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標題: | 糖尿病患體重管理的認知與行為分析
以某內科診所為例 Diabetes Patients’ Cognition and Behavior Analysis Regarding Weight Control: Case Study of an Internal Medicine Clinic |
作者: | Tun-Jen Hsiao 蕭敦仁 |
指導教授: | 黃恆獎,陳忠仁 |
關鍵字: | 糖尿病,肥胖,減肥,量化自我,電子穿戴裝置, quantified self,diabetes,obesity,weight control,electronic wearing device, |
出版年 : | 2015 |
學位: | 碩士 |
摘要: | 肥胖問題是目前全世界共同面臨的公共衛生議題,而糖尿病是與肥胖關係最密切的慢性病。本研究分析某一台灣基層醫療診所中糖尿病患對體重管理的認知與行為分析,希望能據以發展未來積極以體重管理為核心的新糖尿病照護模式。
探討的問題如下: 糖尿病患的肥胖比率?患者知道肥胖症是糖尿病的原因之一嗎?是否知道減肥有助於糖尿病控制?糖尿病患曾接受過哪一些肥胖治療?哪類糖尿病病患較願意談論及接受肥胖治療?目前有新的量化自我的減肥方法,哪些是糖尿病患比較願意接受的?目前減肥屬於自費範疇,糖尿病患每月願意付多少錢接受減肥治療? 此次研究先選定桃園某一內科診所的糖尿病患做為主要研究標的,由研究人員先擬定問卷內容,並請2015年7月有回診的病患填寫。所有問卷在填寫完畢後由工作人員鍵入excel 2010中,再轉入SAS 9.2版做進一步分析。 最後收集113份完整問卷,其中男性54位 (48%),女性59位 (52%)。平均年齡為58.2 ± 12.7歲(32-83歲間)。平均BMI為26.9 ± 4.3,依台灣體位標準BMI≧24為過重,BMI≧27為肥胖,則此診所糖尿病患過重與肥胖者共佔74.3%。若與第五次台灣國民營養調查比較,明顯BMI較大。113位中,認為體重過重是糖尿病的因之一的有54位(47.8%)。在瞭解減重可以改善糖尿病情方面,81位(71.7%)回答減肥有助糖尿病制。47位(41.6%)糖尿病患者曾減肥過,其曾經用過的減肥方法主要為飲食控制及增加運動量。目前有31位(27.4%)糖尿病患正在減肥,其中30位是BMI ≧ 24者,佔需要減肥84位之35.7%,而其用的方法主要仍為飲食控制及增加運動量。74位(65.5%)願意醫師與他談體重問題,但若只看BMI ≧ 24的84位,則也有56位(66.7%)願意醫師與他談體重管理,病患願意與醫師談論體重問題的比率與肥胖與否並無統計相關。若減肥費用自付,則84位中只有27位(32%)願意接受;而這27位願意自費減肥者每月願意花費平均為3046元/月。在診所打算用一些新方法協助糖尿病患減肥的問題中較受歡迎的第一名為每天量體重,並記錄追蹤減肥成效76位(67.3%),第二名為每天帶計步器或電子手環,實行每日5000步計畫,並上傳資料至診所36位(31.9%),三名為跟親朋好友一起進行體重管理,並互相監督減重進度18位(15.9%)。 綜合此次研究發現,我們了解此基層診所糖尿病患體重過重的比率約3/4;只有約一半的患者了解體重上升與糖尿病有關係;而七成病患了解減重有助糖尿病控制;四成糖尿病患有減肥經驗;過重或肥胖的糖尿病患有36%正在減肥,方法以飲食控制與增加運動為主;而新的減肥法中以每天量體重、量化自我、及公開資訊為主,這些發現可作為未來在設計糖尿病患減肥計畫時之參考。 Obesity is one of the greatest public health problems in the world. The prevalence of obesity in Taiwan is increasing these decades. Diabetes correlates closely with obesity. In this study, we focused the diabetes patients in a primary clinic in Tao-Yuan city, Taiwan, and tried to research the cognition and behavior regarding to weight control in them. We want to develop a weight control- based diabetes care model after this work. The issues we want to study are as below: 1. The prevalence of overweight and obesity in these diabetes patients? 2. Do they know obesity in one of the causes of diabetes? And do they know that weight loss can improve diabetes condition? 3. Has they received any obesity treatment before? And how many patients are on a diet now? 4. Do the diabetes patients want their physicians to discuss body weight issue with them? 5. What percentage of diabetes patients might pay for obesity treatment? And how many new Taiwan dollars they could pay? 6. What kinds of quantified self about weight control they like to adopt? Questionnaire was developed by the problems we want to discuss. And the subjects who visited the clinic during 1st to 31st July 2015 were invited to fill out the questionnaire. All the data was keyed in in Excel 2010 edition and was transformed to SAS 9.2 edition for further analysis. Finally, 113 patients completed the questionnaires. They were 54(48%) male gender and 59(52%) female gender. The mean age was 58.2 ± 12.7 years old. The mean BMI was 26.9 ± 4.3. The percentage of the subjects whose BMI ≧ 24 was 74.3%. 54(47.8%) subjects knew that obesity is a cause of diabetes. And 81(71.7%) answered weight loss had good influence in diabetes control. 47(41.6) had the experience of weight control, and the main methods were on a diet and exercise. 30(35.7%) among the 84 whose BMI ≧ 24 has a weight control program now, and the methods were on a diet and exercise also. 74(65.5%) accept their physician to talk weight control issue to them. 27(32%) is willing to pay for weight control program with a mean of 3046 NT dollars/month. The most accepted new methods in weight control were: weight daily, quantified self in walking steps per day, and open information of self. Based on the information gathered from this study, we will keep going to develop a new weight control program for overweight diabetes patients. |
URI: | http://tdr.lib.ntu.edu.tw/jspui/handle/123456789/52125 |
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