透過您的圖書館登入
IP:54.173.214.79
  • 學位論文

第二型糖尿病患心理健康與自我效能之相關性探討

The Relationship of Mental Health and Self-Efficacy in Patients with Type 2 Diabetes Mellitus

指導教授 : 李選

摘要


糖尿病位居十大死因第四位,糖尿病患之心理健康與否已成為影響健康之危害因子,但台灣針對糖尿病與心理健康及自我效能之相關因子探討卻屬有限;研究者期望藉由剖析糖尿病患心理健康與自我效能的相關性,可作為改善其情緒困擾與健康促進之相關依據,以便能及早介入糖尿病治療工作,進而促進病患之身心健康及生活品質。 研究目的在探討第二型糖尿病患人口學變項分別與心理健康、自我效能之相關性及影響以上病患心理健康、自我效能之重要預測變項。 本研究採立意取樣,以曾氏心理健康量表與慢性疾病自我效能測量表為研究工具。取樣對象為台灣某醫學中心之新陳代謝科門診之第二型糖尿病患,未經醫師診斷有精神障礙者;有效樣本143位,取樣時間為2005年10月3日至18日。以SPSS for Windows 10.0進行百分比、平均值、標準差、皮爾森積差相關分析、獨立樣本t檢定、單因子變數分析、LSD事後比較和複迴歸分析等統計方法。 結果發現:樣本平均年齡66.02歲;其中31.5%(45人)有憂鬱情緒;有無憂鬱情緒者在年齡、婚姻狀況、家庭生活滿意度、社交生活滿意度達顯著差異;22.4%(32人)有焦慮情緒,有無焦慮情緒者在年齡、身體質量指數、是否主動尋求糖尿病相關知識達顯著差異。樣本之整體自我效能高低與空腹血糖值、教育程度、收入滿意度、家庭生活滿意度、社交生活滿意度、婚姻狀況、是否主動尋求糖尿病相關知識有顯著差異;而整體自我效能之得分與憂鬱、焦慮皆呈顯著負相關。第二型糖尿病患憂鬱狀態之最佳預測因子為年齡<45歲者、未婚或獨居者、對家庭生活不滿意者、較無法持續社交及休閒活動者、本身症狀處理能力較差者、控制管理憂鬱能力較差者,解釋變異量為50.7%;焦慮狀態之最佳預測因子為年齡<45歲者、身體質量指數標準者、空腹血糖值控制良好者、罹病時間<1年者、無法從家人朋友處獲得幫助者、本身症狀處理能力較差者、糖尿病的自我評量能力較佳者、控制管理憂鬱能力較差者,解釋變異量為45.9%;整體自我效能之最佳預測因子為較不憂鬱者、空腹血糖值控制良好與中等者、教育程度為國、高中和大專以上者、對家庭生活滿意者,解釋變異量為39.0%。 依據本研究有關第二型糖尿病患憂鬱、焦慮與自我效能之最佳預測因子,可運用於臨床護理實務促進糖尿病患治療身心疾病之重要參考依據,並提供護理教育為參考。期望藉由提升自我效能而減低自身壓力與負面情緒;增強家人支持系統建立,在生活上培養良好的健康行為,降低心理問題發生機率。進而減低國家醫療資源浪費及家人負擔。

關鍵字

糖尿病 心理健康 自我效能

並列摘要


Diabetes has been ranked fourth in the top ten causes of death in Taiwan whereas depression has been one of the three most health influential disease and the primary task of health education. Self-efficacy has been shown to be an important predictive variable in initiating and continuing management behaviors such as blood glucose control, appropriate diet and exercise. However, there are limited research examined the relationships between mental health and self-efficacy in Type 2 diabetes patients in Taiwan. Knowledge of the two variables would help provide useful information by clinical nurses and health care professionals promote a better healthy status. The purpose of this study was to explore the relationships and predictors between demographic variables, mental health and self-efficacy in a group of Type 2 diabetes patients. This study is based on a purposive sampling and cross-sectional study. The instrument used in this study included demography data, Zeng’s psychology scale, and chronic disease self-efficacy scale. Data were collected based on the questionnaires completed by the outpatient’s participants from Endocrinology and Metabolism at one selected medical center, whose ages are over 18, were diagnosed as Type 2 diabetes and with no physician-diagnosed mental disorder from Oct. 3rd to Oct. 18th, 2005. Of 145 participants, a total of 143 participants completed validated questionnaires. All data were processed and analyzed using the SPSS for Windows 10.0. Statistic methods included mean, percentile, independent sample t-test, paired t-test, chi-square, and multiple-regression. The study population had a mean age of 66.02 years. 31.5% (45 people) of them reported depression, and there were significant differences on ages, marital status, satisfaction for family life and social life. 22.4% (32 people) reported anxiety, and there were significant differences on ages, whether or not actively seeking diabetes related information and BMI. Analyses revealed that self-efficacy was significantly related to marital status, whether or not actively seeking diabetes related information,level of blood sugar, education, income satisfaction, satisfaction for family life and social life. Results demonstrate a negative relationship between depression and self-efficacy. The best predictors for depression of Type II diabetes are age (<45 year-old), marital status, satisfaction for family life and social life, self-management, depression control and management which explained 50.7% of the variability. The best predictor factors for anxiety of Type II diabetes are age (<45 year-old), BMI,level of blood sugar, history of diabetes (less than 1 year), regularize exercise assessment, self-management, self-evaluation, and depression control and management which explained 45.9% of the variability. The best predictor factors for self-efficacy are depression, level of blood sugar, education, whether or not actively seeking diabetes related information, and satisfaction for family life which explained 39.0% of the variability. Based on the results, the related predictors for depression, anxiety and self-efficacy of Type II diabetes patients can be used for practicing, and it can be the guideline for the nursing education as well. The results can assist nurses to develop an appropriate health care plan and health education for Type II diabetes patients. Through the early intervention by clinical nurses and community resource, it will develop a better support system and health life behaviors to assist to decrease the rate of depression for Type 2 diabetes patients as well as make the best use of the national medical resources.

參考文獻


黃俊仁、楊明仁(2004).糖尿病照護之心理社會探討.安泰醫護雜誌,10(3), 111-115。
行政院衛生署(2004).衛生統計(二)—生命統計.台北行政院衛生署。
方文輝、羅慶幑 (2005).常見疾病與憂鬱症.當代醫學,32(6),483 -488。
施春華、侯淑英、楊明仁、張麗珍、張自強、黃俊仁 (2005).社區老人憂鬱症狀的流行病學及活動參與介入之成效.實證護理,1(1),29-34。
鄭素月、賴裕和、張利中、吳齊殷(2002) .探討乳癌病人的症狀困擾、自我 效能、社會支持與生活品質之關係.新台北護理期刊,4(1),9-21。

被引用紀錄


陳麗君(2009)。高中生幸福感與自我效能關係之研究---以桃園縣公立高中為例〔碩士論文,中原大學〕。華藝線上圖書館。https://doi.org/10.6840%2fcycu200900694

延伸閱讀