臺灣博碩士論文加值系統

研究背景：糖尿病是全球的問題，在台灣的盛行率為5.85%，近年來，更是排行國人十大死因前五名，標準化死亡率為26.6/10萬人，高出許多已開發國家。未控制好糖尿病會引起嚴重的併發症，將造成個人及家庭生活品質下降以及醫療成本升高等問題。研究者臨床發現，糖尿病患多數在生活方式不理想時，其實驗室生化資料及健康狀態亦較差。目前對於糖尿病患者健康狀態的評估，多數由實驗室檢查值來測量；然而，這些指標並無法呈現病患因應疾病的生活方式與自我照顧情形。國內外研究也指出增強病患的自我照顧行為，其血糖控制越好、相關併發症也越少。然而，國內外至今有關糖尿病患者之生活方式與自我照顧情形的量測，仍缺乏簡單整體且全面性的評估工具。
研究目的：因此本研究主要目的為（1）發展屬於國內第2型糖尿病患理想的健康促進量表【DMHP】；（2）探討此量表與第2型糖尿病患健康狀態之關係。
研究方法：本研究採用描述性、相關性之研究設計，包括文獻查證、量表建立過程之信效度檢定、以及生化指標與健康行為之關係探討。研究對象來自北、中、南醫學中心第2型糖尿病患，於民國99年10月~100年3月收案共327位。統計分析包括量表的建構（採用專家效度、探索性因素分析以及信度考驗）；量表的驗證：採用描述性統計分析和推論性統計（包括：獨立樣本t檢定、單因子變異數分析、薛費氏事後比較及線性迴歸分析）。
研究結果及應用：本研究顯示DMHP具有良好的信度與效度，共30題項、6個構面，包括運動行為、減少風險、生命欣賞、壓力與社會支持、健康責任、健康飲食，其內容效度指標CVI為.97，整體的解釋變異量為58.4%，其內在一致性Cronbach's α為.891。也具有良好的同時效度，例如DMHP得分越高、其AC及A1C數值越趨於正常，且A1C數值在所有DMHP之分量表得分也呈現顯著的負相關，表示當患者擁有愈佳的生活方式，其血糖控制越好。運用此量表可以做為社區評估、健康指導以及評價第2型糖尿病患者生活方式與健康狀態之參考依據。
關鍵字：第2型糖尿病，生活方式，健康狀態，糖化血色素

Background: Diabetes Mellitus is a global crisis with no exception to Taiwan. The prevalence rate of diabetes in Taiwan is 5.85%. In recent years, this disease has been ranked fifth in the top ten causes of deaths in Taiwan, in which there are 26.6 deaths for every hundred thousand people. Compared to other developed countries, the mortality rate in Taiwan is higher. Uncontrolled diabetes may result in other severe complications, such as a decrease in the quality of life for the patient and family as well as an increase in the cost for medical care. Currently, the health status of diabetes in Taiwan is most often measured through lab evaluations. However, these values cannot represent a patient’s lifestyle or the situations in self-care. Worldwide studies show that by increasing a patient’s self care, glucose levels can be better maintained along with a decrease in other complications. Nonetheless, there are still no proper tools, which could simply and completely assess the comprehensive lifestyles for diabetes.
Purpose: (1) To develop a scale of health promotion for diabetes mellitus (DMHP) that belong to the ideal lifestyles for Type 2 Diabetes Mellitus patients (T2DM); (2) To investigate the relationship between the scale and the health status of diabetes participants.
Methods: This study was a descriptive, correlation research design. Including literature review, scale development with establishing the reliability and validity, and the relationship between individual behavior and health status. All subjects were prediagnosed of T2DM by physicians in medical centers; from October, 2010 to March, 2011, there are 327 participants recruited in this study. Statistical Analysis: Scale development included the expert validity, exploratory factor analysis and reliability test. Descriptive and inferential statistical analysis included the independent sample t test, one way ANOVA, Scheffe’s posteriori comparison and Linear regression analysis.
Results/Implications: The findings indicated that the scale of DMHP was a good reliability and validity instrument. There are 30 items and six conscructs: (1) exercise behaviors; (2) risk reducing; (3) life appreciation; (4) stress-management and social support; (5) health responsibility; and (6) healthy diet. The scale of DMHP has 0.97-point scontent validity index (CVI), and its total explained variance was 58.4%; its internal consistency Cronbach's α is 0.891. The DMHP also found with a good concurrent validity, e.g. the higher score of DMHP, the better of AC and A1C values. Further, A1C was significantly negative correlated to all subscale of DMHP. This study demonstrated that diabetes patients with better lifestyles could have better blood sugar control. This scale can be used as a valid screening tool for community and clinical areas for the health status of T2DM.
