以生活變遷模式探討糖尿病患血糖及體重之控制

Life-Change Events Model in Analyzing Diabetic Patient's Blood Glucose and Body Weight Control

梁靜祝(C.A.Liang) ； Susan Boehm

《護理研究》 3卷4期 (1995/12) Pp. 298-308

https://doi.org/10.7081/NR.199512.0298

摘要

爲瞭解生活變遷與健康改變之間複雜的因果關係，本研究以美國密西根州的213名非胰鳥素依賴型的糖尿病病人爲對象，探討社會背景特質，不同型態生活變遷，社會心理功能對糖尿病血糖及體重控制的影響。利用直線結構關係(Linear Structural Relationships,LISREL)及爲檢驗生活變遷與糖尿病疾病控制之間的複雜因果模式。首先以因素分析法將生活變遷歸類爲四大項：個人及社交生活改變，家庭結構改變，工作及經驗改變，家庭穩定性改變。原始模式經LISREL修正後可歸納出一個簡約而且良好的模式。
結果顯示不同的社會背景的糖尿病人會經驗不同型態的生活變遷。女性糖尿病人比男性陳述經驗較多影響家庭穩定性的事件，年青糖尿病人比年老病人陳述較多的工作及經濟的改變及家庭結構的改變；並非所有的生活變遷都對糖尿病的體重及血糖控制具衝擊性，經驗愈多個人與社交生活的改變時，體重控制較差；經驗愈多的工作及經濟的改變，病人的血糖昇高，體重降低。社會心理功能是緩衝生活變遷及體重對血糖影響的中介變項，社會心理功能愈好，血糖控制則愈佳。

關鍵字

生活變遷 ； 糖尿病 ； 社會心理功能 ； 個人社會特質 ； LISREL

並列摘要

This study used linear structural relationships (LISREL) to explore a causal model of demographic variables, different categories of life-change events, and psychosocial functioning in predicting body weight and blood glucose levels in 213 patients with Non-Insulin-Dependent Diabetes Mellitus (NIDDM) who came from Michigan State in the United States. Factor analysis was employed to identify four life-change event dimensions: Personal and social activity change, work and financial change, family stability change, and family structure change. Results of this study indicated that patients differences in gender, age, income, and marital status lead to different life-change events. Female NIDDM patients reported more family instability than male patients, and the younger NIDDM patients experienced more work and financial change and family structure change than the older NIDDM patients. Only personal and social activity changes and work and financial changes affected body weight and blood glucose levels. Psychosocial functioning only mediated the influence of life-change events on blood glucose levels. Greater body weight, however, led to a lower psychosocial functioning. Both body weight and psychosocial functioning were intervening variables in the process by which life-change events influence blood glucose levels.

並列關鍵字

life-change events ； NIDDM ； psychosocial functioning ； demographic variables ； LISREL