某醫學中心家庭醫學科門診糖尿病病患對飲食控制及運動的認知

The Perception of Diet Control and Exercise among Diabetes Treated at Medical Center Family Medicine Department

林啓民(Chi-Min Lin) ； 鍾嫈嫈(Jin-Jin Tjung) ； 林建輝(Chien-Hui Lin) ； 黃麗卿(Lee-Ching Hwang)

《中華職業醫學雜誌》 13卷4期 (2006/10) Pp. 245-252

摘要

近年來，糖尿病的盛行率與死亡率不斷的上升，造成龐大的醫療花費，而良好的血糖控制，除了藥物之外，對疾病的認知與非藥物治療（飲食控制與運動）亦是重要的關鍵。然而不同年齡層、不同生活背景，影響非藥物治療的因素也可能相異，但是很少這方面的研究報告。本研究的目的主要在探討不同年齡層之糖尿病病人對飲食及運動的認知及影響其飲食控制與運動的因素。本研究收集2004年7月至2004年12月於本院家庭醫學科門診追從三個月以上之第二型糖尿病個案共299位，由同一位護理人員進行個別訪談完成問卷。結果顯示，小於65歲者學歷與工作的比率皆高於65歲以上（含65歲）的病人。對於飲食控制，小於65歲對飲食控制重要性之認知、滿意度與認定醫師有給予飲食衛教的比率皆高於65歲以上的病人。不論年齡的大小，飲食控制碰到最大的困難仍是無法控制食慾(48.5%)。其他的原因包括：小於65歲者以吃外食(26.2 vs 6.7%)及不容易準備食物(18.1 vs 5.3%)為多，而65歲以上則以認為飲食控制太辛苦的比率較高(30.7 vs 18.8%)。對於運動，小於65歲對運動的重要性、運動觀念、認定醫師有教導運動的比率皆高於65歲以上者，但實際達到運動標準則以65歲以上者多(61.3 vs 41.6%, p=0.001)。運動所面臨的困難，小於65歲者以沒時間(37.6 vs 10.7%, p=0.0001)、工作太累(24.2 vs 2.7%, p=0.0001)及沒有人陪伴(16.1 vs 7.3%, p=0.02)明顯高於65歲以上的病人。對於運動種類的選擇，仍是以走路最為普遍，至於其他，小於65歲的病人比較傾向體能性的活動（如爬山、游泳、慢跑等），而65歲以上的病人則會選擇體操類的活動。由此可見，影響65歲以上病人飲食控制與運動的因素與小於65歲者有所差異。因此，對於不同的年齡族群，應視其不同狀況，給予適當的衛教，如此才能達到事半功倍的成效。

並列摘要

Diabetes had become a global burden. Well glycemic control depends not only on drugs but also on lifestyle change, including diet control and exercise. However, factors influencing lifestyle change are different among ages and backgrounds. The purpose of this study is to evaluate the differences of perception and factors influencing diet control and exercise in diabetes patients younger or older than 65 years. Under a well-trained nurse, the questionnaires were completed by the total of 299 type 2 diabetic patients who had followed at least 3 months in our department during 2004, July to December. The results showed higher education level and more in work in the younger group. Concerning diet control: The younger group perceived more the importance, satisfied more and felt sure of diet education given by Doctor. Difficult to endure good physical desire for food (48.5%) is the major general problem of the unsatisfied diet control. The younger had additional problems of taking meals around (26.2 vs 6.7%) and self-prepared food (30.7 vs 18.8%). The older, on the other hand, treating diet control as an hard effort (30.7 vs 18.8%). Concerning exercise: Even the younger group perceived more the importance of exercise and felt sure of exercise education given by Doctor, but the older group that got more success rate in exercise program (61.3 vs 41.6%). No time available (37.6 vs 10.7%), tired (24.2 vs 2.7%) and loneliness (16.1 vs 7.3%) are the reasons for not exercises in the younger group. Walking is the most popular exercise in all ages. Besides, the younger prefer more intensive exercise as mounting, swimming, and running. The older, on the other hand, prefer light exercise-gymnastics. From the result, factors influencing diet control and exercise are different in different age-groups. For great success, the diabetic education program should vary and depend on the need of different age-group patients.

並列關鍵字

Type Ⅱ DM ； diet control ； exercise