Keywords: Type 2 diabetes(T2DM), lifestyles, health status, DMHP, glycated hemoglobin

目次

中文摘要………………………………………………………………………………Ⅰ
英文摘要………………………………………………………………………………Ⅱ
目次……………………………………………………………………………………Ⅲ
表目錄…………………………………………………………………………………Ⅵ
圖目錄…………………………………………………………………………………Ⅶ
第一章 緒論 …………………………………………………………………………1
第一節 研究背景及動機 ……………………………………………………………1
第二節 研究目的 ……………………………………………………………………2
第三節 研究概念架構 ………………………………………………………………3
第四節 研究問題 ……………………………………………………………………3
第五節 研究假設 ……………………………………………………………………4
第六節 名詞界定 ……………………………………………………………………4
第二章 文獻查證 ……………………………………………………………………5
第一節 第2型糖尿病疾病綜論 …………………………………………………… 5
第二節 第2型糖尿病患者生活方式的構面 ……………………………………… 6
第三節 第2型糖尿病患者健康狀態 - 理想的糖尿病控制指標 ……………… 14
第四節 第2型糖尿病患者生活方式與健康狀態關係…………………………… 15
第五節 國內外已發展與第2型糖尿病患者生活方式相關測量工具之狀況…… 15
第三章 研究方法 ………………………………………………………………… 20
第一節 研究設計與進行步驟 …………………………………………………… 20
第二節 研究對象 ………………………………………………………………… 21
第三節 研究倫理考量 …………………………………………………………… 22
第四節 研究工具 ………………………………………………………………… 22
第五節 統計方法 ………………………………………………………………… 30
第四章 結果與討論…………………………………………………………………31
第一節 研究對象之社會人口學變項、健康狀態之分佈情形……………………31
第二節 研究對象之生活方式（DMHP）得分與人數散佈情形.…………………35
第三節 研究對象之社會人口學變項、健康狀態與生活方式之差異……………39
第四節 研究對象之生活方式與健康狀態之關係…………………………………44
第五章 研究限制……………………………………………………………………46
第六章 結論與建議…………………………………………………………………47
第一節 結論…………………………………………………………………………47
第二節 建議…………………………………………………………………………48
第三節 未來護理運用………………………………………………………………48
參考文獻 ……………………………………………………………………………50
中文部分 ……………………………………………………………………………50
英文部分 ……………………………………………………………………………51

附錄……………………………………………………………………………………61
附錄一…………………………………………………………………………………61
附錄二…………………………………………………………………………………62
附錄三…………………………………………………………………………………85
附錄四…………………………………………………………………………………88
附錄五…………………………………………………………………………………89
附錄六…………………………………………………………………………………91
附錄七…………………………………………………………………………………94
附錄八…………………………………………………………………………………97
附錄九…………………………………………………………………………………99

表目錄

表1 第2型糖尿病患健康促進的生活方式涵蓋構面……………………………………6
表2 國外彙整相關量表工具……………………………………………………………16
表3 國內彙整相關量表工具……………………………………………………………19
表4 問卷內容 - 涵蓋七層面 …………………………………………………………22
表5 本研究之研究目的、研究問題、研究假設及統計方法 .………………………30
表6 研究對象之社會人口學變項與健康狀態人數散佈情形…………………………33
表7-1 DMHP量表與分量表構面得分情形 ……………………………………………37
表7-2 DMHP量表各題得分與人數分佈 ………………………………………………38

圖目錄

圖1 研究架構………………………………………………………………………………3
圖2 研究實施步驟流程圖……………………………………………………………….21
圖3 因素陡坡圖 …………………………………………………………………………28

參考文獻：
中華民國糖尿病衛教學會（2010）．糖尿病衛教核心教材．台北：糖尿病衛教學會。
中華民國糖尿病學會（2010）．2010糖尿病臨床照護指引．台北：中華民國糖尿病學會。
王璟璇、王瑞霞、林秋菊（1998）．自我照顧行為、自我效能和社會支持對非胰島素依賴型糖尿病患者血糖控制的影響．高雄醫誌，14（12），807-815。
王貝婷、謝明家、洪信嘉、何坤炎、蔡吉政（2008）．第二型糖尿病病人牙周健康狀況與血糖控制之相關性探討．台灣口腔醫學科學雜誌，24，23-36。
尹祚芊（2000）．學校衛生護理．台灣醫學，4（2），215-222 。
行政院衛生署國民健康局（2003）．糖尿病防治手冊．台北：遠流。
行政院衛生署（2009）．2020健康國民白皮書．台北：衛生署。
