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研究生: 練淑靜
論文名稱: 第2型糖尿病病人自我照顧行為及其相關因素之研究--以台中市某診所病人為例
指導教授: 呂昌明
學位類別: 碩士
Master
系所名稱: 健康促進與衛生教育學系
Department of Health Promotion and Health Education
論文出版年: 2008
畢業學年度: 96
語文別: 中文
論文頁數: 118
中文關鍵詞: 第2型糖尿病自我照顧行為自我效能社會支持互動關係糖化血色素
英文關鍵詞: Type 2 diabetes, self-care behavior, self-efficacy, social support, interaction, glycosylated hemoglobin (HbA1c)
論文種類: 學術論文
相關次數: 點閱:291下載:117
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  • 本研究主要目的在於探討台中市某診所之第2型糖尿病病人的自我照顧行為及其相關因素之自我效能、社會支持、與治療團隊成員之互動程度 。收案時間自民國96年7月至96年10月止,以台中市某診所加入糖尿病共同照護且接受治療團隊衛教2次(含2次)以上的第2型糖尿病病人為研究對象, 以自填式問卷方式進行資料收集,共得有效樣本190人。所得資料以單因子變異數分析、皮爾森積差相關和複迴歸等方法進行分析,主要結果如下:
    一、研究對象之自我照顧行為尚佳,其中以藥物自我照顧行為得分最高,自我監測血糖行為得分最低。
    二、研究對象之自我效能強度尚佳,其中以藥物自我效能得分最高,自我監測血糖自我效能得分最低。
    三、研究對象之社會支持程度尚可,其中以情緒性支持得分最高,實質性支持得分最低。
    四、研究對象與治療團隊成員互動尚佳,其中與護理師互動最好。
    五、在社會人口學特性及疾病狀況方面,年齡較大、已婚者、與家人同住、罹病時間較久、治療方式以注射胰島素者有較好的自我照顧行為。已婚、注射胰島素治療及有相關併發症者,其糖化血色素較低。
    六、自我效能、社會支持、與治療團隊成員中護理師互動與自我照顧行為均呈正相關,且達顯著水準。其中自我效能中的飲食效能、運動效能、藥物效能與自我監測血糖效能與相因應的自我照顧行為皆有顯著性相關。
    七、糖化血色素數值與自我照顧行為呈負相關,且達顯著水準。將自我照顧行為分為飲食行為、運動行為、藥物行為與自我監測血糖行為四項後,其中只有藥物行為與糖化血色素有顯著負相關。
    八、自我照顧行為的最佳預測因子為自我效能。

    The purpose of this study was to investigate the self-care behaviors and related factors among Type 2 diabetes patients. By using a purposeful sampling method, 190 adult diabetes patients who attend diabetes sharing care and accept more than two times of health education offer by the heath care providers team were selected to participate in this survey. The data was collected by a self-administrated questionnaire in a Taichung City clinic from July to Oct. 2007. One-way ANOVA, Pearson’s product-moment correlation and multiple regression were used to analyze the data.
    The result indicated that:
    1.The subjects’ self-care behaviors belonged moderate. In which, the highest score was medication and the lowest score was self-monitor blood glucose.
    2.The subjects’ self-efficacy belonged moderate. In which, the highest score was medication and the lowest score was self-monitor blood glucose.
    3.The subjects’ social support belonged moderate. In which, the highest score was emotional support and the lowest score was substantial support.
    4.The subjects’ had interaction with their health care providers team belonged moderate, They had best interaction with the nurses.
    5.Old age, married, lived with family, longer disease duration and use insulin treatment patients had better self-care behaviors. Married, use insulin treatment and with related complications patients had lower HbA1c level.
    6.Self-efficacy, social support, interaction between diabetes patients and their health care providers team were significantly associated with self-care behaviors. Including specific items in self-efficacy were significantly correlated with corresponding items in self-care behaviors.
    7.Glycosylated hemoglobin (HbA1c)level was negative significantly associated with self-care behaviors.
    8.Self-efficacy was the strongest predictor of self-care behaviors.

