以專案提昇門診糖尿病病患胰島素注射治療之接受度

Promoting the Decision to Start Insulin Therapy in Type 2 Diabetic Patients

張秋純(Chiu-Chun Chang) ； 陳鈺如(Yu-Ju Chen)

《中山醫學雜誌》 20卷2期 (2009/12) Pp. 233-245

https://doi.org/10.30096/CSMJ.200912.0011

摘要

根據早期接受胰島素注射治療，能有效穩定血糖，台灣地區臨床上卻只有約12%的糖尿病患使用胰島素治療，故本專案旨在提升某單位糖尿病患者胰島素注射治療接受度，以穩定血糖及預防合併症發生。本專案於2007年3月31日至9月14日針對中部某醫學中心新陳代謝科門診第二型糖尿病且糖化血色素＞8%之患者為對象，以面對面訪談進行前後測認知內容調查，發現病患拒絕胰島素注射的原因包括：害怕打針、擔心成癮、害怕影響作息等。經座談會方式進行衛教說明及實務操作注射步驟後，胰島素注射治療接受度由37.5%提升為92.5%。本專案之實施，不但提升其胰島素注射治療接受度，也提升糖尿病患對疾病控制意識，強化自我照顧的行動，對糖尿病患確有實質上的幫助。

關鍵字

第二型糖尿病 ； 胰島素治療

並列摘要

Early initiation of insulin can improve blood sugar control and reduce chronic complications. However, only 12% of drug-treated type 2 diabetic patients received insulin. In this project, we implemented an educational program which involved revising our current educational program and show patient the steps to self-injection to encourage the decision to start insulin therapy in type 2 diabetic patients. To do this, we recruited subjects diagnosed with DM defined as HbA1C ＞8% at our medical center between Mar. 31 2007 to Sep. 14 2007. The subject were interviewed face-to-face to collect pre/post cognition data. We learned reluctance to initiate insulin injection was related to a lack of understanding of insulin therapy, fear of needles, fear of side effects associated with injections, and addiction to insulin. Post assessment revealed that the ratio had increased from 37.5% to 92.5%. In conclusion, type 2 Diabetic patients' decision to start insulin therapy earlier can be promoted by cultivating proper beliefs through education and self-care training.

並列關鍵字

Type 2 diabetes mellitus ； insulin therapy