Title

第II型糖尿病病人身體活動與生活品質之探討

Translated Titles

Physical Activity and Quality of Life in Patients With Type II Diabetes Mellitus

DOI

10.6224/JN.201904_66(2).08

Authors

賴郁菁(Yu-Chin LAI);廖媛美(Yuan-Mei LIAO);林碧珠(Pi-Chu LIN)

Key Words

第II型糖尿病 ; 身體活動 ; 生活品質 ; type II diabetes ; physical activity ; quality of life

PublicationName

護理雜誌

Volume or Term/Year and Month of Publication

66卷2期(2019 / 04 / 01)

Page #

57 - 66

Content Language

繁體中文

Chinese Abstract

背景:第II型糖尿病為國人常見慢性疾病,影響病人的生活品質,成為健康領域中重要議題。目的:探討第II型糖尿病病人身體活動、生活品質之現況及生活品質之預測因子。方法:本研究為橫斷式研究,於2014年1月至10月在台北市某區域教學醫院採方便取樣,共收案100位第II型糖尿病病人。以七日身體活動回憶量表及SF-36生活品質量收集資料。結果:(1)有42%的研究對象在過去7日沒有運動習慣,以輕度活動為主。(2)病人的生活品質屬中等程度,病人年齡(r = -.231, p < .05)、教育程度(r = .279, p < .01)和生理面向生活品質有顯著相關。HbA1c值高於6.5%的病人比低於6.5%者在生理面向(t = -2.595, p < .05)及心理面向(t = -2.522, p < .05)生活品質顯著較差。(3)糖尿病住院次數(r = -.256, p < .05)、有無合併其他疾病(t = 3.29, p = .042)與生理面向生活品質有顯著相關。(4)身體活動與心理健康呈顯著負相關(r = -.205, p < .05),身體活動與生活品質其餘構面均沒有顯著相關性(p > .05)。(5)因糖尿病住院次數是生活品質之顯著預測因素,可解釋14.5%的生理面向生活品質,可解釋5.5%心理面向生活品質。結論/實務應用:當病人血糖得到良好的控制可擁有較好的生活品質,本研究結果可提供臨床參考。

English Abstract

Background: Type II diabetes, a major healthcare issue, is a common chronic disease in Taiwan that affects the quality of life of sufferers. Purpose: To understand the physical activity status and the quality of life of patients with type II diabetes mellitus and to explore the related predictors of quality of life. Methods: This cross-sectional study used convenience sampling to collect relevant data between January to October 2014 from a regional teaching hospital in Taipei. One hundred patients with type II diabetes were included as participants. The seven-day physical activity recall scale and the SF-36 were used to collect data. Result: (1) Forty-two percent of the participants had engaged in no habitual exercise during the prior seven days and had engaged primarily in mildly strenuous activities. (2) The quality of life of the participants was moderate. Patient age (r = −.231, p < .05) and education level (r = .279, p < .01) were significantly correlated with the physical component of quality of life. A significant difference was found between levels of HbA1c and the physical (t = -2.595, p < .05) and mental (t = -2.522, p <.05) components of quality of life. (3) The number of hospitalizations attributable to diabetes (r = -.256, p < .05) and diabetes with a comorbidity (t = 3.29, p = .042) were significantly associated with the physical component of quality of life. (4) Physical activity was significantly and negatively correlated with the mental component of quality of life (r = -.205, p <.05), but physical activity was not significantly correlated with the other components of quality of life (p > .05). (5) The number of hospitalizations due to diabetes was a significant predictor of quality of life, explaining 14.5% and 5.5% of the physical and mental components of quality of life, respectively. Conclusion: Good control of blood glucose was shown to promote quality of life in the type II diabetes mellitus patients in this study. The findings may be referenced and applied in clinical practice.