行政院衛生署統計資料（2011，03月01日）．98年度全民健康保險醫療統計年報．2011年04月16日取自網址：http://www.doh.gov.tw/CHT2006/DM/DM2_2_p02.aspx?class_no=440&now_fod_list_no=11587&level_no=3&doc_no=79126
行政院衛生署統計資料（2010，12月13日）．98年度死因統計．2011年04月16日取自網址：http://www.doh.gov.tw/CHT2006/DM/DM2_2_p02.aspx?class_no=440&now_fod_list_no=11397&level_no=-1&doc_no=76512
行政院衛生署疾病管制局（2010，8月11日）．99年度季節流感疫苗接種計畫．2011年4月23日取自網址：http://flu.cdc.gov.tw/ct.asp?xItem=3296&ctNode=3878&mp=150
行政院衛生署疾病管制局（2009，9月20日）．99年度肺炎鏈球菌多醣體疫苗接種計畫書．2011年4月23日取自網址：http://www.cdc.gov.tw/lp.asp?CtNode=2512&CtUnit=1378&BaseDSD=7&mp=1
杜友蘭（2002）．歐倫「護理綜合理論」的分析和描述：舉例一．於杜友蘭編著，護
理理論與實務應用（117-126頁）．台北：華杏。
江鳳葦（2003）．非胰島素依賴型糖尿病患者家庭支持、生活滿意度、自我照顧行為與糖尿病控制之研究．長庚科技學刊，2，27-50。
余文彬（2004）．糖尿病患者的血糖控制、自我效能、自我照顧和生活品質之探討．未發表碩士論文．台北：國立台北護理學院護理研究所。
呂菁（2008，3月3日）．糖尿病患應預防流感和肺炎．2009年11月21日取自網址：http://hospital.kingnet.com.tw/essay/essay.html?category=%C2%E5%C3%C4%AFe%AFf&pid=17380
張進順（2008）．糖尿病友口腔保健的重要性．糖尿病關懷基金會，3，15-17。
陳建良、何志聰、林自強、張兩溉（2007）．肥胖第2型糖尿病患者之減重治療．內科學誌，18(6)，322-331。
郭寶蓮、蔡秀鸞、陽琪（2002）．充能訓練對糖尿病患者糖化血色素、自我效能和照護之成效．臺灣醫學．6（6），848-857。
黃瀞儀、沈德昌、鄭惠美（1998）．門診糖尿病患對糖尿病知識、態度、行為與糖尿病衛教需求之研究．健康促進暨衛生教育雜誌，18，25-35。
黃情川（2007）．台灣版糖尿病生活品質測量工具Diabetes-39的發展與驗證．台南：長榮大學醫務管理學研究所。
趙明玲、林怜利、余秋霖、方郁文（2007）．訓練對台灣第二型糖尿病中老年患者的血液生理指標及體適能之影響．實證護理，3（1），27-34。
劉淑娟（1999）．台北市立醫院門診糖尿病病患健康自我管理及其相關因素之探討．榮總護理，16 （3），286-297。
鄭英裕（2001）．某區域教學醫院門診糖尿病患者遵醫囑行為及其相關因素之探討．未發表碩士論文，台北：台北醫學大學醫學研究所。
賴妙芬、劉潔心（2003）．促進糖尿病患者社會支持與充能效果之介入研究．衛生教育學報，20，1-28。
盧美秀、鄭綺、林嘉靜（2006）．歐氏自我照顧缺失理論．於盧美秀編著，護理理論與應用（一版，103-140頁）．台北：偉華。
Aikens, J. E., Bingham, R., & Piette, J. D. (2005). Patient-provider communication and self-care behavior among type 2 diabetes patients. Diabetes Educator, 31(5), 681-690.
Akker, I. L. d., Verheij, T. J. M., Buskens, E., & Nichol, K. L. (2006). Clinical effectiveness of first and repeat influenza vaccination in adult and elderly diabetic patients. Diabetes Care, 29(8), 1771-1776.
Alberti, G., Zimmet, P., Shaw, J., Bloomgarden, Z., Kaufman, F., Silink, M., & Consensus Workshop Group. (2004). Type 2 diabetes in the young: The evolving epidemic: The international diabetes federation consensus workshop. Diabetes Care, 27(7), 1798-1811.
Aljasem, L. I., Peyrot, M., Wissow, L., & Rubin, R. R. (2001). The impact of barriers and self-efficacy on self-care behaviors in type 2 diabetes. Diabetes Educator,27(3), 393-404.
American Association of Diabetes Educators (2008). AADE7TM Self-Care Behaviors. The Diabetes Educator, 34(3), 445-449.
American Diabetes Association (2011). Standards of medical care in diabetes-2011. Diabetes Care, 34(Suppl.1), S4- S61.
Anderson, R. M., Funnell, M. M., Fitzgerald, J. T., & Marrero, D. G. (2000). The diabetes empowerment scale: A measure of psychosocial self-efficacy. Diabetes Care, 23(6), 739-743.
