Health Status and Health-Related Behaviors Among Type 2 Diabetes Community Residents

第二型糖尿病社區居民的健康狀態與健康相關行為之探討

陳美燕(Mei-Yen Chen) ； 黃維超(Wei-Chao Huang) ； 彭雲杏(Yun-Shing Peng) ； 鍾明昌(Ming-Chung Jong) ； 陳秋月(Chu-Yeh Chen) ； 林惠娟(Hui-Chuan Lin)

《The Journal of Nursing Research》 19卷1期 (2011/03) Pp. 35-43

https://doi.org/10.1097/JNR.0b013e31820beb5b

摘要

背景　第二型糖尿病之標準化死亡率，在台灣地區是高於其他已開發國家，同時嘉義地區因為糖尿病而死亡的比率也高於國內其他地區。
目的　本研究主要目的是了解嘉義沿海地區患有第二型糖尿病之居民的健康狀態（六項生理指標之測量）、健康相關行為及其影響因素之探討。
方法　針對嘉義沿海九鄉鎮之第二型糖尿病民眾，採用橫斷面及相關性之研究設計，共有387位已經被確立為糖尿病之居民，以簡單隨機方式抽樣並邀請加入本研究調查。
結果　結果顯示，59%的參與者為女性，平均年齡為68.7歲，平均患糖尿病時間7.9年。多數接受基層醫療之照顧並採用口服降血糖藥物(90.7%)，超過40%民眾無規律運動以及33.9%未採飲食控制。整體參與者在身體質量指數、腰圍、糖化血色素、以及週邊神經血管功能有高比率之異常。在控制相關干擾因素後，腰圍越小、有參與社區病友會、有較佳的足部照顧能力以及經常運動者，有較好的健康狀態指標；而患病時間越長、教育程度越低，以及男性民眾則出現較不利的健康指標。
結論／實務應用　本研究顯示，偏遠地區患有第二型糖尿病之社區民眾，其健康狀態及健康相關行為並不理想。建議將提升社區民眾參與糖尿病支持團體、運動頻率與足部自我照顧能力等列為護理措施，特別是教育程度偏低及男性民眾，以提升民眾達到理想的糖尿病控制指標。

關鍵字

糖尿病 ； 基層醫療 ； 社會支持

並列摘要

Background: The standardized mortality rate of type 2 diabetes is higher in Taiwan than that in other developed countries. In Taiwan, the diabetes mortality rate in Chiayi County is the highest nationwide.
Purpose: This study was designed to explore the health status (to measure six physiological indicators), the health-related behaviors, and the associated factors among type 2 diabetes sufferers living in rural communities.
Methods: Researchers used a cross-sectional, correlation design and conducted the study at nine local health districts in Chiayi County, Taiwan. A total of 387 participants previously diagnosed with type 2 diabetes were randomly selected and invited to join in the program.
Results: Fifty-nine percent of participants were women; their mean age was 68.7 years, and their mean duration with diabetes was 7.9 years. Most were treated at local health centers and took oral medications (90.7%). More than 40% did not exercise regularly and 33.9% did not practice diet control. Results found a higher percentage of abnormal health indicators in terms of participant body mass index, waist circumference, HbA1C, and peripheral neurovascular function. After controlling for potential confounding factors, researchers found smaller waist circumference, participating in community support groups, better foot self-care capability, and frequent exercise to be associated with better health indicators. Diabetes duration, lower education, and being of male gender were found to be negatively associated with health status.
Conclusions/Implications for Practice: This study found that rural residents with diabetes do not adequately control their diabetes and exhibit inadequate health-related behavior. Joining community support groups, increasing exercise frequencies, and improving foot self-care capabilities should be employed in nursing strategies and health policies for diabetes control-especially for those who have less formal education or are male.

並列關鍵字

diabetes mellitus ； primary healthcare ； social support

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