門診糖尿病患之醫療信念、醫療行為與血糖控制之相關性研究

本研究旨在探討門診糖尿病患者的醫療信念、醫療行為與血糖控制的相關性。採橫斷性研究設計，以南部某市立中醫醫院與某區域西醫醫院在門診接受治療之糖尿病患者為研究對象，共收案151位。研究工具採結構式問卷，內容包括四個部份：個案基本資料、飲食控制與規律運動行為量表、中西醫療信念量表、糖尿病病患接受中、西醫療之行為及疾病控制問卷，將所收集的資料以SPSS for Windows 10.0 版統計套裝軟體進行統計分析。主要結果如下：(1) 研究對象之「中醫優勢信念」得分指標為70.29分，「西醫優勢信念」之得分指標為73.90分，顯示民眾對中西醫療的看法存在著某種固定的信念。(2) 151位研究對象中有43.05 %目前採用中西醫合併治療，個案複向求醫的比率相當高，尤其是中醫門診的糖尿病病患較偏向複向求醫（72.15%）。(3) 研究對象在剛開始罹患糖尿病時，以採用西醫治療最多(80.79%)。(4) 研究對象糖化血色素平均值為7.8 %，血糖控制有64.9% 屬於控制尚可至良好的情形。(5) 研究對象之「中西醫療信念」可以有效預測與解釋「中西醫療行為」的採用。(6) 目前採用「中西醫合併醫療」的個案其血糖控制優於單獨採用「中醫醫療」者。(7) 飲食控制、年齡、罹病年數與中西醫合併醫療是第二型糖尿病患者糖化血色素值的重要預測因子，可解釋糖化血色素值總變異數的22 %。本研究結果可瞭解影響門診糖尿病患者血糖控制的相關因素，可提供衛生單位作為制定糖尿病病患照護政策、衛教政策之參考。

關鍵字

醫療信念；醫療行為；血糖控制

並列摘要

The purpose of this study was to explore the relationship among medical beliefs, medical behavior, and glycemic control in Diabetes patients at the out-patient department. This is a cross-sectional and correlational study using a convenience sampling. Data were collected from a regional teaching hospital and a Municipal Chinese medical hospital in southern Taiwan. 151 diabetes patients participated in the study. A structured questionnaire and face to face interview used to collected data. The questionnaire was constructed for this study including personal information, the diet and exercise self-care behavior scale, the Chinese-Western medical beliefs Scale, the condition of medical behavior and glycemic control. The data was analyzed by using SPSS 10.0 for window. The result of this study were found as follows mainly: (1) The standardized score of Chinese medicine superior beliefs on patients with diabetes mellitus at the outpatient was 70.29 and Western medicine superior beliefs was 73.90. (2) 43.05 % of patients used combined Chinese/Western medicine treatment. (3) 80.79% of patients used Western medicine treatment of newly diagnosed with diabetes mellitus. (4) The mean value for HbA1c was 7.8 %, and 64.9% of the patients belonged to moderate to well controlled group. (5) The beliefs in Chinese/Western medicine, influence patients’ choice of Chinese/Western medicine. Patients who used Chinese medicine and combined Chinese/Western medicine were found to have a strong belief in traditional Chinese medicine. (6) Patients who used combined Chinese/Western medicine had a lower HbA1c value than patients used Chinese medicine only. (7)using a multiple stepwise regression analysis, diet self-care, age, duration of DM, and used combined Chinese/Western medicine are the four significant predictable variables of glycemic control, and these four variables were found to explain 22% variance of HbA1c level. The results of this study can not only provide a reference for diabetes patients’ health education and related research, but also provide a guidelines for the medical care of diabetes patients in the future.