多媒體衛教，對第2型糖尿病病人筆型胰島素注射技術之成效

Multimedia Health Education on Insulin Injection Skills for Patients With Type 2 Diabetes

背景：多媒體衛教可以提升病人的自我照顧行為，然而多媒體衛教對第2型糖尿病病人注射技術之長期成效的相關研究闕如。 目的：探討多媒體衛教對第2型糖尿病病人的胰島素注射技術、糖化血色素和護理時數之成效。 方法：採隨機對照試驗和重覆測量的研究設計，以72名第2型糖尿病病人初次接受Lantus、Levemir和Novomix藥物之筆型注射器為研究對象；36名接受多媒體衛教，36名接受常規衛教，以結構性問卷、記錄表和手機攝影為研究工具。 結果：研究結果顯示實驗組在裝置新針頭、排氣、轉取藥物劑量、選擇注射部位（腹部、大腿、手臂和臀部）和正確注射等步驟優於對照組；兩組在出院後十三週（T5）的糖化血色素沒有顯著差異；實驗組接受注射衛教的時間是對照組0.38倍。 結論：多媒體衛教不僅可以提升病人居家注射胰島素的技術正確性，而且節省衛教時間。本研究結果可以提供各醫療機構在進行筆型胰島素注射衛教時之參考。

Background: Multimedia health education may be applied to improve self-care behaviors in patients. However, the long-term effects of multimedia health education on insulin injection performance have been insufficiently studied. Purpose: To evaluate the effect of a multimedia insulin pen-injector health education intervention on patients in terms of their insulin injection skills and glycated hemoglobin level and the time spent by nurses on insulin injection education. Methods: Using a randomized controlled trial and two-group repeated-measures study design, patients with type 2 diabetes who were novice users of a Lantus, Levemir, or Novomix pen injector were recruited. A total of 72 patients, comprising 36 in a control group and 36 in an experimental group, participated in the study. The participants’ injection skills were photographed using a smart phone. Results: Patients in the experimental group earned higher scores for attaching a new needle, removing air bubbles, selecting the required dose, selecting a suitable injection site (abdomen, arms, thigh, or buttocks), and injection performance skills than those in the control group. However, no significant differences were found between the two groups in terms of HbA1c levels at 13 weeks after discharge. The time spent by nurses on delivering health education to the experimental group was 0.38 times that of the time spent on the control group. Conclusion: Multimedia health education may not only enhance patients’ self-injection skills but also save on human resources and nursing hours. The findings of this study may provide references for healthcare providers in educating patients with diabetes regarding self-administering insulin pen injections.