Anderson, R. M., Fitzgerald, J. T., Funnell, M. M., & Gruppen, L. D. (1998). The third version of the diabetes attitude scale. Diabetes Care, 21(9), 1403-1407.
Anderson, R. M., Fitzgerald, J. T., Gruppen, L. D., Funnell, M. M., & Oh, M. S. (2003). The diabetes empowerment scale-short form (DES-SF). Diabetes Care, 26(5), 1641-1642.
Anderson, R. M., Fitzgerald, J. T., & Oh, M. S. (1993). The relationship between diabetes-related attitudes and patients' self-reported adherence. The Diabetes Educator, 19(4), 287-292.
Bakker, K., van Houtum, W. H., & Riley, P. C. (2005). The international diabetes federation focuses on the diabetic foot. Current Diabetes Reports, 5(6), 436-440.
Balducci, S., Iacobellis, G.,Parisi, L., Di Biase, N.,Calandriello, E.,Leonetti, F., et al. (2006). Exercise training can modify the natural history of diabetic peripheral neuropathy. J Diabetes Complications,20(4), 216-223.
Bantle, J. P., Wylie-Rosett, J., Albright, A. L., Apovian, C. M., Clark, N. G., Franz, M. J., et al. (2008). Nutrition recommendations and interventions for diabetes: A position statement of the american diabetes association. Diabetes Care, 31, S61-78.
Bradley, C., Todd, C., Gorton, T., Symonds, E., Martin, A., & Plowright, R. (1999). The development of an individualized questionnaire measure of perceived impact of diabetes on quality of life: The ADDQoL. Quality of Life Research : An International Journal of Quality of Life Aspects of Treatment, Care and Rehabilitation, 8(1-2), 79-91.
Boule, N. G., Haddad, E., Kenny, G. P., Wells, G. A., & Sigal, R. J. (2001). Effects of exercise on glycemic control and body mass in type 2 diabetes mellitus: A meta-analysis of controlled clinical trials. JAMA, 286(10), 1218-1227.
Boyer, J. G., & Earp, J. A. (1997). The development of an instrument for assessing the quality of life of people with diabetes. diabetes-39. Medical Care, 35(5), 440-453.
Carroll, C., Naylor, E., Marsden, P., & Dornan, T. (2003). How do people with type 2 diabetes perceive and respond to cardiovascular risk? Diabet Med, 20(5). 355-360.
Castaneda, C., Layne, J. E., Munoz-Orians, L., & Gordon, P. L. (2002). A randomized controlled trial of resistance exercise training to improve glycemic control in older adults with type 2 diabetes. Diabetes Care, 25(12), 2335-2341.
Cederholm, J., Eeg-Olofsson, K., Eliasson, B., Zethelius, B., Nilsson, P., & Gudbjörnsdottir, S. (2008). Risk prediction of cardiovascular disease in type 2 diabetes: A risk equation from the swedish national diabetes register. Diabetes Care, 31(10), 2038-2043.
Ceriello, A., Taboga, C., Tonutti, L., Quagliaro, L., Piconi, L., Bais, B., et al. (2002). Evidence for an independent and cumulative effect of postprandial hypertriglyceridemia and hyperglycemia on endothelial dysfunction and oxidative stress generation: Effects of short- and long-term simvastatin treatment. Circulation, 106(10), 1211-1218.
Chamnan, P., Simmons, R., Sharp, S., Griffin, S., & Wareham, N. (2009). Cardiovascular risk assessment scores for people with diabetes: A systematic review. Diabetologia, 52(10), 2001-2014.
Chen, H. F., Ho, C. A., Li, C. Y. (2006). Age and sex may significantly interact with diabetes on the risks of lower-extremity amputation and peripheral revascularization procedures: evidence from a cohort of a half-million diabetic patients. Diabetes Care, 29(11), 2409-2414
Cheng, A. Y., Tsui, E. Y., Hanley, A. J., & Zinman, B. (1999). Developing a quality of life measure for chinese patients with diabetes. Diabetes Research and Clinical Practice, 46(3), 259-267.
Chin, M. H., Cook, S., Drum, M. L., & Jin, L. (2004). Improving diabetes care in midwest community health centers with the health disparities collaborative. Diabetes Care, 27(1), 2-8.
Cohen, J. (1988). Statistical power analysis for the behavioral science (2nd ed.). NewYork, NY : Academic Press.
Comrey, A. L., & Lee, H. B. (1992). A first course in factor analysis. Hillsdale, N J: Erlbaum.
Corbett, C F. (2003). A randomized pilot study of improving foot care in home health patients with diabetes. Diabetes Edu, 29(2). 273-283.