Topic Category 醫藥衛生 > 預防保健與衛生學
醫藥衛生 > 社會醫學
Reference
  1. 吳治翰、陳豐慈、齊 璘、張育愷(2016).身體活動與創造力關聯之初探.運動教練科學,43,97–106。[Wu, C. H., Chen, F. T., Chi, L., & Chang, Y. K. (2016). A preliminary review on the association between physical activity and creativity. Sports Coaching Science, 43, 97–106.] https://doi.org/10.6194/SCS.2016.43.10
    連結:
  2. 林佑真、溫啟邦、衛沛文(2007).台灣地區成年人之休閒運動行為與健康行為、健康狀況、健康相關生活品質之關係探討.台灣公共衛生雜誌,26(3),218–228。[Lin, Y. C., Wen, C. P., & Wai, P. M. (2007). Leisure-time physical activity and its association with health behaviors, health status and health-related quality of life among Taiwanese adults. Taiwan Journal of Public Health, 26(3), 218–228.] https://doi.org/10.6288/TJPH2007-26-03-06
    連結:
  3. 徐錦興、曹德弘、張蕙雯(2010).運用劑量反應關係解釋老年糖尿病患者之身體活動與糖化血色素控制.嘉大體育健康休閒期刊,9(2),221–228。[Hsu, C. H., Tsao, T. H., & Chang, H. W. (2010). Using dose-response relationships explains physical activity and glycated hemoglobin control in elderly diabetics. Chiayi University Physical Education, Health & Recreation Journal, 9(2), 221–228.] https://doi.org/10.6169/NCYUJPEHR.9.2.23
    連結:
  4. 張祐華、林貴福、盧淑雲(2018).高強度間歇運動對II型糖尿病血糖調控的影響.中華體育季刊,32(1),53–61。[Chang, Y. H., Lin, K. F., & Lu, S. Y. (2018). The impact of high intensity interval training on the blood glucose regulation of type 2 diabetes. Quarterly of Chinese Physical Education, 32(1), 53–61.] https://doi.org/10.3966/102473002018033201006
    連結:
  5. 曾旭民、盧瑞芬、蔡益堅(2003).國人生活品質評量(II):SF-36台灣版的常模與效度檢測.台灣公共衛生雜誌,22(6),512–518。[Tseng, H. M., Lu, J. F. R., & Tsai, Y. J. (2003). Assessment of health-related quality of life in Taiwan (II): Norming and validation of SF-36 Taiwan version. Taiwan Journal of Public Health, 22(6), 512–518.] https://doi.org/10.6288/TJPH2013-22-06-10
    連結:
  6. 趙明玲、林怜利、余秋霖、方郁文(2007).有氧運動訓練對台灣第二型糖尿病中老年患者的血液生理指標及體適能之影響.實證護理,3(1),27–34。[Chao, M. L., Lian, L. L., Yu, C. L., & Fang, Y. (2007). The effect of aerobic exercise training on blood indicators and physical fitness in middle-aged and older people with type 2 DM. Journal of Evidence-Based Nursing, 3(1), 27–34.] https://doi.org/10.6225/JEBN.3.1.27
    連結:
  7. 盧瑞芬、曾旭民、蔡益堅(2003).國人生活品質評量(I):SF-36台灣版的發展及心理計量特質.台灣公共衛生雜誌,22(6),501–511。[Lu, J. F. R., Tseng, H. M., & Tsai, Y. J. (2003). Assessment of health-related quality of life in Taiwan (I): Development and psychometric testing of SF-36 Taiwan version. Taiwan Journal of Public Health, 22(6), 501–511.] https://doi.org/10.6288/TJPH2013-22-06-09
    連結:
  8. 薛名淳、廖 邕、黃品瑄、張少熙(2017).高齡者久坐行為與健康之文獻回顧.台灣公共衛生雜誌,36(4),337–349。[Hsueh, M. C., Liao, Y., Huang, P. H., & Chang, S. H. (2017). A review of sedentary behavior and health in older adults. Taiwan Journal of Public Health, 36(4), 337–349.] https://doi.org/10.6288/TJPH201736106024
    連結:
  9. American Diabetes Association. (2018). 7. Obesity management for the treatment of type 2 diabetes: Standards of medical care in diabetes—2018. Diabetes Care, 41(1, Suppl.), S65-S72. https://doi.org/10.2337/dc18-S007
    連結:
  10. Aune, D., Norat, T., Leitzmann, M., Tonstad, S., & Vatten, L. J. (2015). Physical activity and the risk of type 2 diabetes: A systematic review and dose–response meta-analysis. European Journal of Epidemiology, 30(7), 529–542. https://doi.org/10.1007/s10654-015-0056-z
    連結:
  11. Bize, R., Johnson, J. A., & Plotnikoff, R. C. (2007). Physical activity level and health-related quality of life in the general adult population: A systematic review. Preventive Medicine, 45(6), 401–415. https://doi.org/10.1016/j.ypmed.2007.07.017
    連結:
