糖尿病多媒體衛教之成效

研究背景：糖尿病是全球重要的健康議題。胰島素治療雖然有利血糖控制，但是患者對胰島素的治療通常接受度不高。醫療照護人員宜配合科技進步，運用多媒體的衛生教育，提供病患相關資訊以增加胰島素注射自我效能和提昇胰島素治療的接受度。研究目的：本研究目的在探討多媒體衛教和常規衛教對第2型糖尿病患者初次學習筆型胰島素注射器在糖尿病與胰島素注射相關知識、胰島素注射技術、胰島素注射之自我效能、胰島素注射執行達成率、衛教滿意度、護理時數和生化指標之成效。研究方法：本研究採實驗性隨機分派之重覆測量研究設計，42名住院之第2型糖尿病患者初次接受胰島素筆型注射器為研究對象，其中21名為接受多媒體衛教之實驗組，以及21名為接受常規衛教之對照組，以「糖尿病與胰島素注射相關知識量表」、「胰島素注射之自我效能量表」、「衛教滿意度量表」、「護理時數紀錄表」和「注射技術攝影」為研究工具。資料收集時間為接受措施前、出院前一天、出院後第一週、五週和十三週。資料分析以描述性統計及t檢定、ANCOVA和廣義估計方程式(GEE)等推論性統計方法進行分析及處理。研究結果：1.實驗組在糖尿病與胰島素注射相關知識、胰島素注射技術、胰島素注射自我效能、遵守醫囑之胰島素注射執行達成率和衛教滿意度的平均得分顯著高於對照組。2.實驗組花費護理時數顯著低於對照組。3.兩組的糖化血色素值和肌酸酐值沒有呈現顯著性差異。結論：基於人力和時間的限制，以及學習成效，糖尿病教育應該運用多媒體衛教於衛教計畫中，以提升糖尿病患者的照護品質。未來建議研究擴展至不同屬性的內科病房，以及不同等級的醫院，以增加研究結果有效的推論。

關鍵字

第2型糖尿病；多媒體衛教；糖尿病與胰島素注射相關知識；胰島素注射技術；胰島素注射自我效能；衛教滿意度；胰島素注射執行達成率；護理時數；生化指標

並列摘要

Background: Diabetes is an important global health issue. Insulin therapy is effective in controlling blood glucose levels. However, patients with diabetes may lack confidence to perform insulin self-injections and the performance rate for self-injection of insulin has been low. In addition, regular diabetes education teaching individuals how to self-inject insulin is time consuming. Lack of nursing manpower often results in ineffective diabetes health education. In an era of continuous technological innovation, multimedia teaching materials may offer opportunities to increase patient’s self-efficacy and compliance with insulin therapy. Purpose: The purpose of this study was to investigate the effect of using multimedia disc on patients’ knowledge of diabetes and insulin injection, insulin injection skills, self-efficacy of injecting insulin, compliance with insulin therapy, satisfaction for diabetes education, nursing hours needed, and biophysical status. Method: A repeated measures experimental and random design was used. A totoal of 42 in-patients with type 2 diabetes who had to receive insulin therapy initially from an medical teaching hospital in southern Taiwan were recruited. The experimental group received a multimedia diabetes health education, and the control group received a regular diabetes health education with insulin therapy. The questionnaires including knowledge of diabetes and insulin injection, self-efficacy of injecting insulin, and satisfaction for diabetes education were used. Moreover, nursing hour record form and the insulin injection record form were also used in the study. Data were collected at the time before intervention, the day before discharge, and in the 1st, 5th, and 13th weeks after discharge. Descriptive statistics, t-test, Chi-square, ANCOVA, and GEE were used for data analysis. Result: The experimental group had higer mean scores in knowledge of diabetes and insulin injection, insulin injection skills, self-efficacy of injecting insulin, compliance with insulin therapy, and satisfaction for diabetes education than the control group. However, the experimental group spent lower mean nursing hours than the control group; both groups showed no significant differences in HbA1C and blood creatinine. Conclusion: Limited on manpower and time, as well as the study outcomes, diabetes education with multimedia should be used in teaching plans in order to improve the quality of diabetes care. It is suggested that future study should be done in different medical wards, as well as in different hospitals in order to increase the valid inferences about the study outcomes.

並列關鍵字

Type 2 diabetes ； Multimedia education ； Knowledge of diabetes and insulin injection ； Insulin injection skills ； Self-efficacy of injecting insulin ； Compliance with insulin therapy ； Satisfaction for diabetes education ； Nursing hours ； Biophysical status