The Impact of Learned Resourcefulness on Quality of Life in Type II Diabetic Patients: A Cross-Sectional Correlational Study

第二類型糖尿病患者習得智謀對其生活品質的影響－橫斷性相關性研究

黃瓊玉(Chiung-Yu Huang) ； 彭少貞(Shoa-Jen Perng) ； 陳秀鳳(Hisu-Fung Chen) ； 賴倩瑜(Chien-Yu Lai)

《The Journal of Nursing Research》 16卷4期 (2008/12) Pp. 264-274

摘要

糖尿病患者必須面對每日自我照顧的議題：控制血糖、預防或照顧合併症，這些議題均影響患者的生活品質。研究指出習得智謀對改善心理社會與健康問題有潛在性成效。本研究的目的在檢視第二類型糖尿病患者之習得智謀與其生活品質的關係；並探討患者控制血糖結果與生活品質的關係間，習得智謀是否有中介與緩衝效果。本研究採橫斷性、相關性研究設計，研究對象為來自台灣南部三所醫院的131位第二類型糖尿病患者。蒐集資料的工具包括羅氏(Rosenbaum)自我控制量表與世界衛生組織生活品質量表簡易版。統計方法主要採複迴歸分析生活品質的預測變項。本研究發現包括習得智謀對患者控制血糖結果與生活品質的關係有中介效果。並且大多數患者不滿意自己的生活品質，而有較多習得智謀者其生活品質較好。習得智謀、性別、醣化血色素對患者生活品質的解釋量有352%。男性較女性患者有較好生活品質，但二者在習得智謀並無顯著差異。本研究結果顯示患者血糖控制較差者不利於生活品質，運用較多的自我控制技巧者，可以有較好的生活品質。因此，建議護理人員教導糖尿病患者認知行為因應策略（習得智謀）、協助病患控制血糖，以提高其生活品質。

關鍵字

習得智謀 ； 生活品質 ； 第二類型糖尿病患者

並列摘要

It is well recognized that patients with diabetes encounter a host of daily self-care issues, including controlling blood sugar and preventing and managing complications, which impact significantly upon quality of life. Studies have indicated that learned resourcefulness has a potentially positive effect in dealing with psychosocial and health problems. The purpose of this study was to test the relationship between learned resourcefulness and quality of life in type II diabetic patients. The mediating and moderating effects of learned resourcefulness on the relationship between metabolic control and quality of life of diabetic patients was also examined. This cross-sectional and correlational study included a convenience sample of 131 type Ⅱ diabetic patients recruited from three hospitals in southern Taiwan. Data were collected through questionnaires, which included the Rosenbaum's Self Control Schedule and World Health Organization's Quality of Life (Short Version). Multiple regression techniques were used to analyze outcome predictors. Study findings include identification of a mediating effect of learned resourcefulness between metabolic control and quality of life. While most DM patients were not satisfied with their health, we found that those with greater learned resourcefulness enjoyed a better quality of life. Learned resourcefulness, gender, and HbA1C explained 35.2% of variance in DM patient quality of life. Male diabetic patients enjoyed a better quality of life than females, even though levels of learned resourcefulness between the two groups were not significantly different. Results indicate that poor metabolic control of diabetic patients has a detrimental effect on quality of life, and when diabetic patients use more self-control skills, they may achieve better quality of life. Results suggest that nurses who use cognitive behavior coping strategies (resourcefulness) may help diabetic patients achieve better metabolic control and promote better quality of life.

並列關鍵字

learned resourcefulness ； quality of life ； type Ⅱ diabetic

參考文獻

Aiken, L. S.,West, S. G.(1991).Multiple regression: Testing and interpreting interactions.Newbury Park, CA:Sage.

Bennett, J. A.(2000).Focus on research methods mediator and moderator variables in nursing research: Conceptual and statistical differences.Research in Nursing & Health.23(5),415-420.

Bloomgarden, Z. T.(2002).The epidemiology of complication.Diabetes Care.25(5),924-932.

Burke, J. P.,Williams, K.,Gaskill, S. P.,Hazuda, H. P.,Haffner, S. M.,Stern, M. P.(1999).Rapid rise in the incidence of type 2 diabetes from 1987 to 1996: Results from the San Antonio Heart Study.Archives of International Medicine.159(13),1450-1456.

Chen, H. H.,Yen, M. F.,Tung, T. H.(2001).A computer simulation model for cost-effectiveness analysis of mass screening for type 2 diabetes mellitus.Diabetes research and Clinical Practice.39(1),37-42.