Psychosocial and Biological Factors Associated with Glycemic Control for Patients with Type 2 Diabetes: An Application of Structural Equation Modeling Analysis

影響糖尿病人糖化血色素控制之心理、社會及生理因素之探討

翁慧卿(Hui-Ching Weng) ； 洪朝明(Chao-Ming Hung) ； 紀淑靜(Shu-Ching Chi)

《Pan-Pacific Management Review》 13卷1期 (2010/01) Pp. 33-47

https://doi.org/10.30166/PPMR.201001.0002

摘要

本研究主要探討影響糖尿病人糖化血色素控制之心理、社會及生理方面因素。本研究蒐集285位有完成一年健保局論質計酬第二型糖尿病病人。研究結果顯示糖化血色素的控制與病人之性別、併發症數、個人內控、及行爲改變階段有顯著相關。本結果模型解釋了糖尿病人糖化血色素控制行爲49%的變異數(χ^2=32.18, df=29, p=.31)，顯示配適度良好(AGFI=0.96, RMSEA=0.018)。研究結果指出女性、教育水準較高者，知識較高者、個人內控較強者、及行爲改變階段較爲高階的在糖化血色素控制比較好。研究結果可作爲未來進行健康管理的糖尿病衛教的重要參考。

關鍵字

糖化血色素的控制 ； 糖尿病 ； 憂鬱 ； 行爲改變階段 ； 結構方程式

並列摘要

The purpose of this study is to identify the psychosocial and biologic factors associated with the effectiveness of glycemic control in a type 2 diabetes management program. The study group was comprised of 285 patients with type 2 diabetes mellitus who were enrolled for 12 months in the National Diabetes Pay-by-Quality Program. Structural equation modeling analysis was employed to determine the importance of various parameters to the effectiveness of glycemic control. The results showed that effectiveness of glycemic control was significantly associated with gender, number of complications, locus of control, stages of change and previous status of lycemic control. The final model proved to be valid (χ^2=32.18, df=29, p=.31), showing a sound fit (AGFI=0.96 and RMSEA=0.018). The model explained 49% of the variance of metabolic control at glycemic control. The findings obtained in this study offer an insight into the complexity of patient behavior in diabetes management. Health system specialists must understand the dilemmas of type 2 diabetic patients and their clinicians well as the limitations to successful treatments before expending substantial resources on disease management.

並列關鍵字

glycemic control ； diabetes ； depression ； stage of change ； structural equation modeling

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