背 景足部神經病變不僅是第二型糖尿病病人容易出現的合併症，並且容易增加死亡的風險。早期偵測造 成糖尿病神經病變的因素應有助於避免後續足部潰瘍、下肢截肢及死亡率的發生。 目 的探討人口學、疾病特性、健康素養以及足部自我照護行為等變項，是否為第二型糖尿病病人罹患足 部神經病變的相關危險因素。 方 法採病例對照研究，在北部一所醫學中心招募第二型糖尿病門診病人為研究對象，以兩側足部的密西 根神經病變篩檢工具（Michigan Neuropathy Screening Instrument, MNSI）測得總分 ≥ 2分時為病例組， 然後依病例組的年齡和性別進行配對，共有114位病人參與。以結構式問卷進行資料收集，並透過 Fisher’s exact test、Mann-Whitney U test和logistic regression等統計方法進行資料分析。 結 果研究結果顯示糖化血色素（B = 1.696, p = .041）及溝通和批判性健康素養（B = -0.082, p = .034）與第二 型糖尿病病人發生足部神經病變有關。 結 論／ 實務應用 建議護理師於衛教前，能先評估T2DM病人的健康素養，並且針對血糖控制較差者，發展適切的足 部照護介入措施，以預防後續足部神經病變的發生。

Background: Patients with type 2 diabetes mellitus (T2DM) face a higher risk of diabetic foot neuropathy, which increases the risk of death. The early detection of factors that influence diabetic neuropathy reduces the risk of foot lesions, including foot ulcerations, lower extremity amputation, and mortality. Purpose: To explore the demographic, disease-characteristic, health-literacy, and foot-self-care-behavior factors that affect diabetic foot neuropathy in patients with T2DM. Methods: A case-control study design was employed in which cases (Michigan Neuropathy Screening Instrument, MNSI) ≥ 2 were matched to controls based on age and gender in a medical center. A total of 114 patients diagnosed with T2DM in a medical center were recruited as participants. Data were collected using a structured questionnaire. The collected data were analyzed using Fisher’s exact test, Mann-Whitney U test, and logistic regression. Results: The results of multiple logistic regression showed that glycated hemoglobin (B = 1.696, p = .041) and communication and critical health literacy (B = -0.082, p = .034) were significant factors of diabetic foot neuropathy. Conclusions/Implications for Practice: The findings of this study suggest that nurses should assess the health literacy of patients with T2DM before providing health education and should develop a specific foot-care intervention for individuals with poor glycemic control.