DeFronzo, R. (2009). From the triumvirate to the ominous octet: A new paradigm for the treatment of type 2 diabetes mellitus. Diabetes, 58(4), 773.
Dunn, S. M., Bryson, J. M., Hoskins, P. L., Alford, J. B., Handelsman, D. J., & Turtle, J. R. (1984). Development of the diabetes knowledge (DKN) scales: Forms DKNA, DKNB, and DKNC. Diabetes Care, 7(1), 36-41.
Dunn, S. M., Smartt, H. H., Beeney, L. J., & Turtle, J. R. (1986). Measurement of emotional adjustment in diabetic patients: Validity and reliability of ATT39. Diabetes Care, 9(5), 480-489.
Dunstan, D. W., Daly, R. M., Owen, N., & Jolley, D. (2002). High-intensity resistance training improves glycemic control in older patients with type 2 diabetes. Diabetes Care, 25(10), 1729-1736.
Egede, L. E., & Michel, Y. (2006). Medical mistrust, diabetes self-management, and glycemic control in an indigent population with type 2 diabetes. Diabetes Care, 29(1), 131-132.
Fitzgerald, J. T., Davis, W. K., Connell, C. M., Hess, G. E., Funnell, M. M., & Hiss, R. G. (1996). Development and validation of the diabetes care profile. Evaluation & the Health Professions, 19(2), 208-230.
Fitzgerald, J. T., Funnell, M. M., Hess, G. E., Barr, P. A., Anderson, R. M., Hiss, R. G., et al. (1998). The reliability and validity of a brief diabetes knowledge test. Diabetes Care, 21(5), 706-710.
Fitzgerald, J. T., Gruppen, L. D., Anderson, R. M., & Funnell, M. M. (2000). The influence of treatment modality and ethnicity on attitudes in type 2 diabetes. Diabetes Care, 23(3), 313-318.
Franz, M. J., Bantle, J. P., Beebe, C. A., Brunzell, J. D., Chiasson, J. L., Garg, A., et al. (2003). Evidence-based nutrition principles and recommendations for the treatment and prevention of diabetes and related complications. Diabetes Care, 26, S51-61.
Gaede, P., Lund-Andersen, H., Parving, H. H., & Pedersen, O. (2008). Effect of a multifactorial intervention on mortality in type 2 diabetes. The New England Journal of Medicine, 358(6), 580-591.
Glasgow, R. E., Funnell, M. M., Bonomi, A. E., Davis, C., Beckham, V., & Wagner, E. H. (2002). Self-management aspects of the improving chronic illness care breakthrough series: implementation with diabetes and heart failure teams. Ann Behav Med,24(2), 80-87.
Gleeson-Kreig, J., Bernal, H., & Woolley, S. (2002). The role of social support in the self-management of diabetes mellitus among a Hispanic population. Public Health Nurs,19(3), 215-222
Gorsuch, R. L. (1983). Factor Analysis. (2nd. ed.). Hillsdale, NJ: Erlbaum.
Hair, J. F., Anderson, R. E., Tatham, R. L., & Black, W. C. (1998). Multivariate data analysis(5th ed.). Englewood Cliffs, NJ: Prentice-Hall.
Hak, E., Nordin, J., Wei, F., Mullooly, J., Poblete, S., Strikas, R., et al. (2002). Influence of high-risk medical conditions on the effectiveness of influenza vaccination among elderly members of 3 large managed-care organizations. Clin Infect Dis,35(4). 370-377.
Hamman, R. F., Wing, R. R., Edelstein, S. L., Lachin, J. M., Bray, G. A., Delahanty, L., et al. (2006). Effect of weight loss with lifestyle intervention on risk of diabetes. Diabetes Care, 29(9), 2102-2107.
Hammond, G. S., & Aoki, T. T. (1992). Measurement of health status in diabetic patients. diabetes impact measurement scales. Diabetes Care, 15(4), 469-477.
Haskell, W. L., Lee, I. M., Pate, R. R., Powell, K. E., Blair, S. N., Franklin, B. A., et al. (2007). Physical activity and public health: Updated recommendation for adults from the American College of Sports Medicine and the American Heart Association. Med Sci Sports Exerc,39(8), 1423-1434.
Heisler, M., Smith, D. M., Hayward, R. A., Krein, S. L., & Kerr, E. A. (2003). How well do patients assessments of their diabetes self- management correlate with actual glycemic control and receipt of recommended diabetes services? Diabetes Care,26(3), 738-743.
Herschbach, P., Duran, G., Waadt, S., Zettler, A., Amm, C., & Marten-Mittag, B. (1997). Psychometric properties of the questionnaire on stress in patients with diabetes--revised (QSD-R). Health Psychology : Official Journal of the Division of Health Psychology, American Psychological Association, 16(2), 171-174.
