糖尿病病人自我照護行為及相關因素研究

A Study on Self-Care Behaviors and Related Factors in Diabetes Patients

背景：糖尿病自我照護行為是糖尿病醫療照護中最重要的一環，然而，糖尿病共同照護網之糖尿病病人執行自我照護行為的研究卻很少見。目的：以健康信念模式瞭解糖尿病病人執行自我照護行為與相關因素。方法　採橫斷式研究設計，以方便取樣，選取宜蘭縣某區域教學醫院165位糖尿病共同照護網之第2型糖尿病病人為研究對象。以糖尿病知識量表、糖尿病健康信念量表、糖尿病行動線索量表、糖尿病自我效能量表、糖尿病自我照護行為量表進行問卷調查。以皮爾森積差相關、複迴歸分析等進行統計分析。結果　糖尿病自我照護行為的得分百分比為62.93%，其中以藥物行為最好、血糖監測行為最差。糖尿病健康信念以行動利益性認知得分最高、行動障礙性認知得分最低。藥物治療方式、加入糖尿病共同照護網時間、糖尿病行動線索、年齡及糖尿病自我效能，是影響糖尿病自我照護行為的重要因素，解釋變異量為20.2 %。結論／實務應用　糖尿病衛教人員宜重視糖尿病共同照護網病人之自我照護行為及相關因素，本研究結果可提供醫護人員日後擬定糖尿病健康照護計畫及介入研究之參考。

Background: The self-care behaviors of patients with diabetes represent the most important part of diabetic healthcare. However, few studies have investigated the self-care behaviors of diabetes patients in the context of diabetes shared care networks. Purpose: The present study applied a health belief model to determine the self-care behaviors of diabetes patients and the related factors affecting those behaviors. Methods: A cross-sectional approach and convenience sampling were employed. A questionnaire survey was completed by 165 patients with type 2 diabetes in a diabetes shared care network of a teaching hospital in Yilan County, Taiwan. The questionnaire comprised scales including knowledge, health beliefs, cues to action, self-efficacy, and self-care behavior for diabetes. The collected data were analyzed using the Pearson product-moment correlation and multiple regression analysis. Results: The percentage of accomplishment of diabetes self-care behavior was 62.93%, with taking medication achieving the highest rate of compliance and monitoring blood sugar achieving the lowest rate of compliance. On the diabetes health belief scale, the perceived benefits of taking action scored the highest and the perceived barriers to taking action scored the lowest. Medical treatment, duration of joining the diabetes shared care network, cues to action, age, and self-efficacy were the most important factors of influence in self-care behavior, accounting for 20.2% of total variance. Conclusion / Implications for Practice: Diabetes health educators should pay attention to factors that affect the self-care behaviors of patients receiving diabetes shared care. The results of the present study provide healthcare professionals with information that may be used to develop better healthcare and suggests further research on diabetes interventions.