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篇名 罹患糖尿病與否對冠狀動脈繞道手術後病患的自我效能、治療遵從性及其預測因子差異之比較
卷期 59:3
並列篇名 Difference in Predictors of Self Efficacy and Compliance Between Diabetic and Non Diabetic Patients Who Underwent Coronary Artery Bypass Surgery
作者 連如玉魏崢李君儀童恒新陳強儀
頁次 040-050
關鍵字 冠狀動脈繞道手術糖尿病自我效能治療遵從性coronary artery bypass graftdiabetes mellitusself-efficacycompliance with treatmentMEDLINEScopusTSCI
出刊日期 201206

中文摘要

背景 冠狀動脈繞道手術後之糖尿病患者易發生合併症且預後較差,若能控制相關因子減少合併症發生,並了解手術病人是否同時合併糖尿病,以及其自我效能及治療遵從性的差異,對於患者於生活與疾病上的長期照護非常重要。目的 比較病患罹患糖尿病與否於冠狀動脈繞道手術後,其自我效能、治療遵從性預測因子之差異。方 法採橫斷研究方便取樣方法,以兩家醫學中心及一家區域教學醫院共350位病患為對象。研究工具包括基本資料問卷、慢性病自我效能及治療遵從性量表,以SPSS 17.0 for window進行資料建檔與統計分析。結果 研究顯示兩組之自我效能與治療遵從性皆呈顯著正相關(p < .001),不管罹患糖尿病與否,接受冠狀動脈繞道手術後的病患,自我效能越高,治療遵從性越高;無糖尿病組之自我效能較糖尿病組為佳(t = .273, p = .002),但治療遵從性較差(t = -2.51, p = .012);兩組在自我效能及治療遵從性之預測因子皆有所差異,糖尿病組顯示性別、治療遵從性、教育程度、目前有無工作和婚姻狀況為自我效能之預測因子,總解釋力28.5%(p < .001),自我效能是治療遵從性的單一預測因子,可解釋7.8%之變異數(p < .001)。無糖尿病組自我效能之預測因子包括治療遵從性、照顧者、教育程度、手術後月數、性別及規則運動,總解釋力41.0%(p < .001),而自我效能、照顧者及手術前職業,可共同預測治療遵從性20.0%之變異數(p < .001)。結論 提供了解罹患糖尿病與否於冠狀動脈繞道手術後,病患基本屬性和自我效能、治療遵從性的關係與其預測力,醫護人員可依照病人具有預測力之基本屬性的特異性,來加強病人的自我效能及治療遵從性,持續增進相關的健康行為,提升長期之生活品質。

英文摘要

Background: Compared to their non-diabetic peers, diabetic patients who undergo coronary artery bypass surgery (CABG) face greater complications and poorer outcomes. Identifying related risk factors is essential to improving post-CABG outcomes in this vulnerable population. Improving self-efficacy and compliance can further improve patient outcomes over the long term.Purpose: This study compared differences in self-efficacy predictors and compliance between diabetic and nondiabetic patients who received coronary artery bypass surgeryMethod: We used a cross-sectional design with convenience sampling. A total of 350 patients were recruited from two medical centers and one teaching hospital. Instruments used included a demographics questionnaire, chronic disease self-efficacy questionnaire and compliance scale. SPSS 17.0 for Windows was used to analyze data.Results: Results found self-efficacy positively associated with compliance in both groups. The non-diabetic group had higher self-efficacy and lower compliance than the diabetic group. In the diabetic group, gender, compliance, education, employment status and marital status were all predictors of self-efficacy, with self-efficacy the single predictor of compliance. In the non-diabetic group, compliance, primary care provider, education, time since surgery, gender and exercise were predictors of self-efficacy. Self-efficacy, primary care provider, employee status prior surgery were all predictors of compliance.Conclusions: Results provide valuable information regarding the impact of diabetes on CABG patient outcomes and differences in predictors of self-efficacy and compliance between diabetic and non-diabetic patients. Healthcare providers can promote healthy behavior and enhance quality of life by providing patient support tailored to their characteristics and considering the factors associated with better self-efficacy vs. compliance.

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