機構老人遷移壓力與糖尿病血糖控制之相關因素探討

Exploring Relocation Stress and Diabetes Control in the Elderly Residents of Long-Term Care Facilities

背景：壓力與血糖控制有顯著性的正相關，但糖尿病老人在非自願性的入住機構常產生遷移壓力而導致血糖不昜控制，此相關研究卻相當缺乏。目的：在探討機構糖尿病老人遷移壓力與血糖控制及影響因素。方法：採描述相關性研究設計。以方便取樣方式選取88位南部五家醫院附設護理機構，入住一年內且診斷為糖尿病之老人。研究工具包括基本屬性問卷及遷移壓力量表。所收集資料以SPSS 18.0版進行分析。結果：非自願入住、自我照顧能力愈差、入住前有與人同住、身體健康狀況為常常生病，及憂鬱者，其入住機構後之血糖控制較差。「自我照顧能力」與「遷移壓力」為有效預測血糖控制的變項，可解釋45.7%的變異量。結論／實務應用：本研究結果可以提供醫護人員在照護新入住機構的糖尿病老人協助血糖控制及發展相關衛生教育計畫之參考。

Background: Stress and glycemic control have a significant and positive relationship. However, elderly diabetic patients who are relocated involuntarily to an institution often exhibit poor control of blood sugar. Few studies have addressed the relationship between relocation stress and diabetes control. Purpose: This study explores the relationship between relocation stress and glycemic control in seniors with diabetes in nursing homes. Method: This study used a cross-sectional descriptive correlation design with a convenience sampling method to recruit 88 elderly diabetes patients who had relocated to a nursing home within the past 1 year. The structural questionnaires used in this study adopted a personal and disease characteristics datasheet and the modified Chinese-version Relocation Appraisal Scale (RAS). SPSS (Window 18.0 version) was used for statistical analyses. Result: Those participants with diabetes who relocated involuntary, had low functional independence, lived with their family prior to admission, had poor health, or were diagnosed with depression faced a significantly higher risk of poor diabetes control. The significant predictors for diabetes control were: low functional independence and relocation stress, which accounted for 45.7% of the total variance for diabetes control. Conclusion: The result of this study may be referenced to help reduce relocation stress and help improve glycemic control in recently institutionalized seniors with diabetes.