影響第2型糖尿病患血糖控制方式、心理困擾及生活品質相關因素之研究

Factors Associated with Mode of Glucose Control, Psychological Distress and Quality of Life for Type 2 Diabetes Mellitus

施孟涵(Meng-Han Shih)

《臺灣老人保健學刊》 10卷1期 (2014/06) Pp. 19-43

摘要

背景：糖尿病是可控制但無法根治的疾病，患者的血糖控制方式、心理困擾狀態及生活品質的滿意程度攸關治療的進展。目的：瞭解患者血糖控制方式、心理困擾及生活品質情形，並探討影響患者心理困擾及生活品質之重要因子，做為改善心理困擾與健康促進之依據，提供適當的介入、照護及服務。方法：研究採立意取樣，以258位第2型糖尿病患做為研究對象，研究工具包括「個人基本資料表」、「CES-D憂鬱量表」、「STAI情境焦慮量表」、「WHOQOL-BREF生活品質量表」等四部份量表。以SPSS進行描述性統計、獨立樣本t檢定、單因子變異數分析及多元階層迴歸分析等統計方法。結果：患者HbA1c＞6.5%血糖控制不良者佔79.1%，飲食控制不佳及未做適當運動者分別高達79%及56.2%，但飲食控制不佳者較有焦慮情緒，未做適當運動者較有憂鬱及焦慮情緒；注射胰島素患者比服用降血糖藥患者較有憂鬱情緒；患者憂鬱及焦慮狀態會因年齡的不同，而有顯著差異，年輕者（小於40歲）比年長者憂鬱，年長者（大於80歲）又比年輕者焦慮。另患者整體生活品質亦會受年齡影響，年紀輕及年老者生活品質得分較低。多元階層迴歸分析發現影響患者憂鬱與焦慮狀態之心理困擾的重要預測因子分別為「性別」、「運動」（R^2=0.16）與「性別」、「婚姻狀態」、「運動」（R^2=0.16）；影響患者整體生活品質的重要預測因子為「BMI」、「合併症」及「運動」（R^2=0.19）。結論／實務應用：運動是影響病患心理困擾及生活品質的重要影響因素。建議醫護人員應鼓勵病患多運動及做好飲食控制，可以改善生活品質、減輕心理困擾及降低血糖。

關鍵字

第2型糖尿病 ； 血糖控制方式 ； 心理困擾 ； 生活品質

並列摘要

Background: Diabetes can be controlled, but not to be cured. The mode of glucose control, the state of psychological distress and quality of life satisfaction are relevant to the progress of the treatment. Purpose: Want to understand the situation of the mode of glucose control, the state of psychological distress and quality of life, and to explore the impact of the important factors of patients with psychological distress and quality of life. As a basis for improving the psychological distress and health promotion, provide appropriate intervention, care and services. Methods: A purposive sampling method was used to collect 258 type 2 diabetes patients. Research tool includes four parts of the ＂demographic data＂, ＂CES-D Depression Scale＂, ＂STAI State Anxiety Scale＂, ＂WHOQOL-BREF Quality of Life Scale＂. Using SPSS analyzed the descriptive statistics, independent sample t test, ANOVA and hierarchical multiple regression analysis. Results: 79.1% of Diabetes were glucose poorly controlled (HbA1c＞6.5%), 28.7% of patients with insulin injections, and taking oral hypoglycemic agent accounted for 71.3%. Poor diet and without appropriate exercise were 79.0% and 56.2% respectively. Patients with insulin injections more depression than taking hypoglycemic agents; Patients with depression and anxiety were significantly different from different age. There were younger patients (less than 40 years old) more depression than elders, but older people surpasses (more than 80 years old) more anxiety than younger. Other patients' quality of life was also affected by age, the younger (less than 40 years old) and elder's (more than 80 years old) quality of life score is were relatively lower. Affect the state of psychological distress in patients with depression and anxiety important predictors of ＂gender＂, ＂movement＂ (R^2=0.16) and ＂gender＂, ＂marital status＂, ＂movement＂ (R^2=0.16), respectively. Conclusion/Implications for practice: The exercise is the important factors to affect the patient's psychological distress and quality of life. Suggested that the healthcare professionals should encourage patients to take more exercise and good diet can improve the quality of life, reduce psychological distress and reduce blood sugar.

並列關鍵字

Type 2 diabetes ； mode of glucose control ； psychological distress ； quality of life