行動數位健康素養與自我效能對第二型糖尿病個案自我照顧行為影響之探討

Abstract

全球糖尿病盛行率逐年增加，其致死率與高發病率成為醫療界不得不關注的重要健康問題之一，而此疾病之健康管理與照護問題亦隨之衍生。隨著時代演進，科技在我們生活中扮演的角色日益重要，過去國外相關文獻指出，結合數位健康素養和自我效能的方法，可能是改善糖尿病個案自我照護行為和血糖控制的有效途徑；然而，這樣的正向關聯性在台灣卻鮮少有實證研究可加以驗證。 本研究旨在探討行動數位健康素養、自我效能與人口變項對於糖尿病個案自我照顧行為之影響，透過收集相關數據，可建構理論模型加以了解各變項之影響及其之間的相關性。研究全程遵循研究倫理審查原則進行，採用橫斷性研究，透過方便取樣的方式自臺灣北部一家醫學中心的門診部門招募250位第二型糖尿病個案自填記名問卷，以收集人口變項、臨床特徵、行動數位健康素養、自我效能和自我照護行為等相關數據，資料經除錯與確認後遂進行描述性和推論性統計分析。 主要研究結果發現在糖尿病自我照護行為的各面向中，以藥物自我照顧行為最好、運動行為最差。而在人口變項中糖尿病個案的年齡越大、自我照顧行為較佳，身體質量指數越低、運動行為越好。而婚姻狀況亦在自我照顧行為上產生統計差異，已婚者的自我照顧行為顯著高於未婚者與離婚者。此外，研究亦證實自我效能與自我照護行為確實呈現顯著正相關；研究中也發現，在行動數位健康素養和電子健康素養兩者之間，以及糖尿病個案的自我照顧行為之間，都存在著正向關係。顯示提高行動電子健康素養水平，確實有助於改善糖尿病個案的自我照顧行為，進而提升血糖控制。 整體而言，本研究之結果證實了行動數位健康素養以及自我效能的提升對於糖尿病個案的自我照護行為有著顯著而重要的影響力，相關研究結果將有助於醫療保健專業人員設計更有效的糖尿病管理計畫，提供更適切的健康建議和教育資源，並鼓勵糖尿病個案在日常生活中採取更積極的自我照護措施。這項研究還可以提高糖尿病個案對數位健康科技的認識和使用率，進而改善糖尿病個案的生活品質和健康狀況。

The escalating global prevalence of diabetes and its elevated mortality and morbidity rates have rendered it an indispensable health issue for the medical community to address. As a result, the challenges related to health management and care for this disease have surfaced. Over time, technology has assumed a progressively crucial role in our lives. Prior international literature has posited that the integration of digital health literacy and self-efficacy may constitute an efficacious strategy for enhancing self-care behaviors and glycemic control in diabetic patients. Nonetheless, empirical studies investigating such positive associations remain scarce in Taiwan. This study seeks to explore the relationships among individual characteristics, self-efficacy, and mobile digital health literacy. Through the collection of pertinent data, a theoretical model can be developed to comprehend the influences of these factors on diabetic patients’ self-care behaviors and the interconnections among them. Adhering to the principles of research ethics review, the study employs a cross-sectional design. A convenience sample of 250 patients diagnosed with type 2 diabetes mellitus (T2DM) was obtained from the outpatient department of a medical center in Northern Taiwan, who were requested to complete named questionnaires. These questionnaires gathered data pertaining to demographic variables, clinical features, mobile health literacy, self-efficacy, and self-care behaviors. Subsequent to data cleansing and validation, descriptive and inferential statistical analyses were conducted. The primary findings reveal that, among the various dimensions of diabetes self-care behaviors, medication adherence outperformed exercise adherence. In terms of demographic variables, older diabetic patients and those with lower body mass index (BMI) demonstrated superior self-care behaviors and exercise habits, respectively. Marital status also yielded statistically significant differences in self-care behaviors, with married participants exhibiting markedly higher self-care behaviors compared to their unmarried and divorced counterparts. Furthermore, the study corroborated the existence of a significant positive correlation between self-efficacy and self-care behaviors. Positive relationships were also observed between mobile health literacy and e-health literacy, as well as among the self-care behaviors of diabetic patients. This implies that enhancing mobile e-health literacy levels indeed facilitates improved self-care behaviors and glycemic control in diabetic patients. In summary, the findings of this study substantiate the considerable and vital influence of mobile health literacy and self-efficacy on diabetic patients’ self-care behaviors. These results will assist healthcare professionals in devising more effective diabetes management plans, offering more suitable health advice and educational resources, and motivating diabetic patients to implement more proactive self-care measures in their daily routines. Additionally, this research has the potential to augment diabetic patients’ awareness and utilization of digital health technologies, ultimately improving their overall quality of life and health outcomes.