Horswell, R. L., Birke, J. A., & Patout, C., J. (2003). A staged management diabetes foot program versus standard care: A 1-year cost and utilization comparison in a state public hospital system. Archives of Physical Medicine & Rehabilitation, 84(12), 1743-1746.
Hu, G., Lakka, T. A., Kilpelainen, T. O., & Tuomilehto, J. (2007). Epidemiological studies of exercise in diabetes prevention. Applied Physiology, Nutrition, and Metabolism = Physiologie Appliquee, Nutrition Et Metabolisme, 32(3), 583-595.
Irwin, M. L., Mayer-Davis, E. J., Addy, C. L., & Pate, R. R. (2000). Moderate-intensity physical activity and fasting insulin levels in women: The cross-cultural activity participation study. Diabetes Care, 23(4), 449-454.
Johnson, M., Newton, P., Jiwa, M., & Goyder, E. (2005). Meeting the educational needs of people at risk of diabetes-related amputation: A vignette study with patients and professionals. Health Expectations, 8(4), 324-333.
Johnston, M. V., Pogach, L., Rajan, M., & Mitchinson, A. (2006). Personal and treatment factors associated with foot self-care among veterans with diabetes. Journal of Rehabilitation Research and Development, 43(2), 227-237.
Jones, H., Edwards, L., Vallis, T. M., & Ruggiero, L. (2003). Changes in diabetes self-care behaviors make a difference in glycemic control: The diabetes stages of change (DiSC) study. Diabetes Care, 26(3), 732-737.
Jones, R. A., Utz, S. W., Williams, I. C., Hinton, I., Alexander, G., Moore, C., et al. (2008). Family interactions among african americans diagnosed with type 2 diabetes. Diabetes Educator, 34(2), 318-326.
Jönsson, B. (2002). CODE-2 Advisory Board. Revealing the cost of Type II diabetes in Europe. Diabetologia, 45(7), S5-12.
Juutilainen, A., Lehto, S., Rönnemaa, T., Pyörälä, K., & Laakso, M. (2005). Type 2 diabetes as a "coronary heart disease equivalent": An 18-year prospective population-based study in finnish subjects. Diabetes Care, 28(12), 2901-2907.
Kamarul Imran, M., Ismail, A. A., Naing, L., & Wan Mohamad, W. B. (2010). Type 2 diabetes mellitus patients with poor glycaemic control have lower quality of life scores as measured by the short form-36. Singapore Medical Journal, 51(2), 157-162.
Kaplan, R. M. (2003). The significance of quality of life in health care. Qual Life Res,12(Suppl.1), 3-16.
Kiran, M., Arpak, N., Unsal, E., & Erdoğan, M. F. (2005). The effect of improved periodontal health on metabolic control in type 2 diabetes mellitus. J Clin Periodontol,32(3), 266-272.
Knowler, W. C., Barrett-Connor, E., Fowler, S. E., Hamman, R. F., Lachin, J. M., Walker, E. A., & Diabetes Prevention Program Research Group. (2002). Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. The New England Journal of Medicine,346, 393-403.
Kosaka, K., Noda, M., Kuzuya, T. (2005). Prevention of type 2 diabetes by lifestyle intervention: a Japanese trial in IGT males. Diabetes Research and Clinical Practice,67, 152-162.
Laaksonen, D. E., Lindstrom, J., Lakka, T. A., Eriksson, J. G., Niskanen, L., Wikstrom, K., et al. (2005). Physical activity in the prevention of type 2 diabetes: The finnish diabetes prevention study. Diabetes, 54(1), 158-165.
Langford, C., Bowsher, J., Maloney, J. P., & Lillis, P. P. (1997). Social support: A conceptual analysis. Journal of Advanced Nursing, 25(1), 95-100.
LeRoith, D., Taylor, S. I., & Olefsky, J. M. (2000). Diabetes Mellitus: A Fundamental and Clinical Text (2nd ed.). Philadelphia : Lippincott Williams & Wilkins.
Löe, H. (1993). Periodontal disease - The sixth complication of diabetes mellitus. Diabetes care , 16(Supplement 1), 329-334.
Meadows, K. A., Abrams, C., & Sandbaek, A. (2000). Adaptation of the diabetes health profile (DHP-1) for use with patients with type 2 diabetes mellitus: Psychometric evaluation and cross-cultural comparison. Diabetic Medicine : A Journal of the British Diabetic Association, 17(8), 572-580.
Miller, D.K., & Fain, J.A. (2006). Diabetes Self-Management Education. Nursing Clinics of North America, 41 (4), 655-666.
Nicolucci, A., De Berardis, G., Sacco, M., & Tognoni, G. (2007). Primary prevention of cardiovascular diseases in people with diabetes mellitus: A scientific statement from the american heart association and the american diabetes association: Response to buse et al. Diabetes Care, 30(1), 162-172.
