醫護人員對於胰岛素幫浦治療的態度調查－初步報告

The Attitude of Care Providers in-Preliminary Report

林世鐸(Shi-Dou Lin) ； 杜思德(Shih-Te Tu) ； 蘇矢立(Shih-Li Su) ； 林素蘭(Su-Lan Lin) ； 曾雅玉(Ya-Yu Tseng) ； 黃倍紋(Pei-Wen Huang)

《中華民國內分泌暨糖尿病學會會刊》 21卷4期 (2008/07) Pp. 55-61

https://doi.org/10.7101/ED.200807.0055

摘要

研究顯示，使用胰岛素幫浦治療糖尿病的方式與一天多次的胰島素皮下注射比較，在血糖的控制方面，不但相差無幾，甚至有更佳的表現。近十年來，在美國選擇胰島素幫浦治療的人口急遽增加，許多的歐洲國家也有此趨勢。台灣引進胰島素幫浦至今已超過十年，使用量並不多。本研究的目的在於調查照顧糖尿病患者的醫護人員：對於此種治療方式的看法。研究針對2008年新陳代謝暨糖尿病學會年會當天，參加幫浦治療討論會的與會聽眾進行問卷調查。問卷答題人數爲48人，有治療經驗者則爲12人（佔1/4）。從中分析發現鮮少執行幫浦治療的因素有患者個人的經濟能力問題(66.7%)，醫護人員擔心自身的經驗不足(16.7%)、照顧此類患者須花費較多的時間(16.7%)及單位的人力不足(8.3%)。從沒有治療經驗的36人中分析，沒有執行幫浦治療的原因爲缺乏治療經驗(36.1%)，單位人力不足(33.3%)，患者個人的經濟能力問題(27.8%)等。對於已經使用胰島素但仍血糖控制不良者或第1型的糖尿病患者，有一半以上的機會，會告知胰島素幫浦治療此種治療方式。從結果可發現，幫浦治療所需的費用、缺乏有經驗的醫療團隊是幫浦治療要較爲普及化的主要阻礙。由於醫療人員的態度，對於患者治療方式的選擇，扮有舉足輕重的腳色，因此如何讓醫護人員增加幫浦的治療經驗，以造福更廣大的糖尿病族群，是仍待大家努力的課題。

並列摘要

A number of studies have shown nearly, equal or even, superior glycemic control with insulin pump therapy compared with multiple daily subcutaneous insulin injections. In the past ten years, the number of patients adopting insulin pump therapy has increased rapidly in the United States. Such trend is also seen in many European countries, In Taiwan, although insulin pump therapy was introduced over ten years ago, its use is still very limited. The purpose of this study is to investigate the attitude of diabetes care providers towards insulin pump therapy The study was based on a questionnaire survey of the participants of the pump therapy conference during the annual Endocrinology and Diabetology Society meeting in 2008. The questionnaires were completed by 48 participants, 12 of whom (one fourth) had had experience with pump therapy. According to the 12 experienced participants, the limited application of pump therapy may be attributed to the patient's inability to afford (66.7%), care provider's lack of experience (16.7%), more time needed to care for such patients (16.7%), and insufficient staff in diabetes centers (8.3%). According to the 36 inexperienced participants, the limited: application of pump therapy may be attributed to care provider's lack of experience (36.1%), insufficient staff in diabetes centers (333%), patient's inability to afford (27.8%), etc More than half of the participants will mention insulin, pump therapy to diabetic patients poorly controlled with sonventional insulin or to type 1 diabetic patients. Thus from this study, the major hindrances to gaining wider acceptance of pump therapy are its high cost and the lack of experienced care providers. The care provider's attitude may greatly influence the patient's treatment preferences. Therefore, in order to benefit more diabetic patients, greater efforts should be made to acquaint care providers, with insulin pump therapy.