糖尿病患者健康自我管理與血糖控制相關性探討－以中部某醫學中心為例

The Relationship between Health Self-Management and Glycemic Control among Diabetes Patients-A Case of Medical Center in Central Taiwan

施淑美(Shu-Mei Shih) ； 張彩秀(Tsai-Hsiu Chang)

《健康生活與成功老化學刊》 2卷1期 (2010/12) Pp. 38-53

https://doi.org/10.29775/JHLSA.201012.0004

摘要

背景：糖尿病對人類健康的威脅，源自於血糖控制不良引起的慢性併發症，因此血糖之控制很重要。目的：探討糖尿病患者健康自我管理與血糖控制情形，並分析其相關性。方法：採橫斷面相關調查研究，以方便取樣於中部某醫學中心門診第二型糖尿病患為對象，以結構式問卷調查方式進行資料收集，共收得有效問卷365份。結果：(1)糖尿病患者健康自我管理平均分數為2.82±0.60（分數介於1-4分），表示患者的健康自我管理屬於尚可。健康自我管理三個構面中，「疾病控制」表現最好，其次依序為「疾病適應」與「決策」。(2)33.7%的糖尿病患血糖控制良好，22.7%尚可，43.6%控制不良。(3)與家人親朋同住者、有糖尿病家族史、參加糖尿病衛教課程、教育程度愈高、身體質量指數過輕者的糖尿病患者健康自我管理行為較好。(4)年齡大者其血糖控制顯著較好，目前治療狀況中以口服降血糖藥物的血糖控制最好，胰島素注射合併口服降血糖藥物的血糖控制最差。(5)糖尿病病人健康自我管理越好，糖化血色素愈低，血糖控制越好。結論／實務應用：健康自我管理是促進糖尿病患者具有良好的疾病適應、疾病控制、決策的能力，因此宜培養好的健康自我管理的能力，以利血糖控制。

關鍵字

糖尿病 ； 健康自我管理 ； 血糖控制

並列摘要

Background: Poor glycemic control can cause a variety of chronic complications and even threaten the patient's health. It is therefore vital to keep the blood sugar level stable in order to reduce the incidence of chronic complications. Purpose: The purpose of this study was to investigate the relationship between health self-management and glycemic control among diabetes patients. Methods: A cross-sectional survey was conducted based on a convenience sample of patients with type 2 diabetes. Data were collected via a structured questionnaire from 365 diabetic adults recruited from an outpatient department of a medical center in central Taiwan. Results: (1) The results showed that diabetic patients' self-management ability was considered acceptable (Mean=2.82, SD=0.60, the score varies range from 1 to 4). Among the three domains, score of illness control was the highest and decision making was the worst. (2) Approximately 33.7% of the participants had good control of blood sugar level. On the other hand, 22.7% of the participants had fair control and 43.6% had rather poor control of blood sugar level. (3) Patients achieved better self-management when they have higher educational level, live with families, have family history of diabetes, have low body mass index, and receive education program on diabetes; (4) A positive correlation was found between older patients and better blood sugar level control; (5) The more health self-management ability on diabetes, the better controlled of the blood sugar level. As a result, patients had less HbA1C Conclusions/Implications for practice: The goal of health self-management is to assist patients with diabetes to have good illness adaptation, illness control and decision-making ability. Health professionals need to be competent in developing their patients' health self-management ability in order to have better glycemic control.

並列關鍵字

diabetes ； health self-management ； glycemic control