糖尿病共同照護於第二型糖尿病病人健康促進行為與糖化血色素控制之成效

Effects of a Diabetes Shared Care Program on Health Promotion Behaviors and HbA1c Control for Patients with Type 2 Diabetes

詹紹華(Shao-Hua Chan) ； 蔡明燕(Ming-Yan Tsai) ； 邱智鈴(Ge-Lin Chiu) ； 林為森(Weirsen-Lin)

《澄清醫護管理雜誌》 14卷2期 (2018/04) Pp. 50-57

摘要

目的：糖尿病共同照護網可以提供糖尿病病人可近性、連續性、完整性的醫療照護，以預防及延緩糖尿病併發症的發生。本研究的主要目的為探討參與及未參與糖尿病共同照護方案病人在健康促進行為與糖化血色素控制之照護成效差異。方法：本研究為類實驗設計，採立意取樣，於南部某醫學中心新陳代謝科門診收集樣本，共收案108人。實驗組為加入糖尿病共同照護方案的病人，控制組為未加入糖尿病共同照護方案的病人。於首次收案及6個月後進行資料收集，並以知識、態度、行為及糖化血色素控制狀況檢視方案介入後之成效。結果：研究結果發現，加入糖尿病共同照護方案之病人無論是在知識、態度、行為及糖化血色素控制的表現皆比未加入共同照護方案之病人有顯著性的改善（p＜0.05）。分析主要原因為共同照護方案之介入，能依糖尿病病人的個別需求提供連續且完整性的照護，較能提升病人的學習力與改變力。結論：糖尿病共同照護方案的介入，對於病人知識、態度、行為及糖化血色素的控制均有所助益，因此介入方案有確實的效益與可行性，未來應積極推動糖尿病共同照護方案以提供完整的照護措施。

關鍵字

糖尿病共同照護 ； 糖化血色素 ； 健康促進行為

並列摘要

Purposes: A diabetes shared care network can provide accessible, continuous, and comprehensive medical care to patients with diabetes to prevent and/or delay the occurrence of diabetes complications. The main objective of this study was to investigate differences seen in the effects of care-in terms of health promotion behaviors and glycated hemoglobin (HbA1c) control-between diabetic patients who participated in a shared care program and those who did not. Methods: This was a quasi-experimental study that used purposive sampling. A total of 108 patients with type 2 diabetes were recruited from an outpatient clinic with the Division of Metabolism, located in a medical center in southern Taiwan. Diabetic patients who joined a shared care program formed the experimental group, while those who did not participate in this type of program were in the control group. Data on patients' level of knowledge, attitudes, health promotion behaviors, and HbA1c control were collected at the time of recruitment and 6 months after the intervention to examine its effects on patients. Results: The results demonstrated that the experimental group showed significant improvement (p＜0.05) in level of knowledge, attitude, health promotion behaviors, and HbA1c control compared to the control group. The primary reason for these differences was found to be the intervention through the diabetes shared care program. This program provides continuous and comprehensive care according to the individual needs of patients with diabetes and, as such, may increase a patient's ability to learn and change their behavior. Conclusions: In this study, the diabetes shared care program demonstrates measurable benefits of patients' knowledge, attitudes, health promotion behaviors, and HbA1c control. A diabetes shared care program is truly beneficial and feasible and should be proactively promoted in the future to provide comprehensive care.

並列關鍵字

Diabetes shared care program ； HbA1c ； Health promotion behaviors