糖尿病患支持性運動衛教成效之探討

Effects of the Supportive Exercise Teaching Program on Diabetes

本研究之目的在了解糖尿病人的運動知識及行為，並探討支持性運動衛教對糖尿病運動知識、運動行為、及血糖控制的影響。研究採單組前後測類實驗設計，以立意取樣選取有效樣本39人。以“糖尿病知識問卷”、“糖尿病行為問卷”、及抽血檢驗為工具，資料以次數分佈、百分比、配對t、及相關分析。研究結果顯示：1.糖尿病個案的運動知識、運動行為、所接受之運動衛教及有關糖尿病運動的身體評估均有不足的現象；2.支持性衛教可以增加糖尿病個案的運動知識，改善個案的運動行為；3.無論衛教前後，糖尿病個案的運動知識愈多，其運動行為也愈正確，衛教後運動行為愈正確者，其飯前血糖愈低，以上關係均達統計之意義。建議醫護人員繼續以專人專職推廣糖尿病支持性運動衛教，衛教前仔細評估病患足部及心臟的健康情況；衛教內容除告知其正確的運動方法、血糖外，還應告知其HbAlC值、自我記錄及使用血糖機的重要、運動後低血糖及心臟不適等危險現象；衛教後更應追蹤、評估、諮詢運動時所發生的問題。

The objectives of this study was to investigate the knowledge and behavior of diabetic patients and to determine the effects of a supportive exercise teaching program on increasing diabetes' knowledge, improving diabetes' behavior, and decreasing diabetes' blood sugar level. A quasi-experimental design and convenient sampling regimen were conducted in this research. 39 subjects were investigated through the Diabetes Exercise Knowledge Questionnaire, the Diabetes Exercise Behavior Questionnaire, and blood sugar analysis. Data were analyzed by frequency, percentage, paired t-test, and correlation. The results indicated that: 1. There was an insufficiency in the patients' knowledge, behavior, education, and physical assessment for the diabetic exercise; 2. The patients' knowledge, behavior; and blood sugar control improved significantly after joining the supportive teaching intervention; 3. There was a significant positive relationship between the patients' knowledge and behavior. The more the knowledge, the better the behavior. Also, the higher the patients' knowledge and behavior score, the lower their blood sugar level. This relationship was especially obvious with statistical significance after teaching. We suggest that supportive exercise teaching intervention should be conducted continuously by a diabetes education specialist. The patients' feet and hearts have to be assessed carefully by the specialist before teaching. The patients' blood sugar and HbAlC level, correct methods of exercise, using self blood sugar test by a meter, risks of hypoglycemia and heart attack after exercise are the key contents of diabetes exercise teaching. Follow up assessment and consultation of the problems related to exercise are also necessary for the diabetes exercise teaching.