鄉村高齡糖尿病個案的自我管理教育

Self-Management Education in Rural Older Adults With Diabetes

糖尿病為影響民眾健康的主要慢性病之一，我國推動糖尿病共同照護網政策，提供連續性醫療照護，並提供衛生教育教導個案自主管理。然而對於醫療資源不方便的鄉村高齡糖尿病個案而言，有其障礙取得或利用服務。本文介紹台灣實施糖尿病共同照護網的現狀，參考國內外文獻，討論糖尿病個案自我管理教育與支持的概念，並提出以社區為基礎之策略，以強化糖尿病共同照護的連續性，包括（1）利用多元的服務模式提供糖尿病個案的自我管理教育；（2）增加非專業人員的訓練；（3）提供符合文化的衛教內容。

Diabetes is one of the most prevalent chronic diseases affecting public health. The Taiwan government implemented the Diabetes Shared Care Program to deliver continuous medical care and provide health education in order to help clients with diabetes learn self-management. However, rural older adults with diabetes often have poor access to medical resources and thus face obstacles to obtaining and using the services of this program. This paper introduces the current status of the Diabetes Shared Care Program, discusses the concept of self-management education and support for diabetes cases, and proposes community-based strategies, including (1) provide DSMES (diabetes self-management education and support) with multi-types of services, (2) increase non-professional personnel training, and (3) provide culture-congruent health education, in order to strengthen the diabetes selfmanagement capabilities of rural older adults.