    目 次 中文摘要 …………………………………………………… I 英文摘要 …………………………………………………… II 第一章 緒論 第一節 研究動機………………………………………… 1 第二節 研究目的………………………………………… 5 第三節 研究問題………………………………………… 6 第四節 研究假設………………………………………… 7 第五節 名詞界定………………………………………… 7 第六節 研究限制………………………………………… 8 第二章 文獻探討 第一節 第2型糖尿病概述……………………………… 10 第二節 第2型糖尿病病人之自我照顧行為現況及其血糖 控制情形………………………………………… 13 第三節 第2型糖尿病病人之自我照顧行為及其相關因素 之研究…………………………………………… 20 第三章 研究方法 第一節 研究架構………………………………………… 35 第二節 研究對象………………………………………… 36 第三節 研究工具………………………………………… 37 第四節 研究步驟………………………………………… 40 第五節 資料處理與分析………………………………… 41 第四章 結果與討論 第一節 研究對象之社會人口學變項及疾病狀況分布情形 43 第二節 研究對象之自我效能、社會支持、與治療團隊 成員之互動、自我照顧行為及糖化血色素等變 項之整體趨向情形……………………………… 50 第三節 研究對象之社會人口學變項及疾病狀況分別與 自我效能、社會支持、與治療團隊成員之互動 、自我照顧行為及糖化血色素間的關係……… 63 第四節 研究對象之自我效能、社會支持、與治療團隊 成員之互動與自我照顧行為的關係…………… 80 第五節 研究對象之自我照顧行為與糖化血色素之關係 83 第六節 研究變項對自我照顧行為之預測情形………… 84 第五章 結論與建議 第一節 結論……………………………………………… 88 第二節 建議……………………………………………… 90 參考文獻..………………………………………………………. 92 附錄一 糖尿病控制自我效能、自我照顧量表使用同意書… 101 附錄二 社會支持量表使用同意書………………………… 102 附錄三 與治療團隊成員之互動量表使用同意書………… 103 附錄四 研究同意書………………………………………… 104 附錄五 預試問卷…………………………………………… 105 附錄六 正式問卷…………………………………………… 112 圖表目次 圖目次 圖3-1 研究架構…………………………………………… 35 表目次 表4-1 研究對象之社會人口學變項及疾病狀況分布情形 48 表4-2 研究對象之自我效能分布情形…………………… 52 表4-3 研究對象之社會支持分布情形…………………… 55 表4-4 研究對象與治療團隊成員之互動分布情形……… 58 表4-5 研究對象之自我照顧行為分布情形……………… 61 表4-6 研究對象之糖化血色素分布情形………………… 63 表4-7 研究對象之社會人口學變項及疾病狀況與自我效能 的變異數分析……………………………………… 65 表4-8 研究對象之社會人口學變項及疾病狀況與社會支持 的變異數分析……………………………………… 67 表4-9 研究對象之社會人口學變項及疾病狀況與治療團隊 成員互動的變異數分析…………………………… 69 表4-10 研究對象之社會人口學變項及疾病狀況與治療團隊 成員中醫師互動的變異數分析…………………… 70 表4-11 研究對象之社會人口學變項及疾病狀況與治療團隊 成員中護理師互動的變異數分析………………… 71 表4-12 研究對象之社會人口學變項及疾病狀況與治療團隊 成員中營養師互動的變異數分析………………… 72 表4-13 研究對象之社會人口學變項及疾病狀況與自我照顧 行為的變異數分析………………………………… 76 表4-14 研究對象之社會人口學變項及疾病狀況與糖化血色 素的變異數分析…………………………………… 79 表4-15 自我效能、社會支持、與治療團隊成員之互動與自 我照顧行為之相關分析…………………………… 82 表4-16 自我效能與自我照顧行為之相關分析…………… 82 表4-17 自我照顧行為與糖化血色素之相關分析………… 84 表4-18 自我照顧行為的變項之共線性診斷結果………… 86 表4-19 自我照顧行為之預測變項複迴歸分析表……

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