第2型糖尿病患者自我效能及社會支持與遵醫囑行為之相關研究-以台北縣某區域教學醫院為例

Abstract

本研究目的在探討自我效能、社會支持對糖尿病患者遵醫囑行為的影響。以台北縣某區域教學醫院門診就醫之第２型糖尿病之患者為母群體，採取立意抽樣於九十二年十月二十八日至十一月二十一日間至該院內分泌科門診就醫154位患者做為研究樣本。 以結構性問卷由個案填答或以訪談方式進行調查，所得研究結果如次： 一、糖尿病患者自我效能、社會支持及遵醫囑行為現況方面： （一）糖尿病患者自我效能平均每題3.53分，偏向正向，「依醫囑用藥」最具信心，執行「規律運動」最無自信做到。 （二）病患感受社會支持程度普通（平均每題2.60分），「家人」為社會支持的主要來源。 （三）糖尿病患者之遵醫囑行為平均每題3.40分，偏向正向，「依醫囑用藥」行為最佳，其次依序為「飲食控制」，「規律運動」。 二、個人基本資料變項對自我效能、社會支持及遵醫囑行為影響方面： （一）社經地位層次高者自我效能的程度較強；有宗教信仰者其自我效能程度高於無宗教信仰者。 （二）社經地位層次高者感受社會支持程度較強；有宗教信仰者其社會支持感受程度高於無宗教信仰者；血壓正常者有較佳的社會支持。 （三）男性遵醫囑優於女性；社經地位層次高者遵醫囑行為較佳；無併發症者較傾向遵循醫囑；血壓正常者有較佳的遵醫囑行為；血糖控制情形良好者其遵醫囑行為顯著優於不良者。 三、自我效能、社會支持與遵醫囑行為之相關性分析方面： （一）自我效能與「整體遵醫囑行為」、「依醫囑用藥」、「飲食控制」、「規律運動」呈現顯著正相關。 （二）社會支持與「整體遵醫囑行為」、「依醫囑用藥」、「規律運動」呈顯著正相關，但與「飲食控制」之相關性未達顯著水準。 四、「社經地位」、「是否有併發症」、「血壓情形」、「血糖控制情形」及「自我效能」、「社會支持」對糖尿病患者「整體遵醫囑行為」的預測力為60%。其中「自我效能」為最有力的預測變項。

The purpose of the study was investigating the influence degree of compliance behaviors for Diabetes Mellitus patients by self-efficacy and social support. Selecting type II Diabetes Mellitus patients as parent sample from a regional teaching hospital in Taipei Hsien by purposive sampling. Data was collected by means of interviewing and questionnaire at one endocrine out–patient department from 28th October, 2003 to 21th November, 2003 , and 154 questionnaire were completed in this study. The main findings of the study were as following: (I)The current condition of self-efficacy、Social support and compliance behaviors: (i) The average score of Diabetes Mellitus patients’ self-efficacy were 3.53, tended to positive.「Compliance behaviors」was most confidently;「Execution regular sports」was least confidently. (ii) The feeling of Diabetes Mellitus patients’ social support degree was ordinary (average score was 2.6); 「family」was main source of social support. (iii) The average score of Diabetes Mellitus patients’ compliance behaviors was 3.4, tended to positive; 「compliance behaviors」 was best, the next was 「diet controlling」 and 「regular sport」 (II)The influence of self-efficacy、Social support and compliance behaviors by personal basic data items (i) The Diabetes Mellitus patients who was the higher social position, the stronger degree of self-efficacy (F=8.48***) and who had faith was stronger degree than not as well( t=3.26**) (ii) The Diabetes Mellitus patients who was the higher social position, the stronger degree of social support(F=5.39***) and who had faith was stronger degree than not as well( t=3.35**). The Diabetes Mellitus patients who was normotensive had better social support. (iii) Male Diabetes Mellitus patients’ compliance behaviors was better than female(t=2.42*). The higher social position,the better compliance behaviors (F=4.26**) The Diabetes Mellitus patients had no complication was more tending to compliance behaviors (t=2.88**) The Diabetes Mellitus patients who was normotensive had better compliance behaviors (t=2.63**) The compliance behaviors of Diabetes Mellitus patients who had controlling blood sugar well was better than bad controlling.(F=4.90**) (III)The correlation analysis of self-efficacy、social support and compliance behaviors. (i) Self-efficacy with 「overall compliance behaviors」、「taking medicine by doctor's advice」、「diet controlling」、「regular sport」had positive correlation (correlation coefficient were 0.73, 0.57, 0.62 and 0.84 ,respectively) (ii) Social support with 「overall compliance behaviors」、「taking medicine by doctor's advice」、「regular sport」had positive correlation (correlation coefficient were 0.36, 0.17, 0.42 ,respectively), but 「diet controlling」did not . (IV)「Social position」、「complication」、「blood pressure」、「blood sugar controlling」、「self-efficacy」、「social support」 can explain 60% of variance of Diabetes Mellitus patients’ overall compliance behaviors, and「self-efficacy」was the best variable in the above variables.