| 摘要: | 本研究目的為探討社區糖尿病個案自我照顧行為現況，並從社會人口學、疾病狀況、生活型態、疾病監測認知及醫療使用五個部份探討與自我照顧行為之關係。研究對象以健康檢查篩檢出禁食血漿血糖值≧126mg/dL，並經專科醫師診斷出之第2型糖尿病個案，以進行面對面問卷訪談收集資料，計完成97名；平均年齡為67.1歲。 本研究發現：一、在社會人口學方面，自我照顧行為女性較好(p=0.011)；中、高社經地位較低社經地位好(p=0.023)；無宗教信仰者較有宗教信仰者好(p=0.049)；經濟來源由家人資助與老農津貼者較自己薪水所得與靠退休金者好(p=0.053)。二、在疾病狀況方面，沒服藥者之自我照顧行為較差(p<0.001)。三、在生活型態方面，有喝酒(p<0.001)、有吸菸(p=0.002)和有嚼檳榔者(p=0.041)之自我照顧行為較沒有者為差。有運動行為者(p<0.001)及有參與團體運動者(p=0.012)之自我照顧行為較好。四、在疾病監測認知方面，知道正確空腹血糖控制值(p=0.057)及總膽固醇控制值(p=0.052)、有量血壓(p=0.001)、有抽血做血糖檢查(p<0.001)和有蒐集健康資訊者(p<0.001)在自我照顧行為上的表現較好。五、在醫療使用方面，有就醫者自我照顧行為較好(p<0.001)，而拿慢性病處方籤者(p<0.001)比其他就醫行為者自我照顧行為好。六、複迴歸顯示自我照顧行為的預測因子為就醫狀況、運動行為、蒐集健康資訊、吸菸行為、遵囑服藥、性別及社經地位，可解釋自我照顧行為總變異量的74.4%。 建議基層健康單位應增進與社區糖尿個案的互動關係和評估照護需求，並提升個案疾病知識與自我照護技能。
The main objective of the present study is to investigate the self-care behaviors of individuals with diabetes mellitus. The association between self-care behavior and socio-demographic characteristic, disease status, lifestyle, knowledge of disease self-monitoring, and the utilization of medical facilities were evaluated. Participants whose fasting blood glucose level were greater than 126mg/dL and diagnosed to have type 2 diabetes by medical specialists were recruited from health screenings. Face-to-face interviews using structured questionnaire were conducted and completed on 97 individuals. The average age of the participants was 67.1 years. Results indicated that in terms of socio-demographic characteristic, females had better self-care behavior (p=0.011); those who were in the middle to high socioeconomic status had better self-care behavior than those who were in the low socioeconomic status (p=0.023); those with no religious affiliation had better self-care behavior than those who had religious affiliation (p=0.049); and those with source of income from other family members or from subsidization for farmers had better self-care behavior than those who received wages from work or those who were depending on retirement pension (p=0.053). In terms of disease status, those who did not take medication had worse self-care behavior than those who did (p<0.001). In terms of lifestyle, those who had the habits of drinking alcohol (p<0.001), smoking (p=0.002), or chewing betel nut (p=0.041) had worse self-care behavior than those who did not. Those who exercised (p<0.001) and participated in group exercise (p=0.012) had better self-care behavior. In terms of knowledge of disease self-monitoring, those who understood fasting blood glucose level (p=0.057) and total cholesterol level (p=0.052), monitored their blood pressure (p=0.001), went for blood glucose test (p<0.001), or collected health information (p<0.001) had better self-care behavior. In terms of utilization of medical facilities, those who sought medical treatment (p<0.001) and those who obtained three-month prescription for their disease had better self-care behavior (p<0.001) Results from multiple stepwise regression indicated that medical utilization behavior, physical activity, health information seeking behavior, smoking, sex, and socioeconomic status were important predictors for self-care behavior. These factors could explain 74.4% of the variances in self-care behavior. It is suggested that the health units should increase interaction with the people in the community and should evaluate their needs for health care. Health units should also help the people in the community to increase the knowledge about their health and to improve their self-care skills. |
