比較不同衛教工具對第二型糖尿病患者疾病控制：初探實驗性研究

Comparison of Different Educational Tools on Disease Control in Patients with Type 2 Diabetes: A Preliminary Experimental Study

目的：本研究主要比較食物九宮格與傳統紙本營養衛教工具介入，對參與者糖尿病營養知識、飲食行為、糖尿病自我管理及血糖控制之影響。方法：採初探實驗性研究設計，收案條件為HbA1C≧7.5%之第2型糖尿病的病患，最終共收60人。運用單盲隨機分配至實驗組及控制組，營養師給兩組相同衛教內容，每月一次平均約30-60分鐘，共三次，實驗組使用食物九宮格衛教工具；控制組用傳統紙本衛教工具，以血糖為指標，亦收集糖尿病營養知識、糖尿病自我管理及飲食行為等量表，運用SPSS Statistics.22版進行資料分析。結果：實驗組在血糖控制（空腹血糖及糖化血色素）比控制組顯著進步，經詹森－內曼法分析，前測之糖化血色素>8.43%時，組間才達顯著性差異(p<0.05)。另外，兩組在知識、行為及自我管理無顯著差異，但實驗組之糖尿病自我管理進步幅度優於控制組。結論：新型「食物九宮格」的衛教模式可達成較佳的血糖控制，可能是經由遊戲式衛教模式，達到較佳的糖尿病自我管理，進而達到較佳血糖控制的目標。

Objectives. This study aimed to compare the effects of the ''9-grid diet'' and paper-based educational tool on participants' nutritional knowledge, self-management, dietary behavior and blood sugar control.
Methods. The preliminary experimental research design was conducted to recruit participants who had the diagnosis of Type 2 diabetes and HbA1C≧7.5%. A total of 60 people was assigned to experimental and control groups using single blind randomized controlled technique. Dietitians gave the same contents of nutritional education to both groups with an average duration of 30-60min/per month for three months. The ''9-grid Diet'' educational tool was applied in the experimental group and traditional paper-based educational tool was applied in the control group. The indicators included blood glucose and scales such as diabetic nutritional knowledge, diabetic self-management and diabetic dietary behavior using SPSS Statistics.22 version of statistical software for data analysis.
Results. The findings showed the experimental group has significantly improved blood glucose control (fasting blood glucose and glycosylated hemoglobin) than the control group. Using Johnson-Neyman method to analysis, when the pre-test of glycated hemoglobin was>8.43%, a significant difference was found between groups (p<0.05). Although there was no significant difference between two groups in terms of knowledge, behavior and self-management, but the experimental group had better diabetic self-management than the control group.
Conclusion. A new educational tool of the ''9-grid Diet'' to improve participants’blood sugar control may come from the game-style health education model by achieving better self-management, and then achieve the goal of better blood sugar control in diabetes.