第二型糖尿病個案情緒困擾、賦權感受、自我照顧行為與生活品質關係之探討

Relationships Between Emotional Distress, Empowerment Perception and Self-Care Behavior and Quality of Life in Patients With Type 2 Diabetes

背景：糖尿病是全球廣泛盛行的慢性疾病，不僅造成醫療費用負擔，更衝擊糖尿病個案的生活品質，因此了解影響糖尿病個案生活品質的相關因素是極重要的。目的：本研究目的在探討第二型糖尿病個案個人特性、疾病特性、情緒困擾、賦權感受、自我照顧行為與生活品質間之相關性及影響生活品質之重要解釋因子。方法：採橫斷性、描述性相關性研究設計，以診斷期十年內之220位糖尿病個案為研究對象，以個人與疾病特性、情緒困擾、賦權感受、自我照顧行為與生活品質等量表進行資料收集，其中生活品質量表分別測量滿意度、衝擊與糖尿病的擔憂層面之生活品質。結果：研究結果發現：(1)研究對象生活品質得分指標為79.6，呈中上程度；(2)不同教育程度、年齡、有無加入共同照護網與使用胰島素在生活品質上有顯著差異；(3)情緒困擾越嚴重，各層面生活品質越差；(4)個案賦權感受程度越好，生活品質滿意度越好；(5)自我照顧行為越好，滿意度生活品質越佳；(6)情緒困擾為生活品質最重要的解釋因子，可解釋28.7%至53.8%之變異量。結論：實務應用建議專業醫療人員早期評估糖尿病個案情緒困擾問題，提供情緒支持與諮詢，並應用賦權策略，提昇個案生活品質。

Background: Diabetes mellitus is a chronic disorder prevalent worldwide that, in addition to being costly to manage, severely impacts patient quality life. Therefore, it is extremely important to understand the factors associated with quality of life in diabetic patients. Purpose: The purposes of this study were to investigate relationships between variables including demographics, disease characteristics, emotional distress, empowerment perception, and self-care behavior and quality of life, as well as to identify the important explanatory factors of quality of life in patients with type 2 diabetes. Methods: This study used a design that was cross-sectional, descriptive and correlated. A total of 220 patients diagnosed with type 2 diabetes in the previous ten year period were recruited as participants in this study. Data was collected using a structured questionnaire that incorporated scales to capture demographic, disease characteristic, emotional distress, empowerment perception, self-care behavior and quality of life data. The quality of life scale measured the three domains of satisfaction, impact, and worried about the diabetes. Results: Results included: (1) the standardized score of quality of life was 79.6, considered in the moderate to high range; (2) Education level, age, “diabetes shared care” participation and insulin therapy were variables with significant impact upon quality of life; (3) The more severe the emotional distress, the worse quality of life scores were in every domain; (4) The better the perception of empowerment, the better the score in the satisfaction domain; (5) The better self care behavior was, the better the score in the satisfaction domain; and (6) emotional distress was the most important explanatory factor of quality of life, accounting for 28.7%-53.8% of total variance. Conclusion / Implications for practice: The findings of this study suggested that health professionals should evaluate emotional distress of diabetic patients in the early stage, provide emotional support and consultation and apply empowerment strategy to promote their quality of life.