第2型糖尿病自我管理血糖不佳中年患者的生活經驗

Life Experience of Self-Management Regarding Blood Glucose in Middle-Aged Patients with Type 2 Diabetes and Poor Glycemic Control

吳月珠(Yueh-Ch Wu) ； 陳易芬(Yih-Fen Chen) ； 王郁茗(Yu-Ming Wang) ； 黃建寧(Chien-Ning Huang)

《安泰醫護雜誌》 27卷2期 (2021/12) Pp. 61-75

摘要

目的：探討接受胰島素治療的中年第2型糖尿病患者血糖自我監測的經驗。方法：採用質性研究方法，我們招募了台灣中部某醫學中心糖尿病門診接受胰島素治療且糖化血色素超過8.0%的中年第2型糖尿病患者。以個別的深度訪談，使用內容分析法來分析文本。結果：共對10名患者進行了訪談，發現有五個主題：（1）由罹病經驗反思個人健康行為:仗恃年輕體壯，輕忽疾病威脅；經歷生命威脅而覺醒健康重要性。（2）注射胰島素與工作角色的衝突：隱藏注射胰島素需求或延遲注射／進食時間；為保有工作尊嚴，犧牲自身健康。（3）心有餘而力不足：意識到生理功能逐漸退化；失去改變的動力與信心。（4）不安全與自責的存在感：安全感的瓦解；罪惡與自責的心理狀態。（5）在疾病自我管理中性別角色行為的不同表現。結論：第2型糖尿病自我管理血糖不佳中年患者往往會經歷因輕忽疾病及工作環境壓力減少對自我管理血糖的動機，建議未來研究可針對不同性別建構合適的第2型糖尿病患者的介入照護。

關鍵字

第2型糖尿病 ； 自我管理 ； 血糖控制不佳 ； 中年 ； 質性研究

並列摘要

Objective: To explore the blood glucose self-monitoring experience of type 2 diabetes mellitus middle-aged patients who are receiving insulin therapy. Methods: Using qualitative research methods, we recruited middle-aged type 2 diabetes patients with glycosylated hemoglobin over 8.0% who were treated with insulin in the diabetes clinic of a medical center in central Taiwan. Individual in-depth interviews were used to analyze the text using content analysis. Results: Interviews from a total of 10 patients were analyzed and five themes were found as follows: (1) reflection on personal health behaviors from the experience of being sick: relying on the young and strong, neglecting the threat of disease; the importance of awakening health through a life-threatening disease, (2) the conflict between insulin injection and work role: hiding insulin injection needs or delaying the time of eating / insulin injection; in order to maintain work dignity, sacrifice one's health, (3) sufficient will, but insufficient awareness: realization that physiological function has gradually deteriorated; loss of motivation and self-confidence for change, (4) insecurity and self-blame, sense of existence: the disintegration of a sense of security; the psychological state of ＂sin＂ and self-blame (5) Different manifestations of gender role behaviors in disease self-management. Conclusion: Middle-aged patients with type 2 diabetes who have poor self-management of blood glucose tend to experience reduced motivation for self-management of blood glucose due to neglect of disease and work environment pressure. It is recommended that future studies construct appropriate interventional care for patients with type 2 diabetes according to gender.

並列關鍵字

Type 2 Diabetes Mellitus ； Self-management ； Poor glycemic control ； Middle-aged ； Qualitative study