患糖尿病衛教團體成效探討的研究卻明顯不足。本研究目的為探討精神分裂病患糖尿病衛教團體之實施成效，採類實驗法單組前後測研究設計。研究對象為某區域教學醫院精神科日間病房精神分裂病患合併糖尿病患者共七人，參與糖尿病衛教團體共八次。研究工具包括糖尿病自我照顧量表、糖尿病知識量表及團體滿意度量表。統計方式包括描述性統計及無母數Wilcoxon signed ranks test。結果顯示個案的糖尿病自我照顧量表分數，由前測之100.50（SD=38.63），進步為後測之121.75（SD=25.45）（z=-2.52， p=.012），糖尿病知識量表也由前測之14.60（SD=2.89），進步為後測之15.80（SD=0.84），但未達統計上之顯著差異。團體滿意度分數團體滿意度平均值為4.23（SD=0.80），介於同意與非常同意之間。本研究初探之結果可提供精神科護理人員實施及推展精神分裂合併糖尿病患者衛教團體之參考。Due to cognitive and learning dysfunction, schizophrenic patients with Diabetes Mellitus (DM) are more likely to control their DM poorly. A psychoeducational group is helpful for obtaining accurate knowledge and better self-care for schizophrenic patients with DM. However, few studies exploring the effectiveness of a psychoeducational group for schizophrenic patients with DM. The aim of this study was therefore to explore the effectiveness of a psychoeducational group for schizophrenic patients with DM. A one-group pretest-posttest study design was used for this pilot study. A convenience sampling was used to recruit 7 subjects being diagnosed with schizophrenia and comorbid with DM from the psychiatric day care in the regional hospital located in Northern Taiwan. All the subjects participated 8 sessions of a psychoeducational group. Study instruments included the Diabetes Knowledge Scale (DKS), Diabetes Self-Care Scale (DSC), and Group Satisfaction Scale (GSS). Non-parametric wilcoxon signed ranks test was used to compare differences in measures between pretest and posttest. Results revealed that scores on the DSC incraesed from pretest to posttest (mean=100.50, SD=38.63 v.s mean=121.75, SD=25.45) (z=-2.52, p=.012). Scores on the DKS also increased from pretest to posttest (mean=14.60, SD=2.89 v.s mean=15.80, SD=.84). However, this difference did not reach statistical significance. The mean score on the GSS was 4.23 (SD=0.80), which indicates that most of the group memebers rated their agreement on satisfaction between agree and agree uery much. Results from this pilot study generally supported the effectiveness of a psychoeducational group, and could be a reference for spychiatric mental health nurses of implementing a psychoeducational group for schizophrenic patients with DM.