科技部專題研究計畫主持人
MOST-108-2410-H-227-004 -SSS
評估二型糖尿病人不同病人健康分群與併發症之風險:以某區域醫院為例
Assessment of different health profiles with the risk of complications among patients with Type II diabetes based on a regional hospital
科技部
Ministry of Science and Technology
國立台北護理健康大學
National Taipei University of Nursing and Health Sciences
邱尚志
Shang-Jyh Chiou
國立台北護理健康大學
National Taipei University of Nursing and Health Sciences
邱尚志
副教授
0975009890
shangjyh@ntunhs.edu.tw
計畫執行期間起:2019-08-01
計畫執行期間迄:2020-07-31
2019-12-05
2020-05-31
第二型糖尿病人
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001
01
二型糖尿病、健康概況分群、糖尿病併發症、病人行為、潛在剖面分析、多面項資 料
type II diabetes, health profiles group, diabetes complication, patient behavior, latent profile analysis, multiple dimensions data
糖尿病盛行率居高不下,隨著人口老化也伴隨著嚴重的經濟負擔與健保資源的大量投入,大部分的研究指出糖尿病控制的好其生活品質可大幅改善也降低之後併發症發生的風險,為更瞭解病人自我管理行為與併發症之間的相關性,本研究採用健康概況的分群的概念來瞭解不同病人分群與之後發生視網膜病變與洗腎的風險。研究採用某區域醫院的第二型糖尿病為研究對象,使用病人的檢驗檢查生化值,採用潛在剖面分析(latent profile analysis)的方式進行第一層病人健康概況分群,採用病人問卷調查,主要針對糖尿病自我管理評量(C-DMSES)、自我動機(TSRQ-diabetes)、自我管理障礙、生活品質滿意度(EQ5-D)與憂鬱量表(PHQ-9)等方面進行資料收集,有助於建構第二層次的病人健康概況分群,以及預測未來併發症發生之風險,目前的研究結果發現,自我規範、自我管理與糖尿病的併發症風險無統計顯著相關,自我動機強烈的病人其眼睛病變的勝算比較低,但採用健康概況分群的方式無統計上的顯注意義,僅有生化數據的健康概況分群與眼睛病變的風險有關,雖然生化數據的正常率與病人行為有關,但目前的統計結果較不顯著,不過其方向仍與原研究假設一致。該資料有助於完整病人健康概況分群的測試與驗證,採用不同層面的資訊有助於探討不同病人健康概況分群與之後發生併發症之風險,也可提供糖尿病照護團隊對於病人自我控制於不同危險因子之間對於之後併發症發生之影響,有助於未來糖尿病照護進行建議與改善。
The high prevalence of diabetes with aging population can bring the serious economic burden and intense National Health Insurance resources input. Most studies revealed that the well-control diabetes situation can lead good quality of life and reduce the risk of complications in the future. The purpose of this study is to explore the relationship between the self-management behavior with the complications. We adopt the health profiles methodology to investigate the different subgroups for different health profiles with the risk of diabetic retinopathy and nephropathy. The study population come from the regional hospital which start up a case management system from a decade ago to help Type II diabetes patients can control their diabetes in an optimal situation. This study contacts the hospital information system to grab the biomedical test results records during the study period using the Latent profile analysis. Later, we design the patient survey questionnaires including Chinese version Diabetes Management Self-Efficacy Scale (C-DMSES), Treatment Self-Regulation Questionnaire for diabetes (TSRQ-diabetes), barriers, quality of life (EQ5-D), and depression (PHQ-9) as the major components. Those results from patient survey can help construct second levels of patient health profiles. Those information can help us frame the comprehensive patient health profiles and test the validation in the risk of complications in the future. The study indicated that the relationship between the diabetes complications and self-efficacy and self-management were not significant; however, the higher self-regulation scale may reduce the likelihood of diabetes complication in eye comparing with those who were the lower self-regulation scale. By using the LPA method, health profiles in patient behavior did not show the significant results, but health profiles in biomarkers find the positive results with the diabetes complications in eye. Although, we believe maintaining the normal rate of biomarkers were associated with patient behavior, we still need more evidence from the further studies. Those results related to patient behavior were not statistical significances but still followed the hypothesis we used in this study. Using different dimensions of data collection help us evaluate the relationship between patient health profiles and the risk of complications in diabetes control. Those results also improve the knowledge in self-management behavior and provide useful strategies in clinical care for Type II diabetes patients.
是,已處理
僅就有無可識別個人身份資料進行檢查及處理,不對變項名稱、變項及選項數值說明與問卷是否一致或有定義進行核對或修改。
追蹤清單
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