運用跨理論模式介入措施對糖尿病病人運動行為之成效

The Effects of a Transtheoretical Intervention in Exercise Behavior for DM Clients

陳佩琦(Pei-chi chen)

指導教授 ： 江純瑛

義守大學/醫學院/醫務管理學系/碩士(2016年)

摘要

罹患糖尿病比率始終居高不下，患者通常以藥物、飲食及運動在控制，但有在規律運動的人很少且遵行率也低，為了加強糖尿病患者可以規律運動來改善糖化血色素值，本研究目的是在測試運用跨理論模式所設計衛教對糖尿病病人運動行為之成效。本研究採類實驗研究設計，於南部某區域教學醫院，以立意取樣方式收案，納入條件須為(1)第二型糖尿病病人，(2)意識清醒，活動力正常，無肢體障礙者，(3)願意接受問卷可以配合護理措施之個案。排除條件有(1)心肺疾病者，(2)走路運動會喘者。共收集實驗組60位給予八週的跨理論模式運動衛教措施及對照組60位。本研究所使用的研究工具包括運動改變階段、運動改變過程、運動決策平衡及運動自我效能等量表。
本研究以SPSS 18.0中文版統計套裝軟體進行各項統計分析，並以α=.05顯著水準來進行各項考驗，採用X2 、獨立t檢定、無母數分析統計方法Mann-Whitney U檢定法、皮爾森積差相關(Pearson’s correlation coefficient)及迴歸等來進行研究變項之檢定，以呈現描述及相關性及推論性統計結果。
研究結果發現：(1)研究對象之運動階段分佈：運動前期32.5%，運動期5.0%，準備期17.5％，行動期15.8％，維持期29.2％。(2) 跨理論模式衛教在決策平衡、自我效能、糖化血色素皆無顯著差異。(3) 跨理論模式衛教在運動改變過程中社會開放有顯著差異。控制組比實驗組利用較多的社會資源。(4) 迴歸結果發現在運動改變過程中社會開放前測結果是可以預測後測結果，可解釋的共變量為74.7%。(5)單身、學歷越高及有在運動者可以接受社會資源程度越高。根據研究結果，將對糖尿病病人不同運動改變階段，規劃多選擇的運動措施，讓病患可以確實達到運動的效果。

關鍵字

糖尿病 ； 跨理論模式 ； 運動行為

並列摘要

The prevalence of diabetes mellitus is high in our society. Hypoglycemic agents, diet control and exercise could help to control the blood sugar. However, the compliance for regular exercise is poor. We designed a quasi-experimental study via transtheoretical model to test the effects of education intervention on the exercise behavior for diabetic patients. Purposive sampling has been used in our study. All the subjects were recruited from a district teaching hospital in southern Taiwan. The inclusion criteria were (1) type 2 diabetes mellitus, (2) clear consciousness, (3) free from limbs impairment, (4) willing to fill the questionnaires and follow the intervention. We excluded the patients with cardiopulmonary diseases or dyspnea on exertion. The total sample size was 60 patients was in the experiment group and 60 patients in the control group. The questionnaires were including scales for exercise in stages of change, processes of change, decisional balance and self-efficacy.
We used SPSS 18.0 software to perform the statistics. The statistical methods included Chi-square test, t test, Mann-Whitney U test, Pearson’s correlation coefficient and regression. The significance was set at 0.05. for this study.
The results were: (1) The distribution of the stage of change was 32.5% of the participant was in pre-contemplation stage, 5% of the participant was in contemplation stage, 17.5% of the participant was in preparation stage, 15.8% of the participant was in action stage and 29.2%of the participant was in maintenance stage. (2) There was no significant difference between two groups in decisional balance, self-efficacy and glycated hemoglobin. (3) There was a significant difference between two groups in social liberation. The result found that the control group could access more social resource than experimental group. (4) The results of regression indicated that the pretest of the social liberation is a stronger factor which could predict the posttest of the social liberation . It could explain 74.7% of the variance. (5) Single, well-educated patients and those who had had exercise behavior before the study could access more social resource. We suggested diversified options of exercise in different stages of exercise behavior change for the diabetic patients could effect on the compliance of exercise.

並列關鍵字

Diabetes mellitus ； Transtheoretical model ； Exercise Behavior

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