| 摘要: | 研究背景：糖尿病為國人十大死因之一，隨著時代的變遷，糖尿病人口逐漸增加，如果血糖未控制好，容易發生併發症。而不良的醫病溝通加上病患本身對糖尿病的認知不足，或者醫護人員未說明清楚，皆容易造成病患不遵醫囑的因素，進而影響糖尿病患者的生活品質。
研究目的：本研究應用健康信念模式、醫病溝通、醫病關係來探討影響遵醫囑行為之因素，和遵醫囑行為是否影響生活品質。
研究方法：本研究採用橫斷式研究，對象為高雄某診所及身邊親朋好友之糖尿病患者，以結構式紙本問卷和Google表單進行研究資料收集，總共發放200份問卷，有效問卷150份，有效回收率為75%。使用SPSS18.0版統計軟體，統計分法包括獨立樣本T檢定、單因子變異數分析、皮爾森相關分析、迴歸分析來進行假說檢定。
研究結果：結果顯示健康信念模式、醫病溝通、醫病關係部分具有顯著正向相關性(P<0.05)；健康信念模式構面中之自覺行動利益、自我效能對遵醫囑行為具有顯著正向影響(P<0.05)；健康信念模式構面中之自覺行動障礙對遵醫囑行為具有顯著負向影響(P<0.01)；醫病溝通對遵醫囑行為具有顯著正向影響(P<0.01)；醫病關係對遵醫囑行為具有顯著正向影響(P<0.01)；遵醫囑行為對生活品質具有顯著正向影響(P<0.01)。
研究建議：建議針對不遵從醫囑服藥的糖尿病患者，設計出正確服藥的衛教宣導，且宣導正確的糖尿病觀念；辦理醫護人員增能講座，以利提升醫護人員的溝通能力；對患者加強指導與衛教糖尿病相關資訊，讓患者瞭解如果血糖控制良好，生活品質會提升。
Background: Diabetes is one of the top ten causes of death among people, with the changes of the times, the population of diabetes is gradually increasing. If blood sugar is not well controlled, complications are easy to occur, and poor medical communication and the patient's own awareness of diabetes are insufficient. If the medical staff does not explain clearly, it is easy to cause the patient to fail to comply with the doctor's advice, which in turn affects the quality of life of diabetic patients.
Research purposes: This study applies the health belief model, medical communication, doctor-patient relationship to explore the factors affecting the adherence behavior, and whether the adherence behavior care affects the quality of life.
Research method: This study used a cross-sectional study of a clinic in Kaohsiung and a family of friends and relatives.The research papers were collected by structured paper questionnaire and Google form. A total of 200 questionnaires were distributed and 150 valid questionnaires. The effective recovery rate was 75%. Using SPSS statistical software, statistical methods include T-test, One-way ANOVA, Pearson’s product moment correlation, and analysis of regression for hypothesis testing.
Results: The results showed that there was a significant positive correlation between the health belief model, the medical communication, and the doctor-patient relationship (P<0.05). The conscious action interests and self-efficacy in the health belief model facet have a significant positive impact on the adherence behavior. The conscious behavior disorder in the health belief model had a significant negative impact adherence behavior(P<0.01). The communication between the doctors and the patient had a significant positive effect adherence behaiorv. (P<0.01). The relationship between doctor-patient had a significant positive effect patient’s adherence (P<0.01). The patient’s adherence had a significant positive impact on quality of life (P<0.01).
Research suggestion: It is recommended to design a correct medical education for diabetic patients who do not follow the doctor's advice, and to promote the correct concept of diabetes.Handle energy-saving lectures for medical staff to improve the communication skills of medical staff. Strengthen the guidance and information about diabetes in patients, and let patients know that if blood sugar is well controlled, the quality of life will improve. |
