探討台灣糖尿病個案在健康識能、糖尿病相關自我照護行為與醫療利用間之相關影響

Associations among Health Literacy, Diabetes-related Self-care Behaviors, and Health Utilization in Persons with diabetes in Taiwan

邱姵穎(Pei-Yin Chiu)

指導教授 ： 謝慧敏

高雄醫學大學/健康科學院/公共衛生學系公共衛生學碩士班/碩士(2018年)

摘要

背景及研究目的: 糖尿病是一種慢性代謝性疾病，雖無法完全治癒，但病患若能配合糖尿病自我照護行為，將能有效控制血糖，延緩或避免糖尿病相關慢性併發症與合併症的發生。近年國際間許多研究指出健康識能為影響糖尿病自我照護行為之重要因子，惟在台灣是類研究仍有限，故本研究旨在探討台灣糖尿病個案在健康識能、糖尿病相關自我照護行為與醫療利用的相關影響。
研究方法: 本文採用衛生福利部國民健康署、財團法人國家衛生研究院及衛生福利部食品藥物管理署於2009年所執行的「國民健康訪問暨藥物濫用調查」問卷做為資料來源，並以結構方程模型分析台灣糖尿病個案的健康識能對糖尿病自我照護行為與醫療利用的影響。
結果: 根據此橫斷面分析結果，健康識能對糖尿病自我照護行為無直接顯著相關，但透過生活型態調整方式可間接影響其糖尿病自我照護行為。此外，健康識能較高者或糖尿病自我照護越佳者，可降低其醫療利用。
結論: 醫療服務提供者在衛教糖尿病個案或製作糖尿病相關衛教文宣時，應考量不同健康識能程度個案之需求，以利病患能真正瞭解與落實糖尿病相關自我照護行於日常生活中，進而減少再急診與再住院之醫療資源耗用。

關鍵字

健康識能 ； 糖尿病子我照護行為 ； 醫療利用

並列摘要

Background: The associations among health literacy, diabetes-related self-care behaviors, and health utilization in persons with diabetes was not well evaluated in Taiwan.
Methods: This was a cross-sectional survey of 420 participants with diabetes, aged 18 or older, completed the scale of health literacy were included in the study. Health literacy was measure by the National Health Interview Survey (NHIS) in 2009. The structural equation model (SEM) were conducted.
Results: Health literacy was insignificantly associated with diabetes-related self-care behaviors (p=0.489), but it positively correlated with life-style adjustment approach (ß =0.225,p=0.034) and negatively correlated with health utilization (ß =-0.207, p=0.047).
Conclusions: better health literacy may perform better life-style adjustment approach then improving in self-care behaviors as well as reducing emergency department visits and hospitalizations.

並列關鍵字

Health literacy ； diabetes ； self-care ； health utilization

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