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研究生:陳佩琦
研究生(外文):Pei-chi chen
論文名稱:運用跨理論模式介入措施對糖尿病病人運動行為之成效
論文名稱(外文):The Effects of a Transtheoretical Intervention in Exercise Behavior for DM Clients
指導教授:江純瑛江純瑛引用關係
指導教授(外文):Chun-Ying Chiang
學位類別:碩士
校院名稱:義守大學
系所名稱:醫務管理學系
學門:商業及管理學門
學類:醫管學類
論文種類:學術論文
論文出版年:2016
畢業學年度:104
語文別:中文
論文頁數:86
中文關鍵詞:糖尿病跨理論模式運動行為
外文關鍵詞:Diabetes mellitusTranstheoretical modelExercise Behavior
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罹患糖尿病比率始終居高不下,患者通常以藥物、飲食及運動在控制,但有在規律運動的人很少且遵行率也低,為了加強糖尿病患者可以規律運動來改善糖化血色素值,本研究目的是在測試運用跨理論模式所設計衛教對糖尿病病人運動行為之成效。本研究採類實驗研究設計,於南部某區域教學醫院,以立意取樣方式收案,納入條件須為(1)第二型糖尿病病人,(2)意識清醒,活動力正常,無肢體障礙者,(3)願意接受問卷可以配合護理措施之個案。排除條件有(1)心肺疾病者,(2)走路運動會喘者。共收集實驗組60位給予八週的跨理論模式運動衛教措施及對照組60位。本研究所使用的研究工具包括運動改變階段、運動改變過程、運動決策平衡及運動自我效能等量表。
本研究以SPSS 18.0中文版統計套裝軟體進行各項統計分析,並以α=.05顯著水準來進行各項考驗,採用X2 、獨立t檢定、無母數分析統計方法Mann-Whitney U檢定法、皮爾森積差相關(Pearson’s correlation coefficient)及迴歸等來進行研究變項之檢定,以呈現描述及相關性及推論性統計結果。
研究結果發現:(1)研究對象之運動階段分佈:運動前期32.5%,運動期5.0%,準備期17.5%,行動期15.8%,維持期29.2%。(2) 跨理論模式衛教在決策平衡、自我效能、糖化血色素皆無顯著差異。(3) 跨理論模式衛教在運動改變過程中社會開放有顯著差異。控制組比實驗組利用較多的社會資源。(4) 迴歸結果發現在運動改變過程中社會開放前測結果是可以預測後測結果,可解釋的共變量為74.7%。(5)單身、學歷越高及有在運動者可以接受社會資源程度越高。根據研究結果,將對糖尿病病人不同運動改變階段,規劃多選擇的運動措施,讓病患可以確實達到運動的效果。

The prevalence of diabetes mellitus is high in our society. Hypoglycemic agents, diet control and exercise could help to control the blood sugar. However, the compliance for regular exercise is poor. We designed a quasi-experimental study via transtheoretical model to test the effects of education intervention on the exercise behavior for diabetic patients. Purposive sampling has been used in our study. All the subjects were recruited from a district teaching hospital in southern Taiwan. The inclusion criteria were (1) type 2 diabetes mellitus, (2) clear consciousness, (3) free from limbs impairment, (4) willing to fill the questionnaires and follow the intervention. We excluded the patients with cardiopulmonary diseases or dyspnea on exertion. The total sample size was 60 patients was in the experiment group and 60 patients in the control group. The questionnaires were including scales for exercise in stages of change, processes of change, decisional balance and self-efficacy.
We used SPSS 18.0 software to perform the statistics. The statistical methods included Chi-square test, t test, Mann-Whitney U test, Pearson’s correlation coefficient and regression. The significance was set at 0.05. for this study.
The results were: (1) The distribution of the stage of change was 32.5% of the participant was in pre-contemplation stage, 5% of the participant was in contemplation stage, 17.5% of the participant was in preparation stage, 15.8% of the participant was in action stage and 29.2%of the participant was in maintenance stage. (2) There was no significant difference between two groups in decisional balance, self-efficacy and glycated hemoglobin. (3) There was a significant difference between two groups in social liberation. The result found that the control group could access more social resource than experimental group. (4) The results of regression indicated that the pretest of the social liberation is a stronger factor which could predict the posttest of the social liberation . It could explain 74.7% of the variance. (5) Single, well-educated patients and those who had had exercise behavior before the study could access more social resource. We suggested diversified options of exercise in different stages of exercise behavior change for the diabetic patients could effect on the compliance of exercise.

謝辭 ………………………………………………………………………i
中文摘要 …………………………………………………………………ii
英文摘要 …………………………………………………………………iii
目錄 ………………………………………………………………………v
表目錄 ……………………………………………………………………viii
圖目錄 ……………………………………………………………………x
第一章 緒論
第一節 研究背景與動機 ………………………………………1
第二節 問題陳述與研究目的 …………………………………3
第三節 研究重要性 ……………………………………………8
第二章 文獻探討
第一節 跨理論模式之理論 ……………………………………9
第二節 第二型糖尿病及糖化血色素之病因 …………………17
第三節 糖尿病患者之運動………………………………………19
第四節 應用跨理論模式於運動行為之效能 …………………21
第三章 研究方法
第一節 研究設計 ………………………………………………………23
第二節 抽樣設計 ………………………………………………24
第三節 研究架構 ………………………………………………25
第四節 資料蒐集 ………………………………………………28
第五節 變項衡量 ………………………………………………30
第六節 資料分析 ………………………………………………33
第四章 結果與討論
第一節 描述性統計 …………………………………………34
第二節 推論性統計 …………………………………………40
第五章 結論與建議
第一節 研究結論 ……………………………………………48
第二節 理論與實務涵義 ……………………………………51
第三節 研究限制 ……………………………………………53
第四節 後續研究建議 ………………………………………54
參考文獻
中文部分 ………………………………………………………55
英文部份 ………………………………………………………58
附錄
附錄A 研究工具使用同意書 …………………………………66
附錄B 研究工具 ………………………………………………67
附錄C 糖尿病病人運動行為改變之研究問卷 …………………68

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