雲林地區糖尿病患健康行為模式之概況研究

Research on the Diabetics in Yunlin Area about Their Healthy Behavior Modes

鄭素味(chêng su wei)

指導教授 ： 范宗宸 ； 李明明 ； 范宗宸

亞洲大學/人文社會學院/生活應用科學學系碩士班/碩士(2007年)

摘要

糖尿病已成為國人最常見的疾病之一，不僅對患者的健康和生活品質造成影響，在經濟層面上也對個人及社會造成沉重的負擔。本研究期望透過糖尿病患者的健康行為，以瞭解患者在控制糖尿病效果上的差異，做為醫院對糖尿病患臨床治療以及患者平時的醫療方式的參考。 本研究參考相關文獻並依據本研究架構，設計一份符合本研究目的的結構式問卷，輔以Likert 五點尺度測量，利用非常同意、同意、無意見、不同意、非常不同意等選項讓填答者勾選。本研究之研究對象為雲林地區台大醫院、成大醫院、慈濟醫院、慈愛醫院等糖尿病門診患者，由於糖尿病患者樣本取得不易，因此本研究採取便利抽樣方法，於民國九十六年六月六日至六月二十二日期間，派員展開問卷式訪談，經由受過訓練之訪談員進行一對一面談，以取得病患之有效問卷，本問卷最後總共回收122 份之有效問卷。 本研究的研究發現為，(1)女性糖尿病患者比男性更為重視藥物控制治療。(2)年齡在41 到55 歲的糖尿病患者最主要的醫藥認知訊息管道來源則是親友、電視、網路、電台等非專業性管道。(3)教育程度並不會對醫藥知識或訊息的來源管道、平時的健康行為模式造成太大的顯著性差異。(4)從事軍公教類的糖尿病患者很重視非專業的醫藥認知訊息管道。(5)月平均收入愈高的糖尿病患者愈可能透過非專業性的醫藥認知訊息管道獲取保健醫療等相關知識與資訊。主要的醫藥認知訊息管道來自於專業醫師或醫護人員的糖尿病患，較能夠按時服用醫師開的藥物並且按時複診。若糖尿病患者的醫藥訊息來源同時受到專業醫師、醫護人員和非專業性的親友、電視、網路、電台的影響，這些醫藥認知訊息管道皆會鼓勵病患多從事飲食療養的健康行為。另一方面，透過親友、網路、電視、電台等非專業性管道的介紹，會影響糖尿病患者服用補充性食品。糖尿病患者在接受藥物控制治療、飲食療養、服用補充性食品等治療可以減輕心理的壓力，並有助於病情的發展。此外，按時遵照醫師囑咐看診、服藥之患者，血糖值控制的情況較良好。糖尿病患者在多吃有益於身體健康的食物方面，以食用青菜、水果類的人數最多(49%)，表示糖尿病患者仍以蔬果為最主要的食物來源。在三餐食物烹煮方式改變方面，以清淡、少油的烹煮的方式最受到糖尿病患者的青睞，各佔37.8%、22.2%的比率。在服用西式補充性食品方面，以鈣和維他命為糖尿病患者最常服用的西式補充性食品，各佔15.5%、11.1%的比重。而在服用中式補充性食品方面，六味地黃丸、香椿茶、當歸、枸杞、粉光、冬蟲夏草、何首烏、龜鹿二仙精都是糖尿病患者常服用的中式補充性食品。 經過文獻探討與實證後，本研究所得結論為，病患特徵會對醫藥認知訊息管道和病患健康行為造成顯著性不同的影響，而醫藥認知訊息管道的不同也會對病患的健康行為有顯著性的影響；另一方面，不會因為病患健康行為的不同，而對糖尿病的控制效果有顯著差異影響；多吃青菜、清淡、多吃鈣、或六味地黃丸等補充性食品是糖尿病患者常見的健康行為。

