運用健康信念模式探討糖尿病前期民眾之健康飲食行為和規律身體活動行為

A Study of the Healthy Eating Behaviors and Regular Physical Activity Behaviors of Persons with Prediabetes Based on Health Belief Model

楊伊蓉(I-Jung Yang)

指導教授 ： 張媚

國立臺灣大學/醫學院/護理學研究所/碩士(2016年)

https://doi.org/10.6342/NTU201610449

摘要

背景：糖尿病多年占據十大死因第四至第五名。介入防治措施可延緩或減少糖尿病的發生。而健康信念會影響其執行健康飲食及規律身體活動行為，故而可作為設計行動方案時之參考。
目的：探討社區糖尿病前期民眾之健康信念、自我效能和行動線索與其健康飲食行為和規律身體活動行為的關係，以及這些行為與目前空腹血糖值的關係。
方法：以橫斷性研究設計方式；於新北市某行政區衛生所以立意取樣，招募空腹血糖異常民眾共129人；運用結構性問卷：「健康信念量表」、「健康行為自我效能量表」及「健康促進生活型態量表Ⅱ中文版量表」收集資料；以SPSS 22版統計軟體進行分析。
結果：本研究於2015年10月至12月收案，有效問卷125份，問卷有效率96.9%。研究發現健康信念會因部份個人特質不同而有顯著差異；健康飲食行為及規律身體活動行為皆與自我效能呈顯著正相關，與自覺障礙呈顯著負相關；逐步複迴歸分析發現，營養之自我效能、行動線索、年齡、自覺障礙及性別可解釋健康飲食行為42.0%的變異量，其中營養之自我效能為主要預測變項，可解釋23%變異量，以及運動之自我效能、曾參加運動/保健活動、自覺障礙及健檢年份可解釋規律身體活動行為50.0%變異量，其中運動之自我效能為主要預測變項，可解釋43%變異量；於2013年接受健檢者健康飲食行為及規律身體活動行為得分皆高於平均者，有較高比率的人目前空腹血糖值在100mg/dL以下。
結論：健康信念模式中之自我效能及自覺障礙可解釋糖尿病前期個案之健康飲食行為及規律身體活動行為；另外，根據研究結果提出實務之建議。

關鍵字

糖尿病前期 ； 健康信念 ； 行動線索 ； 自我效能 ； 健康飲食行為 ； 規律身體活動行為 ； 空腹血糖值

並列摘要

Background: Diabetes has been the fourth to fifth leading cause of death in Taiwan for several years. Preventive intervention can delay or reduce the incidence of diabetes. The health belief model can affect whether people engage in healthy eating and regular physical activity; therefore, it can be used to guide the design of action programmes.
Purpose: The aim of this study was to investigate the associations between health belief, self-efficacy, cues to action and healthy eating behaviors, and regular physical activity behaviors in people with prediabetes, and to investigate the associations between those behaviors and current fasting glucose level.
Methods: A cross-sectional study and purposive sampling were employed, and 129 participants with impaired fasting glucose were recruited from the Zhonghe District Public Health Center in New Taipei City. A structured questionnaire, including the Health Belief Scale, Self-Rated Abilities for Health Practices Scale, and Health Promotion Lifestyle Profile II, was used to collect data, which were analyzed using SPSS 22.0.
Results: Data were collected from October to December 2015, and 125 valid questionnaires were returned, resulting in a valid response rate of 96.9%. Some personal characteristics were found to significantly affect health beliefs. Healthy eating and regular physical activity were determined to be associated with self-efficacy (r = .48/.66, p < .01) and perceived barriers (r = −.36/−.41, p < .01). Multiple regression analysis revealed that greater diet-related self-efficacy, more cues to action, older age, fewer perceived barriers, and female sex were significantly associated with healthy eating, explaining 42.0% of the total variance; self-efficacy was the most influential variable, explaining 23.0% of the variance. Multiple regression analysis revealed that greater exercise-related self-efficacy, activity experience, fewer perceived barriers, and received examination year were significantly associated with regular physical activity, explaining 50.0% of the total variance; self-efficacy was the most influential variable, explaining 43.0% of the variance. Among the participants who had healthy eating and regular physical activity scores both higher than the means in 2013, those with a higher rate of fasting glucose exhibited a result that is less than 100 mg/dL during the current study period.
Conclusions: The self-efficacy and perceived barriers of the health belief model can explain the healthy eating and regular physical activity of those with prediabetes. In addition, suggestions for practice can be derived from the study findings.

並列關鍵字

Prediabetes ； health belief model ； cues to action ； self-efficacy ； healthy eating ； regular physical activity ； fasting glucose

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