胰島素治療之第2型糖尿病人定期血糖自我監測行為意圖的相關因素探討

Abstract

本研究旨在引用計畫行為理論（Theory of Planned Behavior）的架構探討並瞭解以胰島素治療之第2型糖尿病病人血糖自我監測（Self Monitoring Blood Glucose）行為意圖的相關因素，研究過程先以開放式引導問卷擷取主要信念，隨之編製結構式問卷訪談台北市某教學醫院每天注射胰島素至少二次之第2型糖尿病病人共計125位。 研究結果顯示，態度、主觀規範、自覺行為控制與其構成信念的相關性方面，除了態度與「行為與信念結果評價的交乘積和」未達顯著相關（r＝0.11）外；主觀規範與「規範信念與依從動機的交乘積和」（r＝0.79）、自覺行為控制與「控制信念與自覺力量的交乘積和」（r＝0.38）皆呈顯著相關。 研究對象對於執行定期血糖自我監測行為意圖趨於正向。研究對象的態度（r＝0.48，P＜.01）、主觀規範（r＝0.48，P＜.01）、自覺行為控制（r＝0.63，P＜.01）皆與定期血糖自我監測行為意圖達顯著正相關，且「態度」、「主觀規範」及「自覺行為控制」可解釋定期血糖自我監測行為意圖58.0％的變異量，其中又以自覺行為控制的預測力最強。而其餘模式外變項無法在理論變項之外顯著增加影響力。 進一步分析自覺行為控制之信念發現阻礙血糖自我監測之因素主要為「懶惰或覺得麻煩」；主觀規範中會影響病人血糖自我監測行為意圖者為來自醫護人員、家人、病友、親近的朋友的規範信念。研究者並依結果提出臨床應用之建議。

This study introduced the Theory of Planned Behavior as the framework to explore and understand related factors affecting the behavioral intention of regular self-monitoring blood glucose for type 2 diabetics treated with insulin. Major ideas were collected with an open-ended introductory questionnaire first and then a structured questionnaire was used to interview a total of 125 type 2 diabetes patients with at least twice injections of insulin per day at a certain teaching hospital in Taipei City. The results showed that in terms of the relationship between the attitude, subjective norm, perceived behavioral control, and the fundamental belief, except for the attitude that did not have a significant relationship with the product of “behavioral beliefs” and “evaluation” (r＝0.11), subjective norm and the product of “normative beliefs” and “motivation to comply” (r＝0.79), and perceived behavioral control and the product of “control beliefs” and “power” (r＝0.38) are both significantly related. Participants’ behavioral intention to self-monitor their blood glucose regularly was positive. Their attitude (r＝0.48，p＜.01), subjective norm (r＝0.48，p＜.01), perceived behavioral control (r＝0.63，p＜.01) are all positively related to the behavioral intention of regular self monitoring blood glucose and the attitude, subjective norm and perceived behavioral control could explain 58.0% of the variance in the behavioral intention of regular self monitoring blood glucose, among which perceived behavioral control was the most significant predictor. The other variables outside the theory model were not influential in any significant way. Advanced analysis on the belief behind the perceived behavioral control found that “laziness or feeling it was troublesome” was the major barrier to self-monitoring blood glucose. In the subjective norm, primary influencers on the patients’ intention to self monitor their blood glucose were the medical staff, family members, other patients, and close friends. A clinical application based on the results was recommended by the researchers.