關鍵字

病患特徵 ； 醫藥認知訊息管道 ； 病患健康行為、糖尿病控制效果

並列摘要

Diabetes has become one of the most common diseases in our country. It not only effects patient’s health and living quality, but also becomes an economically heavy burden for the person and the society. This research through diabetic’s healthy activities is expected to understand the differences of the result that the patients control their diabetes. It would provide a reference to the hospitals where patients receive clinical diagnosis, and also provide a reference to the diabetes who do every day medical care.
This research is made after consulting relevant documents. Based on the framework of this research, a structured questionnaire conforming to the research purpose is designed. The questionnaire is supported with Likert 5-interval scale. The questionnaire fillers may select “completely agree”, “agree”, “no comments”,
“disagree” or “completely disagree”.The researched subjects are the diabetic outpatients in National Taiwan University, Cheng Kung University Hospital and Buddhist Tzu Chi General Hospital and TZU-AI General Hospital in Yunlin area, Taiwan. As it is not easy to get the diabetic samples, this research is made by convenience sampling. In 2007 a questionnaire interview was made from June 6 to June 22. The well-trained interviewers proceeded one-to-one interviews, and got valid questionnaires from the patients. Total 122 copies of the valid questionnaire are received.
The finding of the research shows – (1) Females pay more attentions to the medical control and treatment than males. (2) For the diabetics aged from 41 to 55, their main medically cognitive information source comes from non-professional channels, such as relatives, friends, TV programs, network and broadcast stations. (3) Education degree can’t cause heavy dominance difference to medicine cognitive information channel and healthy behavior model. (4) Engaged in the educational, government or soldier diabetics pay more attention to non-professional counseling channel. (5) The high income diabetics are more dependants on non-professional medically cognitive information chancels, and diabetics of the monthly income in 20000-30000 pay more attention to supplementary food. The diabetics that the main medicine cognitive information channel comes from professional doctor or medical personnel take medicine and subsequent visit on time.Diabetics have professional medically cognitive information sources, such as professional doctors and medical personnel, and non-professional medically cognitive information sources, such as relatives, friends, TV programs, network and broadcast stations. All of these medical sources will encourage the patients to take diet treatment as a healthy behavior. Besides, the non-professional channels of relatives, friends, network, TV programs and broadcast stations will introduce the diabetics to take supplementary food as a healthy behavior. The diabetics may reduce their mental pressure when they receive medical control treatment, diet treatment and supplementary food. It is helpful to improve patient’s condition. Besides, the patients who follow doctor’s instructions to the hospital and take medicine have a better control on their blood sugar value. For healthy food, most of the diabetics eat vegetables and fruits. They occupy 49% of the total samples. In other words fruits and vegetables are the main food sources for the diabetics. For improving cooking method for 3 meals, the less salt and less oil cooking methods are most popular to the diabetics. They occupy 37.8% and 22.2% respectively. For taking western style supplementary food, calcium and vitamins are the most common supplementary food for the diabetics. They occupy 15.5% and 11.1% respectively. For taking Chinese style supplementary food, 6-herb Rehmannia pills, Xiang Chun tea (Toona sinensis Roem), udo, froctus lycii, American ginseng (Panacis Quinquefolii Radix), winter worm and summer grass (cordyceps sinensis), he shou wu (radix polygoni multiflori) and turtle-deer two fairy jelly are often used by the diabetics.After probing into the documents and experiments, this research comes to a conclusion – the characters of the patients will obviously effect the patients on their healthy behaviors and selecting channels of medically cognitive information. On the other hand, there is no obvious difference on the efficiency of controlling the diabetes because of patient’s different healthy behavior. It is a common healthy behavior that the diabetics eat less salt, more green vegetable, calcium or 6-herb Rehmannia pills as supplementary food.

並列關鍵字

the characters of the patients ； channels of medically cognitive information

參考文獻

4. 劉育昀(2005)。中草藥複方發酵產物在小鼠降血糖之評估。南台科技大學生物科技系碩士論文。

19. 康翠秀、陳介甫、周碧瑟(1998)。台北市北投區居民對中醫醫療的知識、信念與行為意向及其對醫療利用型態之影響。中華衛誌，17(2): 80-91。

28. 范靜媛(1997)。非胰島素依賴型糖尿病盛行率與危險因素。中華衛誌，16(4):291-308。

3. 行政院衛生署國民健康局，http://www.bhp.doh.gov.tw/BHP/index.jsp。

5. 美國疾病管制局，http://www.cdc.gov。