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    Please use this identifier to cite or link to this item: http://asiair.asia.edu.tw/ir/handle/310904400/111162


    Title: 糖尿病病患視網膜病變之生活品質探討及其影響因素-以中部某地區醫院為例
    Authors: 陳靜純
    Contributors: 健康產業管理學系健康管理組碩士在職專班
    Keywords: 糖尿病、視網膜病變、生活品質、SF-36v2、diabetes、retinopathy、quality of life、SF-36v2
    Date: 2018
    Issue Date: 2018-07-16 14:22:41 (UTC+8)
    Publisher: 亞洲大學
    Abstract: 研究目的:2017年國際糖尿病聯盟(IDF)統計資料顯示,全球有4.25億人罹患糖尿病,且有逐年增加之趨勢,其併發視網膜病變者超過1/3,而國內盛行率亦高達31.1%。本研究為探討糖尿病病患之視網膜病變其生活品質及相關影響因素。
    研究方法:本研究為立意取樣,調查2017年10月至2018年1月,至中部某地區醫院就診之眼科門診病患,已確診為糖尿病患者、無其他眼科疾患為研究對象。本研究以SF-36v2健康生活品質量表及自設之結構式問卷,佐以病歷查閱等方式收集資料,並計算所需之最少樣本數為242人。統計分析方法除敘述性統計,以t-test、ANOVA檢定各變項對生理面向(PCS)生活品質分數及心理面向(MCS)生活品質分數之差異,並以線性複廻歸模式,分別探討影響糖尿病病患視網膜病變之PCS及MCS生活品質之顯著相關因素。
    研究結果:本研究對象,148位(56.3%)病患無糖尿病視網膜病變,有糖尿病視網膜病變共有115位(43.7%),平均年齡為62歲,以60~69歲最多(38.4%),女性為144人(54.8%),81%的病患患有其他慢性病,以高血壓人數最多。SF-36v2構面中,以「社會功能」的分數最高(86.45分),「一般健康狀況」的分數最低(63.76分)。影響PCS生活品質的相關因素分別為性別、年齡、居住狀況、有無工作、有無其他慢性疾病、視力、及視網膜病變治療方式;影響MCS生活品質的相關因素,則為性別、年齡、糖尿病治療方式及視網膜病變程度。
    結論與建議:本研究中,糖尿病視網膜病變所佔比例為43.7%,整體病患平均年齡為62歲,生活品質量表中,以「社會功能」的分數最高,「一般健康狀況」的分數最低。除個人基本特性,最主要影響糖尿病病患視網膜病變之PCS生活品質面向之因素為視力,其次為有無工作;而影響MCS生活品質面向之最主要因素則為糖尿病治療方式,其次為視網膜病變程度。建議:(1) 糖尿病病患,不論第一型或第二型糖尿病,皆應將血糖控制在正常範圍,以延緩合併症的產生及視力的喪失,並提醒病患每年應定期至眼科進行視網膜檢查;另建議將所有糖尿病者皆納入糖尿病照護網,以利追蹤及監控病患之血糖,確保其健康。(2)醫護人員及病患家屬,應鼓勵病患,尤其是年長病患,多參與社會化的活動與次數,增加與他人的互動頻率與機會,以提升其生活品質。Research Purposes: According to the statistics from International Diabetes Federation (IDF) in 2017, 425 million people in the world suffered from diabetes, and the figure tends to increase year by year. The incidence of retinopathy complication is more than 1/3, and the domestic prevalence rate is as high as 31.1% in Taiwan. This study explored the quality of life and relevant influencing factors of patients with diabetic retinopathy.
    Research Method: By purposeful sampling, this study investigated the patients who sought treatment at the ophthalmology clinic of a certain hospital in Central Taiwan from October 2017 to January 2018, and were diagnosed as diabetic patients without other ophthalmic diseases. They were selected as subjects of this study. This study collected data via a SF-36v2 healthy life quality questionnaire and self-defined structured questionnaire, as well as reference to medical records. The minimum number of samples required is calculated to be 242. In addition to descriptive statistics, the statistical analysis methods of t-test and ANOVA were adopted to clarify the differences of the variables on the Physical Component Summary (PCS) of life quality and Mental Component Summary (MCS) of life quality. This study adopted the linear regression model to respectively explore the significant factors affecting the PCS and MCS life quality of patients with diabetic retinopathy.
    Research Findings: In this study, 148 (56.3%) patients had no diabetic retinopathy, while 115 (43.7%) patients had diabetic retinopathy. With the average age of 62 years, the patients in the 60-69 age group made up the largest share (38.4%); 144 (54.8%) of them were female, while 81% of the patients had other chronic diseases, mostly hypertension. From the perspective of SF-36v2, the score for “social functioning” was the highest (86.45), while the score for “general health” was the lowest (63.76). Relevant factors affecting PCS life quality included gender, age, living status, presence or absence of work, other chronic diseases, vision, and treatment methods of retinopathy. Relevant factors affecting MCS life quality included gender, age, treatment methods of diabetes and severity of retinopathy.
    Conclusions and Recommendations: In this study, the proportion of diabetic retinopathy is 43.7%, and the average age of all the patients is 62 years old. In the life quality table, the score for “social functioning” is the highest while the score for “general health” is the lowest. In addition to the basic personal characteristics, the most important factor affecting the PCS life quality of patients with diabetic retinopathy is visual acuity, followed by the presence or absence of work; while the most important factor affecting the MCS life quality is the treatment methods of diabetes, followed by the severity of retinopathy. Thus, the recommendations of this study are as the follows: (1) Patients of diabetes, regardless of type 1 or type 2 diabetes, should control their blood glucose within the normal range to delay the development of complications and loss of vision; the patients should be reminded to have their retinas checked every year. It is also recommended to include all diabetes patients in the Diabetes Care Network to facilitate tracking and monitoring of patients’ blood glucose to ensure their health. (2) Medical workers and patients’ family members should encourage patients, especially older patients, to engage in social activities more frequently and increase the opportunities of interaction with others to improve their quality of life.
    Appears in Collections:[健康產業管理學系] 博碩士論文

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