  12. Chao, M., Wang, C., Dong, X., & Ding, M. (2018). The effects of Tai Chi on type 2 diabetes mellitus: A meta-analysis. Journal of Diabetes Research, 2018, Article ID 7350567. https://doi.org/10.1155/2018/7350567
    連結:
  13. Chew, B. H., Mohd-Sidik, S., & Shariff-Ghazali, S. (2015). Negative effects of diabetes–related distress on health-related quality of life: An evaluation among the adult patients with type 2 diabetes mellitus in three primary healthcare clinics in Malaysia. Health and Quality of Life Outcomes, 13, 187. https://doi.org/10.1186/s12955-015-0384-4
    連結:
  14. Emadian, A., & Thompson, J. (2017). A mixed-methods examination of physical activity and sedentary time in overweight and obese south Asian men living in the United Kingdom. International Journal of Environmental Research and Public Health, 14(4), 348. https://doi.org/10.3390/ijerph14040348
    連結:
  15. Evenson, K. R., Wen, F., Metzger, J. S., & Herring, A. H. (2015). Physical activity and sedentary behavior patterns using accelerometry from a national sample of United States adults. International Journal of Behavioral Nutrition and Physical Activity, 12, 20. https://doi.org/10.1186/s12966-015-0183-7
    連結:
  16. Graham, J. E., Stoebner-May, D. G., Ostir, G. V., Al Snih, S., Peek, M. K., Markides, K., & Ottenbacher K. J. (2007). Health related quality of life in older Mexican Americans with diabetes: A cross-sectional study. Health and Quality of Life Outcomes, 5, 39. https://doi.org/10.1186/1477-7525-5-39
    連結:
  17. Grøntved, A., Pan, A., Mekary, R. A., Stampfer, M., Willett, W. C., Manson, J. E., & Hu, F. B. (2014). Muscle-strengthening and conditioning activities and risk of type 2 diabetes: A prospective study in two cohorts of US women. PLoS Medicine, 11(1), e1001587. https://doi.org/10.1371/journal.pmed.1001587
    連結:
  18. Kalyani, R. R., Cannon, C. P., Cherrington, A. L., Coustan, D. R., De Boer, I. H., Feldman, H., ... Umpierrez, G. E. (2018). Professional practice committee: Standards of medical care in diabetes—2018. Diabetes Care, 41(1, Suppl.), S3–S3. https://doi.org/10.2337/dc18-SPPC01
    連結:
  19. Kueh, Y. C., Morris, T., & Ismail, A. A. S. (2017). The effect of diabetes knowledge and attitudes on self-management and quality of life among people with type 2 diabetes. Psychology, Health & Medicine, 22(2), 138–144. https://doi.org/10.1080/13548506.2016.1147055
    連結:
  20. Lee, S. A., Xu, W. H., Zheng, W., Li, H., Yang, G., Xiang, Y. B., & Shu, X. O. (2007). Physical activity patterns and their correlates among Chinese men in Shanghai. Medicine & Science in Sports & Exercise, 39(10), 1700–1707. https://doi.org/10.1249/mss.0b013e3181238a52
    連結:
  21. Mensberg, P., Nyby, S., Jørgensen, P. G., Storgaard, H., Jensen, M. T., Sivertsen, J., ... Vilsbøll, T. (2017). Nearnormalization of glycaemic control with glucagonlike peptide1 receptor agonist treatment combined with exercise in patients with type 2 diabetes. Diabetes, Obesity & Metabolism, 19(2), 172–180. https://doi.org/10.1111/dom.12797
    連結:
  22. Perneger, T. V., Leplège, A., Etter, J. F., & Rougemont, A. (1995). Validation of a French-language version of the MOS 36-Item Short Form Health Survey (SF-36) in young healthy adults. Journal of Clinical Epidemiology, 48(8), 1051–1060. https://doi.org/10.1016/0895-4356(94)00227-H
    連結:
  23. Su, J. B., Zhao, L. H., Zhang, X. L., Cai, H. L., Huang, H. Y., Xu, F., ... Wang, X. Q. (2018). HbA1c variability and diabetic peripheral neuropathy in type 2 diabetic patients. Cardiovascular Diabetology, 17, 47. https://doi.org/10.1186/s12933-018-0693-0
