研究背景與目的. 糖尿病至2002年已經躍升為十大死亡原因第四位,估計至2005年台灣約有100萬糖尿病人口,且年齡有年輕化的趨勢,可見糖尿病的適應,是值得我們去重視的問題。本研究希望利用共通信念模式結合自我效能的概念,從糖尿病患對糖尿病的認知和因應出發,深入瞭解台灣糖尿病患者持續自我管理糖尿病行為的改變因素和心理適應程度對生活品質的影響。 研究方法. 本研究根據立意取樣方式決定參與之受試者,研究對象為第1型及第2型的糖尿病患者。收案來源以中壢地區某區域教學醫院新陳代謝科門診之罹患糖尿病的病患為主。研究工具為問卷的形式,共包含五個部份,分別為:基本資料、疾病表徵、慢性病患因應行為量表、中文版糖尿病管理自我效能量表以及台灣版世界衛生組織生活品質問卷。收案結束後,總計回收117份,有效111份、癈卷6份、同意書58份。 研究結果. 在疾病表徵中疾病所造成的結果及疾病可否被控制能顯著的預測生活品質;在疾病表徵中利用疾病可否被控制預測生活品質時,因應策略中的正向解釋與接受疾病具有部份中介的效果;在因應策略中利用尋求資訊預測生活品質時,自我效能將會造成調節效果。 討論. 證實共通信念模式中,疾病表徵預測因應策略及因應策略預測生活品質的關係存在,也證實因應策略中正向解釋與接受疾病具部份中介效果,且疾病表徵中疾病可否被控制預測生活品質的效果不因為因應策略加入有大的變動,顯示病患在評估生活品質時,很多時候被認知主導了一切,因應策略只會稍微調整評估的結果。另外自我效能雖然在因應策略中尋求資訊預測生活品質時造成調節效果,卻又在因應策略中趨向因應預測生活品質時造成部份中介效果,須進一步檢驗自我效能在因應策略預測生活品質間的關係。
Background and purpose. Diabetes has move up to the fourth of the top ten causes of death till 2002. Suppose there are approximately a million of diabetes in Taiwan till 2005 and pathogenic age of patients tend to be younger. So it’s obviously that we should pay more attention to the accommodation of diabetes patients. We hope to combine common sense model and self efficacy, with diabetes patients’ cognition and coping of diabetes, to understand more detailed about the influence of the reason which keep diabetes patients persist in self-management and the accommodation on Taiwan diabetes patient's quality of life. Method. Subjects were purposive sampling of patients with Type I or Type II diabetes. All subjects were diabetes outpatients of Endocrinology and Metabolism clinic of one Regional teaching hospital in Jhong Li. Research instruments were questionnaires, include five parts, they were : basic data, illness perception questionnaire-reverse version, coping behavior of chronic patients scale, chinese version of the diabetes management self-efficacy scale, WHOQOL-BREF Taiwan version. We retrieve 117 questionnaires, with 111 valid, 6 invalid, 58 valid informed consent. Result. The Consequences and control of illness representation can obviously infer quality of life. When the control of illness representation infer quality of life, explain positive and accept illness of coping strategy show some mediator effect; when the information search of coping strategy infer quality of life, self-efficacy show the slight moderator effect. Discussion. This study confirm that relationship of illness representation infer coping strategy and coping strategy infer quality of life. Also confirm that explain positive and accept illness of coping strategy show some mediator effect, and the effect of control of illness representation infer quality of life won’t be influence by coping strategies. This tell us that patients evaluate quality of life by cognition, coping strategies can only slightly adjust the effect. And although self-efficacy show slight moderator effect when information search of coping strategy infer quality of life, it also show some mediator effect when approach focus of coping strategy infer quality of life. This unclarity relationship of self-efficacy between coping strategy infer quality of life should verify in further study.