自我調節方案對前期糖尿病者自我效能、生活型態與生理指標改變之成效

Effects of self-regulation protocol on the self-efficacy, lifestyle and physiologic measures changes of pre-diabetes

徐貴珍(Guey-Jen Shyu)

指導教授 ： 林秋菊

高雄醫學大學/護理學院/護理學系研究所/碩士(2012年)

摘要

背景:前期糖尿病是糖尿病出現之前的先兆，假如未經適當改善或處置，將在數年之中慢慢惡化進展成真正的糖尿病。

目的:本研究旨在探討「自我調節方案」對前期糖尿病個案自我效能、生活型態與生理指標(空腹血糖、葡萄糖耐量測試、糖化血色素、身體質量指數、腰臀圍比值)之成效。

方法:研究採雙組前、後測之實驗設計；受試者來自南部某醫學中心員工與社區民眾。以抽籤方式隨機分配受試者至實驗組(n=16)與控制組(n=15)。實驗組接受為期四週，每週一次之「自我調節方案」介入；此介入方案係以自我調節理論為根基設計而成；此方案包括四次團體活動及每週兩次的電話追蹤。

結果:研究結果顯示「自我調節方案」介入後的第四週(後測一)與第十二週(後測二)，實驗組在自我效能、生活型態與生理指標均顯著改善且優於控制組。

結論 /實務應用:實證數據結果支持，以自我調節理論為根基的教育方案，具有預防前期糖尿病者疾病進展之潛在功效。健康照護者可將之運用於臨床與社區中糖尿病高危險族群。也建議未來研究採用此介入方案施測於大規模樣本，確認其效應，並追蹤自我調節方案對前期糖尿病者之延宕效果。

關鍵字

前期糖尿病 ； 自我調節 ； 自我效能 ； 生活型態 ； 生理指標

並列摘要

Background:Pre-diabetes is an early warning sign for diabetes. It may progressively deteriorate and develop into frank diabetes within years if not improved or managed properly.

Purpose:The purpose of this study was to explore the effects of a self-regulation protocol on the self-efficacy, lifestyle, and physiological parameters (fasting blood glucose, glucose tolerance test, glycated hemoglobin, body mass index, and waist to hip ratio) in patients with pre-diabetes.

Methods:A two-group, pretest-posttest experimental design was used. Subjects recruited included employees of a medical center in southern Taiwan and community people and were randomly assigned to the experimental group (n = 16) or the control group (n = 15) by drawing lots. The experimental group received the intervention of a “self-regulation protocol” derived from self-regulation theory once per week for 4 weeks. This protocol included follow-up phone calls twice per week and four group activities.

Results:Results indicated that the self-efficacy, lifestyle, and physiological parameters of the experimental group at the 4th (posttest 1) and 12th (posttest 2) weeks after the intervention of “self-regulation protocol” were significantly improved and better than those of the control group.

Conclusions/ Implications for practice:This study provides evidence-based data to support the potential effects of a self-regulation theory based protocol in preventing disease progression in patients with pre-diabetes. Therefore, health care providers may apply it to patients at high risk of developing diabetes in clinical and community care. We also suggest that future studies apply this self-regulation intervention to a large sample size to confirm the effects and follow-up its delayed effects on patients with pre-diabetes.

並列關鍵字

Pre-diabetes ； self-regulation ； self-efficacy ； lifestyle ； physiological parameters

參考文獻

鍾寶玲（2001）．老年糖尿病患健康促進生活型態及相關因素之探討（未發表碩士論文）．高雄醫學大學護理研究所。

魏米秀、呂昌明（2005）．「健康促進生活型態中文簡式量表」之發展研究．衛生教育學報，24，25-46。

Anderson, E. S., Winett, R. A., & Wojcik, J. R. (2007). Self-regulation, self-efficacy, outcome expectations, and social support: Social cognitive theory and nutrition behavior Annals of Behavioral Medicine, 34(3), 304-312.

Anderson, E. S., Winett, R. A., & Wojcik, J. R. (2007). Self-regulation, self-efficacy, outcome expectations, and social support: social cognitive theory and nutrition behavior. Annals of Behavioral Medicine 34(3), 304-312.

American Diabetes Association, (2010). Diagnosis and classification of diabetes mellitus. Diabetes Care, 33(1), S62-S69.