- 學位論文
第二型糖尿病個案情緒困擾、賦權感受、自我照顧行為與生活品質 關係之探討
The relations of emotional distress, empowerment perception and self-care behavior to quality of life in patients with type 2 diabetes
摘要
本研究目的為(1)調查第二型糖尿病個案情緒困擾、賦權感受、自我照顧行為與生活品質情形；(2)探討第二型糖尿病個案個人特性、疾病特性、情緒困擾、賦權感受、自我照顧行為與生活品質之相關性；(3)探討第二型糖尿病個案生活品質之重要解釋因子。 採橫斷性、描述性相關性研究設計，以糖尿病十年內之糖尿病個案為研究對象，採結構式問卷調查和方便取樣方式共收案220位。問卷內容包括：個人與疾病特性、情緒困擾、賦權感受、自我照顧行為與生活品質等量表，其中生活品質量表分別測量滿意度、衝擊與糖尿病的擔憂層面之生活品質。量表經信度及效度檢定，包括內在一致性、再測信度、專家效度與表面效度。研究資料以百分比、平均值、標準差、獨立樣本t檢定、單因子變異數分析、皮爾森積差相關與逐步複迴歸分析。 研究結果發現：(1)研究對象生活品質得分指標為79.6，呈中上程度；(2)教育程度、年齡、加入共同照護網與使用胰島素在生活品質上有顯著差異；(3)研究對象情緒困擾得分指標為36，呈現輕度情緒困擾，且情緒困擾越嚴重，各層面生活品質越差；(4)研究對象賦權感受得分指標為76.8，呈中上程度，個案賦權感受程度越好，滿意度生活品質越好；(5)糖尿病個案自我照顧行為得分指標為68.8，呈中上程度，自我照顧行為越好，滿意度生活品質越佳。飲食、運動、高低血糖的預防與處理和足部自我照顧行為越好，滿意度生活品質越佳。而藥物與血糖監測自我照顧行為越好，其糖尿病的擔憂層面生活品質越差。個案足部自我照顧越好，衝擊和與糖尿病的擔憂層面生活品質越差；(6)情緒困擾為總生活品質與其各次量表之重要解釋因子，可分別單獨解釋28.7%-53.8%之總變異量。
並列摘要
The purposes of the research are to (1) explore emotional distress, empowerment perception, self-care behavior and quality of life in patients with type 2 diabetes; (2) investigate the relations of demographic data, disease characteristics, emotional distress, empowerment perception, and self-care behavior to quality of life in patients with type 2 diabetes; and (3) identify the important explanatory factors of quality of life in patients with type 2 diabetes. This is a cross-sectional, correlated and descriptive research design. The participants of this study are patients who have been suffering from type 2 diabetes within ten years. With purposive sampling, participants were collected from one medical center and two regional teaching hospitals after consent forms were obtained. A total of 220 questionnaires were collected. In this study, a constructed questionnaire was established with relevant scales, including questions on demographic data, disease characteristics, emotional distress, empowerment perception, self-care behavior and quality of life. The quality of life scale measured three domains of the quality of life: satisfaction, impact, and worried about the diabetes. The reliability and validity of the questionnaire were evaluated for internal consistency, test-retest reliability, surface validity and content validity. Data analysis was performed by using percentage, mean, standard deviation, independent t-test, one-way ANOVA, Pearson’s correlation, and stepwise multiple regression analysis. The results were: (1) the score index of quality of life was 79.6, considered as a moderate to high level; (2) patients with different educational level, age, diabetes share care disease management participation and insulin therapy showed a significant difference in quality of life; (3) the score index of emotional distress was 36, considered as a relatively low level. The more severe emotional distress is, the worse quality of life in every domain is; (4) the score index of empowerment perception was 76.8, considered as a relatively moderate to high level. The better empowerment perception is, the better the satisfaction domain of quality of life is; (5) the score index of self-care behavior was 68.8, considered as a moderate to high level. The better self care behavior is, the better the satisfaction domain of quality of life is; moreover, the better dietary, exercise, management of abnormal blood sugar level and foot care is, the better the satisfaction domain of quality of life is. However, the better self care behavior in medication-taking and blood sugar monitoring is, the worse the anxiety domain of quality of life is; moreover, the better the foot self-care behavior is, the worse the impact and anxiety domains of quality of life is; (6) emotional distress was the most important explanatory factor for the total and each domains of quality of life and accounted for 28.7%-53.8% of the total amount of variance.