探討利用不同衛教工具對第2型糖尿病患之飲食認知、血糖及血脂之影響

The effects of different patient education materials on dietary cognition, glycemic control and lipid profiles in type 2 diabetic patients

劉玲汝(Ling-Ju Liu)

指導教授 ： 黃詩茜

中山醫學大學/健康管理學院/國際健康產業經營管理碩士在職專班/碩士(2021年)

https://doi.org/10.6834/csmu202100020

摘要

國際糖尿病聯盟2020年數據顯示，全球約有4.63億糖尿病人口，盛行率已達9.3 %，若能有良好血糖控制，可降低併發症和死亡率。飲食為糖尿病控制的基石，該如何提升患者營養知識，成為營養師一大挑戰。過去糖尿病衛教多以文字單張為素材，近年來會融入圖像衛教，但較少探討使用此兩項工具，對第2型糖尿病患進行衛教後，對於提升患者飲食認知、以及能否改善血糖及血脂的成效比較。因此，本研究目的為利用不同衛教工具對於第2型糖尿病患之飲食認知、血糖及血脂之影響。本研究為介入型研究，於長安醫院新陳代謝科募集60位第2型糖尿病患，衛教前先進行飲食認知問卷前測，再隨機分派文字組或圖像組，衛教後進行第一次後測，於第12週再進行第二次後測，並記錄受試者第1、12週體位資料、飲食攝取情形與血液生化值。結果發現，兩組兩次後測分數皆顯著高於前測，但兩組間分數無顯著差異，兩組於衛教介入後糖化血色素皆顯著下降。患者認識食物類別分數變化量會與空腹血糖變化量呈顯著正相關 (β= 22.83, p =0.008)。本研究認為不同衛教工具皆可增加第2型糖尿病患者對於食物認知，並可改善患者糖化血色素，未來可延長介入時間或衛教頻率，以釐清並探討不同衛教工具對於食物認知與血糖、血脂之間的關係。

關鍵字

第2型糖尿病 ； 圖像衛教 ； 文字衛教 ； 飲食認知 ； 血糖 ； 血脂

並列摘要

According to the report of International Diabetes Federation in 2020, there are 4.63 billion diabetes population all over the world. In the meantime, the diabetes prevalence is over 9.3% in the world. It will reduce the complications and mortality rate significantly if diabetes patients have adequate blood sugar control. Diabetes diet control is a cornerstone of diabetes control. How to improve patients' nutritional knowledge has become a major challenge for nutritionists. Currently, it lacks of the diabetes education related interventional study for type 2 diabetes patients’ dietary cognition, blood sugar and blood lipids via utilizing words or image education materials in Taiwan. Therefore, the objective of this study is to utilize the different educational materials to influence the dietary cognition, blood sugar and blood lipids in patients with type 2 diabetes. This is an interventional study, and recruited total 60 subjects in Division of Endocrinology and Metabolism in Chang'an Hospital in Taiwan. Before the health education, the dietary cognition questionnaire was pre-tested, and then the word or image group was randomly assigned. After the health education, the first and post-test were performed. At the 12th week, the second post-test was performed, and the anthropometrics, dietary intakes and blood biochemical date of the subjects were recorded in the 1st and 12th weeks. The results showed that the dietary cognition scores of the two post-tests groups were significantly higher than the pre-tested, but there was no significant difference in the scores between the two groups. The HbA1c of the two groups were decreased significantly after the intervention of health education. The change in the recognize food category will be significantly positively correlated with the fasting blood glucose (β=22.83, p=0.008). In conclusion, the different diabetes nutritional educational materials could increase the food cognition effectively, and improved HbA1c in type 2 diabetic patients. In the future, we will extend the period of intervention to clarify the relationship between different diabetes educational materials and the dietary cognition, blood sugar and blood lipids.

並列關鍵字

type 2 diabetes ； image health education ； word health education ； dietary cognition ； blood sugar ； blood lipids

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