    連結:
  24. Tsai, S. Y., Chi, L. Y., Lee, L. S., & Chou, P. (2004). Health-related quality of life among urban, rural, and island community elderly in Taiwan. Journal of the Formosan Medical Association, 103(3), 196–204. https://doi.org/10.29828/JFMA.200403.0005
    連結:
  25. Valentiner, L. S., Ried-Larsen, M., Karstoft, K., Brinkløv, C. F., Brøns, C., Nielsen, R. O., ... Langberg, H. (2017). Long-term effect of smartphone-delivered interval walking training on physical activity in patients with type 2 diabetes: Protocol for a parallel group single-blinded randomised controlled trial. BMJ Open, 7(4), e014036. https://doi.org/10.1136/bmjopen-2016-014036
    連結:
  26. Zhou, P., Hughes, A. K., Grady, S. C., & Fang, L. (2018). Physical activity and chronic diseases among older people in a mid-size city in China: A longitudinal investigation of bipolar effects. BMC Public Health, 18(1), 486. https://doi.org/10.1186/s12889-018-5408-7
    連結:
  27. 中華民國糖尿病學會(2018).2018糖尿病臨床照護指引.臺北市:作者。[The Diabetes Association of the Republic of China (Taiwan). (2018). Clinical practice guidelines for diabetes care- 2018. Taipei City, Taiwan, ROC: Author.]
  28. 王建楠、李璧伊(2015).缺乏身體活動之不良健康效應:系統性回顧及統合分析.中華職業醫學雜誌,22(1),9–19。[Wang, J. N., & Lee, P. I. (2015). Physical inactivity and adverse health effects: Systemic review and meta-analysis. Chinese Journal of Occupational Medicine, 22(1), 9–19.]
  29. 王耀萱(2004).糖尿病健康相關生活品質影響因素之研究—以南投縣埔里地區為例(未發表的碩士論文).臺北市:國立陽明大學醫務管理研究所。[Wang, Y. S. (2004). Factors associated to health-related quality of life in diabetic patients—A study on Puli Township of Nantou County (Unpublished master’s thesis). National Yang-Ming University, Taipei City, Taiwan, ROC.]
  30. 呂昌明、林旭龍、黃亦清、李明憲、王淑芳(2000).身體活動自我報告量表之效度及信度的研究—以Polar Vantage NV心搏率監測器為效標.衛生教育學報,14,33–48。[Lu, C. M., Lin, S, L., Huang, Y. C., Lee, M. S., & Wang, S. F. (2000). A study on validity and reliability of self-report measures of physical activity--Using Polar Vantage NV heart rate monitor as criterion. Journal of Health Education, 14, 33–48.]
  31. 國民健康署(2015).糖尿病友「腰」約控糖!取自https://www.hpa.gov.tw/Pages/Detail.aspx?nodeid=1135&pid=2996 [Health Promotion Administration, Taiwan, ROC. (2015). Diabetes and the importance of glycemic control. Retrieved from https://www.hpa.gov.tw/Pages/Detail.aspx?nodeid=1135&pid=2996]
  32. 國民健康署(2017).世界糖尿病日由來與國內宣導響應.取自https://www.hpa.gov.tw/Pages/Detail.aspx?nodeid=1090&pid=6426 [Health Promotion Administration, Taiwan, ROC. (2017). The origin of World Diabetes Day and the response in Taiwan. Retrieved from https://www.hpa.gov.tw/Pages/Detail.aspx?nodeid=1090&pid=6426]
  33. 童雅欣(2012).八週健走遊戲課程對社區中高齡者身體活動與健康相關生活品質之影響(未發表的碩士論文).桃園市:國立體育大學運動保健學系碩士班。[Tung, Y. H. (2012). Effect of an 8-week walking game program on physical activity and health-related quality of life in community-dwelling middle-age and older adults (Unpublished master’s thesis). National Taiwan Sport University, Taoyuan City, Taiwan, ROC.]
  34. International Diabetes Federation. (2017). Diabetes atlas (8th ed.). Retrieved from http://www.diabetesatlas.org/
  35. Kamarul Imran, M., Ismail, A. A., Naing, L., & Wan Mohamad, W. B. (2010). Type 2 diabetes mellitus patients with poor glycaemic control have lower quality of life scores as measured by the short form-36. Singapore Medical Journal, 51(2), 157–162.
  36. World Health Organization. (2018, February 23). Physical activity. Retrieved from http://www.who.int/mediacentre/factsheets/fs385/en/