糖尿病合併認知功能障礙之衛教指南發展與臨床適用性評值

Development and Clinical Applicability of an Educational Guidebook for Managing Diabetes With Cognitive Impairment

背景：糖尿病與認知障礙相關，糖尿病合併認知障礙病人通常醫療遵從性、自我照顧及決策能力較低，易導致血糖控制不良及併發症。需加強跨專業支持與資源協助，以提升照護品質並減輕家庭負擔。
目的：本研究旨在為糖尿病衛教師發展糖尿病合併認知功能障礙之衛教指南，並建立專家效度與測試臨床適用性。
方法：透過文獻回顧和前階段研究結果發展糖尿病共病認知功能障礙衛教指南，以修正型德爾菲法建立專家效度，並邀請糖尿病衛教師實際運用於糖尿病衛教後評值適用性。
結果：本衛教指南包含糖尿病與認知功能障礙介紹、給衛教師的建議、常見之護理困境與建議策略及家庭支持。其專家內容效度= 1.0，適用性評值參與衛教師有78.6%認為內容重要且清晰，質性評價亦肯定其對糖尿病衛教的實用性與幫助。
結論：本衛教指南具良好專家效度與臨床適用性，獲多數衛教師肯定，適用於糖尿病合併認知障礙者的照護。建議在糖尿病衛教師繼續教育中推廣，並根據不同機構需求調整。

Background: A correlation between diabetes and cognitive impairment is supported in the literature. People with both diabetes and cognitive impairment have on average lower medical adherence, self-care abilities, and decision-making capacity than their peers with diabetes only, often leading to poor glycemic control and complications. Enhanced professional support and resource integration are needed to improve care quality and reduce the burden of family caregivers.
Purpose: The goal of this study is to develop an educational guidebook for diabetes educators designed to improve the management of diabetes in patients with cognitive impairment and then establish expert validity and evaluate its clinical applicability.
Methods: The educational guidebook was developed based on a literature review and the findings of prior research. Expert validity was established using a modified Delphi method, and diabetes educators were invited to implement the guidebook in diabetes education to evaluate its applicability.
Results: The educational guidebook developed in this study covers an introduction to diabetes and cognitive impairment, recommendations for diabetes educators, care challenges and recommended strategies, and family support. The expert content validity score was 1.0, and 78.6% of the diabetes educators in the applicability assessment rated the content as important and clear. Furthermore, the qualitative data confirmed the guidebook as a practical and effective tool in diabetes education.
Conclusions: The developed guidebook demonstrated excellent expert validity and clinical applicability, reflecting a high level of endorsement from diabetes educators. It is well suited to addressing the challenges faced in diabetes care by patients with cognitive impairment. The guidebook should be integrated into continuing education for diabetes educators and tailored to meet the specific needs of different institutions.