第II型糖尿病病人身體活動與生活品質之探討

背景：隨著生活型態及飲食習慣改變，第二型糖尿病人口不斷增加，約每10個人就有1人罹病，根據國民健康局的統計盛行率已高達9.2％。且糖尿病人的醫療費用為正常人的4.3倍，其中有四分之三的醫療費用用於治療併發症，故提供適當處置延緩糖尿病併發症的發生，已是刻不容緩的問題。目的:本研究旨在瞭解第二型糖尿病人身體活動狀況及生活品質分佈情形，及糖尿病人社會人口學及疾病特性與身體活動、生活品質相關性，並探討糖尿病人生活品質之預測因子。方法：本研究為橫斷式研究設計，採立意取樣，於2014年1月至10月在臺北某區域醫院門診收案，研究對象為第二型糖尿病病人共100位。研究工具包括人口學及疾病特性資料、七日身體活動回憶量表、SF-36生活品質量表，統計方法包括描述性統計、獨立樣本 t 檢定、單因子變異數分析、皮爾森積差相關、斯皮爾曼等級相關、階層回歸分析、逐步回歸分析。結果如下: 一、研究對象每週平均消耗243.86 ±32.46Kcal/kg，身體活動項目以輕度活動為主，在過去7日42%的病人沒有從事運動。二、研究對象生活品質中上程度，疾病特性與生活品質之相關性，最近一次飯前血糖值與角色受限因情緒問題(RE)呈現顯著負相關（r = -.231，p < .05）。最近一次飯前血糖值與角色受限因生理問題(RP)呈現顯著正相關（r = .216，p < .05）。最近一次飯前血糖值與一般健康狀況(GH)呈現顯著負相關（r = -.261，p < .01）。三、最近一次飯前血糖值與身體活動呈現顯著負相關（r = -.336，p< .01），即血糖值越高，身體活動量越少。四、身體活動與生活品質之生理面向具顯著正相關（r=.296，p<.05），身體活動與生活品質之心理面向具顯著正相關（r=.125，p<.05）。五、病人因糖尿病住院次數對生理面向生活品質有顯著影響（β= -.259，p< .05），因糖尿病住院次數每增加3次，生理面向生活品質水準下降25.9%，因糖尿病住院次數對心理面向生活品質亦有顯著影響（β = -.234，p = .020），其餘人口學變項、疾病特性、及身體活動變項對生活品質沒有顯著影響。結論：多數病人並無規律運動的習慣，常因血糖控制不佳，經常出入醫療院所，造成個人生活品質下降。期望研究結果能提供臨床參考，為病人量身訂做一套容易身體力行的運動處方，使血糖得到良好的控制進而擁有優質的生活品質。

關鍵字

第II型糖尿病；身體活動；生活品質

並列摘要

Background: With the life style and diet habit changes, type II diabetes patients are growing so rapidly. There are about one for every 10 people who diseased with type II diabetes. According to the statistics of the National Health Council, the prevalence has reached 9.2%. Medical costs for diabetes were 4.3 times than healthy people, which have three-quarters of medical expenses for treatment of complications, so provide adequate medical care to delay complications occurred, are an important issue. Objective: This study aims to understand physical activity status and quality of life among patients with type II diabetes Mellitus, the relationship between demographic and disease characteristics and quality of life, and to explore the predictors of quality of life. Methods: The study was cross-sectional study design with purposive sampling. The 100 type II diabetes Mellitus patients were recruited from a regional hospital, outpatient clinic, from January to October 2014. Research tools included seven physical activity recall scale and SF-36 quality of life scale. Data were analyzed by descriptive statistics, t-test, one-way ANOVA, Pearson’s product-moment correlation, Spearman’s rank correlation, and multiple regressions. Results are as following:(1)The patients consumed an average 243.86 ±32.46 Kcal/kg weekly, which were mainly mild activity. Forty-two percent of the patients did not engage in physical activity in the past the 7days.(2) The patients had moderate Quality of life level. The recent fasting blood glucose levels and role limitations due to emotional problems (RE) presented a significant negative correlation (r = -.231, p<.05), and role limitations due to physical problems (RP) presented a significant positive correlation (r = .216, p<.05). The recent fasting blood glucose levels and general health (GH) presented a significant negative correlation(r = -.261, p<.01).(3)The recent fasting blood glucose levels and physical activity presented a significant negative correlation(r = -.336, p<.01),that is,the higher the blood sugar level, the less physical activity. (4)Physical activity and physical component quality of life had a significant positive correlation(r = .296,p<.05),physical activity and mental component quality of life had a significant positive correlation(r = .125, p<.05)(5)The number of patients hospitalized with diabetes had a significant impact on the physical component quality of life(β = -.259, p<.05),due to diabetes hospitalized three times to decrease physical component quality of life 25.9%, the number of hospitalizations with diabetes had a significant impact on mental component quality of life(β = -.234, p = .020),the remaining demo graphic variables, disease characteristics, and physical activity variables had no significant impact on the quality of life. Conclusions :Most patients found no regular exercise habit, and due to poor glycemic control going to clinic frequented, resulting in decreased quality of life. The results can be as a clinical reference, to provide patients a tailor-made exercise prescription. It can obtain good control of blood sugar and thus has an excellent quality of life.