Norris, S. L., Nichols, P. J., Caspersen, C. J., Glasgow, R. E., Engelgau, M. M., Jack, L., et al. (2002).Increasing diabetes self-management education in community settings : a systematic review. Am J Prev Med, 22, 39-66.
Pan, X. R., Li, G. W., Hu, Y. H., Wang, J. X., Yang, W. Y., An, Z. X., et al. (1997). Effects of diet and exercise in preventing NIDDM in people with impaired glucose tolerance. The Da Qing IGT and Diabetes Study. Diabetes Care, 20(4), 537-544.
Peeples, M., Tomky, D., Mulcahy, K., Peyrot, M., & Siminerio, L. (2007). Evolution of the American Association of Diabetes Educators' diabetes education outcomes project. Diabetes Educator, 33(5), 794-817.
Permutt, M. A., Wasson, J., Cox, N. (2005). Genetic epidemiology of diabetes. J Clin Invest, 115(6), 1431-1439.
Petersen, K. F., Dufour, S., Befroy, D., Garcia, R., & Shulman, G. I. (2004). Impaired mitochondrial activity in the insulin-resistant offspring of patients with type 2 diabetes. The New England Journal of Medicine, 350(7), 664-671.
Peyrot, M., Peeples, M., Tomky, D., Charron-Prochownik, D., Weaver, T., & AADE Outcomes Project and AADE/UPMC Diabetes Education Outcomes Project. (2007). Development of the american association of diabetes educators' diabetes self-management assessment report tool. The Diabetes Educator, 33(5), 818-826.
Polonsky, W. H., Anderson, B. J., Lohrer, P. A., Welch, G., Jacobson, A. M., Aponte, J. E., et al. (1995). Assessment of diabetes-related distress. Diabetes Care, 18(6), 754-760.
Polonsky, W. H., Fisher, L., Earles, J., Dudl, R. J., Lees, J., Mullan, J., et al. (2005). Assessing psychosocial distress in diabetes: Development of the diabetes distress scale. Diabetes Care, 28(3), 626-631.
Raccah, D. (2006). Importance of blood glucose management in the multifactorial approach of absolute cardiovascular risk in type 2 diabetes: the lessons from the Steno 2 study. Diabetes Metab, 32(Spec No 2), 2S48-2S51.
Ramachandran, A., Snehalatha, C., Mary, S., Mukesh, B., Bhaskar, A.D., Vijay, V., & Indian Diabetes Prevention Programme (IDPP). (2006). The Indian Diabetes Prevention Programme shows that lifestyle modification and metformin prevent type 2 diabetes in Asian Indian subjects with impaired glucose tolerance (IDPP-1). Diabetologia, 49, 289-297.
Rapley, P., Passmore, A., & Phillips, M. (2003). Review of the psychometric properties of the diabetes self-efficacy scale: Australian longitudinal study. Nursing & Health Sciences, 5(4), 289-297.
Redekop, W. K., Koopmanschap, M. A., Stolk, R. P., Rutten, G. E. H. M., Wolffenbuttel, B. H. R., & Niessen, L. W. (2002). Health-related quality of life and Treatment satisfaction in Dutch patients with Type 2 diadetes. Diabetes Care, 25(3), 458-463.
Rubin, R. R., Peyrot, M., Siminerio, L. M., & Brorly, I. (2006). Health care and patient-reported outcomes: Results of the cross-national diabetes attitudes, wishes and needs (DAWN) study. Diabetes Care, 29(6), 1249-1255.
Schade, C. P., & McCombs, M. A. (2000). Influenza immunization and mortality among diabetic Medicare beneficiaries in West Virginia. W V Med J ,96(3). 444-448.
Schaffner, W., Rehm, S., & Elasy, T. (2007). Influenza Vaccination: An Unmet Need in Patients With Diabetes. Clinical Diabetes, 25(4), 145-149.
Scollan-Koliopoulos, M.(2004). Consideration for legacies about diabetes and self-care for the family with a multigenerational occurrence of type 2 diabetes. Nurs Health Sci, 6(3). 223-227.
Shah, C. (2008). Diabetic retinopathy: A comprehensive review. Indian Journal of Medical Sciences, 62(12), 500-519.
Shen, W., Kotsanos, J. G., Huster, W. J., Mathias, S. D., Andrejasich, C. M., & Patrick, D. L. (1999). Development and validation of the diabetes quality of life clinical trial questionnaire. Medical Care, 37(4 Suppl Lilly), AS45-66.
Shiu, A. T., Wong, R. Y., & Thompson, D. R. (2003). Development of a reliable and valid chinese version of the diabetes empowerment scale. Diabetes Care, 26(10), 2817-2821.
