Determinants of Dietary Self-Care Behaviours among Taiwanese Patients with Type 2 Diabetes

台湾2型糖尿病病患饮食自我照顾行为之决定因素

Chung-Mei Ouyang ； Johanna T Dwyer ； Paul F Jacques ； Lee-Ming Chuang ； Catherine F Haas ； Katie Weinger

《Asia Pacific Journal of Clinical Nutrition》 24卷3期 (2015/09) Pp. 430-437

https://doi.org/10.6133/apjcn.2015.24.3.02

摘要

此研究调查了184位门诊40岁以上之2型糖尿病病患，评估病患特质对饮食自我照顾行为配合度之影响。利用一份72题（共八面向）之调查问卷，评估病患之特质，包括影响糖尿病患配合度之内在因素（此疾病相关之知识与态度、自我效能和心理问题）、能力因素（对糖尿病的理解度和环境因素），以及加强因素（医疗和家庭支持）。有关病患饮食自我照顾行为之配合度，共调查了七项饮食行为（遵循糖尿病饮食计划、食物代换表、每餐固定醣量、醣类计算、减少油脂、增加纤维摄取，和记录饮食日志）。病患饮食行为配合度调查结果为17%至74%。没有单一（内在、能力和加强）因素可预测所有的饮食行为配合度；然而，自我效能越强、理解度越佳、和有较好糖尿病的态度，则与五项以上的饮食行为配合度表现相关。特别的自我照顾行为，如女性在醣类计算上可能较男性佳（OR=5.75），在减少脂肪摄取上亦同（OR=2.57）；病患参加较多次的营养教育课程，则较可能遵循糖尿病饮食计划（OR=2.11），和糖尿病食物代换（OR=3.07）。需鼓励卫教者对糖尿病自我照顾行为教育的努力，和留意在病患人口统计学与社会心理学特质上的价值，以提升病患的配合度。

關鍵字

2型糖尿病 ； 台湾 ； 自我照顾行为 ； 病患教育和饮食配合度

並列摘要

The effects of patient characteristics on reported adherence to dietary self-care behaviours in 184 Taiwanese outpatients 40 years or older with type 2 diabetes was assessed. Patient characteristics included the presence of predisposing factors affecting diabetes adherence (knowledge and attitudes about the disease, self-efficacy, and the absence of psychological problems), enabling factors (understanding of diabetes and environmental factors affecting it), and reinforcing factors (presence of medical and social support) which were evaluated using a 72 item self-administered questionnaire with 8 subscales. Adherence was assessed by patients' reports of carrying out 7 self-care behaviours (following a diabetic meal plan, following the diabetes exchange system, eating meals providing the same amount of carbohydrate every day, counting carbohydrates, reducing dietary fat, consuming high fiber foods, and keeping a daily food record). Reported adherence ranged from 17% to 74%. No single predisposing, enabling, or reinforcing factor predicted adherence to all of the dietary self-care behaviours. However, more self-efficacy, better understanding, and a better attitude toward diabetes were associated with performing five or more of the dietary self-care behaviours examined. With respect to specific self-care behaviours, women were more likely than men to count carbohydrates (OR=5.75) and reduce fat in their diets (OR=2.57). Patients who attended more nutrition education sessions were more likely to follow diabetes meal plans (OR=2.11) and the diabetes exchange system (OR=3.07). Efforts are needed to encourage providers to teach diabetes self-care behaviours to patients and to capitalize upon demographic and psychosocial characteristics that can enhance patient adherence.

並列關鍵字

type 2 diabetes mellitus ； Taiwan ； self-care behaviours ； patient education ； dietary adherence