運用跨理論模式探討認知行為教育課程介入對第二型糖尿病患者運動階段、運動自我效能及血糖控制之影響

The Impact of Cognitive-Behavioral Education Courses (CBEC) on Stage of Exercise, Exercise Self-Efficacy, and Blood Glucose Control among Type 2 Diabetes Patients: Applying Transtheoretical Model

李書芬(Shu-Fen Lee) ； 紀玫如(Mei-Ju Chi) ； 鄭綺(Chii Jeng)

《新臺北護理期刊》 17卷1期 (2015/03) Pp. 21-31

https://doi.org/10.6540/NTJN.2015.1.003

摘要

糖尿病是21世紀罹患率及死亡率增加最快速的慢性病，推動糖尿病衛教課程介入是公共衛生的一大課題。本研究目的在探討｢認知行為教育課程｣介入對運動階段、運動自我效能及血糖控制之影響。採單組前後測設計，自北區某醫院新陳代謝門診，招募運動階段處於「意圖前期」及「意圖期」之第二型糖尿病患者共67位，參與四週共12小時認知行為教育課程。結果顯示，認知行為教育課程介入後個案空腹血糖（t=4.286，p＜.001）及糖化血色素（t=3.978，p＜.001）均顯著改善，自我效能總分顯著提高（t=4.741，p＜.001）。有86.5%個案（58人）進階到下一運動階段。本研究結果支持四週認知行為教育課程，除了對個案血糖控制有改善外，亦能提升其運動行為。

關鍵字

認知行為教育課程 ； 運動階段 ； 第二型糖尿病

並列摘要

Diabetes mellitus is the most rapid increasing chronic disease in the morbidity and mortality in the 21^st century. Implementation of Health education of diabetes plays a major role in prevention and management of diabetes. The purpose of this study is to explore the impact of applied Cognitive-Behavioral Education Courses on exercise behavior, exercise efficacy, and glucose control among type 2 diabetics. A total of 67 Type 2 diabetic patients who met the ＂pre-contemplation＂ and ＂contemplation stages of exercise were recruited from department of endocrine at a teaching hospital in the north of Taiwan .One-group pre-post test design, with four weeks on Cognitive-Behavioral Education Courses (CBEC) was selected. The results showed fasting glucose (t=4.286, p=.001) and HbA1c (t=3.978, p=.001) significantly improved after 4 week education. Also, the total scores of exercise self-efficacy significantly increased (t=4.741, p＜0.001). Thus, 86.5% of patients moved into an advanced exercise stage. The findings supported the CBEC. It not only had potential specific effects on glucose control, but also had promoted the exercise behavior among sedative diabetes groups.

並列關鍵字

Cognitive-Behavioral Education Courses (CBEC) ； Exercise stage ； type 2 diabetics

參考文獻

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中華民國糖尿病衛教學會（2010a）‧糖尿病臨床照護指引2010‧臺北：中華民國糖尿病學會。

中華民國糖尿病衛教學會（2010b）‧糖尿病衛教核心教材‧臺北：中華民國糖尿病學會。

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全民糖尿病觀測站（2013）‧Low adherence to diet and exercise changes in type 2‧取自 http://www.diabetes.org.tw/epaper20131229.htm