Shulman, G. I. (2004). Unraveling the cellular mechanism of insulin resistance in humans: New insights from magnetic resonance spectroscopy. Physiology (Bethesda, Md.), 19, 183-190.
Singh, N., Armstrong, D. G., Lipsky, B. A. (2005). Preventing foot ulcers in patients with diabetes. JAMA, 293(2), 217-228.
Speight, J., & Bradley, C. (2001). The ADKnowl: Identifying knowledge deficits in diabetes care. Diabetic Medicine : A Journal of the British Diabetic Association, 18(8), 626-633.
Stevens, R. J., Kothari, V., Adler, A. I., & Stratton, I. M. (2001). The UKPDS risk engine: a model for the risk of coronary heart disease in type II diabetes (UKPDS 56). Clin Sci (Lond), 101, 671–679.
Stratton, I. M., Adler, A. I., Neil, H. A., Matthews, D. R., Manley, S. E., Cull, C. A., et al. (2000). Association of glycaemia with macrovascular and microvascular complications of type 2 diabetes (UKPDS 35): prospective observational study. BMJ, 321, 405-412.
Toobert, D. J., Hampson, S. E., Glasgow, R. E. (2000). The summary of diabetes self-care activities measure: results from 7 studies and a revised scale. Diabetes Care, 23(7), 943-950.
Trento, M., Passera, P., Tomalino, M., & Bajardi, M. (2001). Group visits improve metabolic control in type 2 diabetes: A 2-year follow-up. Diabetes Care, 24(6), 995-1000.
Tuomilehto, J., Lindstro¨m, J., Eriksson, J. G., Valle, T. T., Ha¨ma¨la¨inen, H., Ilanne-Parikka, P., & Finnish Diabetes Prevention Study Group. (2001). Prevention of type 2 diabetes mellitus by changes in lifestyle among subjects with impaired glucose tolerance. The New England Journal of Medicine, 344,1343-1350.
UK Prospective Diabetes Study (UKPDS) Group. (1998). Effect of intensive blood- glucose control with metformin on complications in overweight patients with type 2 diabetes (UKPDS 34). Lancet, 352, 854-865.
Urbanski, P., Wolf, A., & Herman, W. (2008). Cost-Effectiveness of Diabetes Education. Journal of the American Dietetic Association, 108(4 Suppl 1), S6-11.
Vincze,G., Barner,J.C.,& Lopez,D.(2004).Factors associated with adherence to self-monitoring of glucose among persons with diabetes. The Diabetes Educator,30(1), 112-125.
Viswanathan, V., Madhavan, S., Rajasekar, S., Chamukuttan, S., & Ambady, R. (2005). Amputation prevention initiative in south india: Positive impact of foot care education. Diabetes Care, 28(5), 1019-1021.
Walker, S. N., Sechrist, K. R., & Pender, N. J. (1987). The health-promoting lifestyle profile: Development and psychometric characteristics. Nursing Research, 36(2), 76-81.
Waltz, C. F., Strickland, O. L., & Lenz, E. R. (1991). Measurement in nursing research (2nd. ed.). Philadelphia: A. Davis.
Wei, J. N., Sung, F. C., Lin, C. C., Lin, R. S., Chiang, C. C., & Chuang, L. M. (2003). National surveillance for type 2 diabetes mellitus in Taiwanese children. JAMA, 290(10), 1345-1350.
Welschen, L. M. C., Bloemendal, E., Nijpels, G., & Dekker, J. M. (2005). Self-monitoring of blood glucose in patients with type 2 diabetes who are not using insulin: A systematic review. Diabetes Care, 28(6), 1510-1517.
Wild, S., Roglic, G., Green, A., Sicree, R., & King, H. (2004). Global prevalence of diabetes: Estimates for the year 2000 and projections for 2030. Diabetes Care, 27(5), 1047-1053.
Wong, A. K., Stewart, A. G., & Furler, J. S. (2009). Development and validation of the diabetes management orientation scale (DMOS): Assessing culturally related approaches to diabetes self-management. Diabetes Research and Clinical Practice, 86(1), 24-30.
World Health Organization (2011, January). Diabetes. Retrieved Apr 23, 2011, from http://www.who.int/mediacentre/factsheets/fs312/en/index.html
Yam, J., & Kwok. A. (2007). Update on the treatment of diabetic retinopathy. Hong Kong Med J, 13(1), 46-60.
Yetzer, E. A. (2004). Incorporating foot care education into diabetic foot screening. Rehabilition Nursing, 29(3), 80.
Yokoyama, H., Emoto, M., Araki, T., & Fujiwara, S. (2004). Effect of aerobic exercise on plasma adiponectin levels and insulin resistance in type 2 diabetes. Diabetes Care, 27(7), 1756-1758.