糖尿病共同照護對病患生理指標的影響－以某區域醫院實施ㄧ年為例

Abstract

本研究主要探討接受糖尿病共同照護的病患與未參與共同照護制度的病患，相關流程、行為與生理指標之變化是否有所差異。收案個案排除腎功能不良者、胰島素注射者與無法自行照護及溝通的病患，分為接受糖尿病共同照護的「介入組」（44位）與一般門診照護的「對照組」（49位），共計93位糖尿病患。資料分析結果顯示介入組病患的相關流程與行為等指標指執行率皆優於對照組病患的相關指標。兩組病患之糖化血色素、空腹血糖、飯後血糖、收縮與舒張壓等生理指標，前後測之變化亦呈現顯著差異；進一步以差異中差異方法分析比較兩組收案一年前後的情形，結果顯示介入組之糖化血色素、空腹與飯後血糖值及膽固醇均達到顯著進步。根據研究結果，本研究結論為在某區域級醫院，接受糖尿病共同照護的病患，在一年期間內，其生理指標之變化，比未參加共同照護之糖尿病患有顯著的正向改善。

This research primarily studies patients who participated in diabetic shared care and patients who did not participate in the shared care system, and whether there were differences in the changes related to the process, behavior and physiological indeces. After eliminating patients who had renal function impairment, received insulin injection and patients who could not care for themselves or communicate, a total of 93 diabetic patients were divided into “intervention group” (44 patients) who participated in the shared care program, and “control group” (49 patients) who received regular outpatient service. Data analysis shows that the related process and behavior index rate of the patients in the intervention group were higher than that of patients in the control group. The glycosylated hemoglobin, fasting glucose, postprandial glucose, systolic pressure, diastolic pressure of the patients in these two groups changed significantly pre and post-study; the changes of one year were further compared with difference in difference. It shows that glycosylated hemoglobin, fasting glucose, postprandial glucose and cholesterol had significant difference. According to the research results, the conclusion of this research is that the physiological change in the patients who participated in the diabetic shared care had more positive improvements than patients who did not participate in the diabetic shared care.