飲食份量拼圖介入對糖尿病患飲食控制之成效探討

Effi cacy of Diet Portion Mapping Intervention on Dietary Control in Patients with Type 2 Diabetes Mellitus

目的：現行糖尿病飲食衛教在飲食份量和飲食代換的教材對個案來說是抽象且不易理解的，為改善飲食衛教的成效，研究者研發飲食份量拼圖，並取得專利，將飲食份量與代換具象化且易於操作的拼圖，實際應用於第二型糖尿病患，並探討成效。方法：本研究採類實驗研究法，以台中某基層診所第二型糖尿病患為對象，進行立意取樣，並隨機分為實驗組及對照組各30 名。實驗組以飲食份量拼圖為工具，進行為期12 週之介入；對照組接受糖尿病醫療品質照護改善方案照護，以糖尿病飲食問卷評量了解介入成效。結果：實驗組對糖尿病飲食份量和代換等知識63.4 分顯著高於對照組49.1 分（p < .05）；實驗組對糖尿病飲食控制的態度85.9 分顯著高於對照組80.8 分（p< .05），實驗組對飲食代換、分配等行為 81.1 分顯著高於對照組67.5 分（p <.05）。糖化血色素實驗組介入前、後，由7.58±1.40 降至7.14±1.00，達顯著差異（p < .05），對照組則無顯著差異。結論：研究結果顯示飲食份量拼圖在介入後，實驗組在糖尿病控制的知識、態度、行為和糖化血色素的控制均顯著優於對照組。此結果可提供未來臨床衛教之參考。

Objectives: Currently, the materials involving portions and exchanges in diabetes dietary education are abstract and difficult to comprehend. To improve the efficacy of dietary education, a fi gurative and easy-to-use dietary portion mapping was designed. Moreover, a patent was registered on the design, then the design was applied to type 2 diabetes mellitus. The purpose of this research is to explore the effi cacy of dietary portion mapping. Methods: Research design and methods were purposive sampling and quasi-experimental methods. Sixty volunteers were recruited to participate in this study from a clinic in Taichung City, and divided into experimental and control groups by random assignment. There were 30 patients in each group. The experimental group followed dietary portion mapping for 12 weeks. The control group had access to regular primary care. A diabetic dietary KAP questionnaire was the assessment tool used to evaluate the effi cacy of the intervention. Results: The knowledge score was 63.4 in the experimental group and 49.1 in the control group (P < .05). The attitude score was 85.9 in the experimental group and 80.8 in the control group (P < .05). The practice score was 81.1 in the experimental group and 67.5 in the control group (P < .05). The HbA1C was improved in the experimental group.The average HbA1c was reduced from 7.58 ± 1.40 to 7.14 ± 1.00 (P < .05) in the experimental group, but there was no signifi cant difference in the control group (P > .05). Conclusion: The intervention was effective with respect to knowledge, attitude, and practice of dietary control, and HbA1C control in the experimental group. The implication of this research can provide a reference for diabetes dietary education in the future.