臺灣博碩士論文加值系統

背景：第二型糖尿病已是增加速度最快且最耗用醫療資源之慢性病，預防糖尿病是當務之急，目前已知生活型態介入可顯著降低糖尿病風險，由於傳統衛教需大量成本支出，網際網路具有超越時間與空間限制的特性，運用其可近性、即時性且可降低耗費成本之優點，有助於達到推廣正確預防糖尿病之目標。
目的：本研究主要目的為探討社群網路健康照護介入對糖尿病前期者的知識、健康行為及生理指標之差異，了解社群網路健康照護介入是否可有效提升第二型糖尿病預防及衛生教育成效。
研究方法：本研究採類實驗研究設計，以立意取樣自北部某傳統公司的糖尿病前期員工，共60名。實驗組30名接受以「LINE」社群網路介入之衛教模式，控制組30名僅給予糖尿病前期衛教單張，介入期間共六週。研究工具包括：「糖尿病預防知識量表」、「糖尿病健康行為量表」及生理指標「空腹血糖、身高、體重、腰圍及臀圍」，資料以描述性統計及獨立樣本t檢定、配對樣本t檢定、Wilcoxon Signed Ranks Test、Mann-Whitney U Test及多元線性迴歸分析的推論性統計分析。
結果：本研究發現社群網路健康照護介入後對於糖尿病前期員工知識、健康行為及空腹血糖具有成效，但對腰圍、臀圍及腰臀圍比沒有顯著差異。結果呈現社群網路健康照護介入後(一)實驗組糖尿病前期員工的知識量表得分顯著高於控制組(b=3.48, p=0.001)，且「糖尿病預防知識量表」後測(M=10.67, SD = 1.85) 顯著高於前測(M=4.47, SD=2.03) (p<0.001)；(二)實驗組糖尿病前期員工的健康行為量表得分顯著高於控制組(b = 29.18, p=0.001)，且「糖尿病健康行為量表」後測(M=107.00, SD=4.98)顯著高於前測(M=70.87, SD=15.67) (p<0.001)；(三)實驗組糖尿病前期員工的空腹血糖後測平均空腹血糖103.27mg/dL (SD = 9.49)低於控制組後測平均空腹血糖106mg/dL (SD =7.26)但未統計上顯著差異(b=-2.45, p=0.49)，但實驗組空腹血糖值後測平均值(M=107.00, SD=4.98)低於前測平均值(M=109.03, SD=7.57)，達顯著差異 (p＝0.02)；(四)實驗組及控制組糖尿病前期員工的腰圍、臀圍及腰臀圍比無顯著差異，且兩組腰圍、臀圍及腰臀圍比前後測平均值無顯著差異。
結論：本研究結果顯示社群網路健康照護介入可有效提升糖尿病前期員工的知識、健康行為及空腹血糖，增加生活型態改變之動機，因此可提供給臨床實務、衛生教育單位及職場，以推動社群網路介入健康照護，作為糖尿病防治計畫之參考。

Background: As type 2 diabetes (T2D) is a chronic disease that increases at a rapid rate and consumes the most medical resources, diabetes prevention has become a top priority. Currently, lifestyle intervention has been found to significantly reduce the risk of diabetes. Compared to the high costs required for traditional health education, the Internet has the advantages of accessibility, immediacy and reduced costs due to its ability to transcend the limitations of time and space. Using Internet resources may help achieve the goal of promoting proper diabetes prevention.
Objective: The main purpose of this study is to explore the differences in the knowledge, health behaviors and physiological parameters of prediabetic patients through social network health care interventions. This study aims to find out if social network health care interventions may effectively enhance the effectiveness of T2D prevention and health education.
Research Methodology: Adopting a quasi-experimental research design, this study examined sixty prediabetic employees from a traditional company in northern Taiwan through the purposive sampling method. The thirty subjects in the experimental group received social network health care interventions through an application called LINE, whereas the thirty subjects in the control group were only given health education leaflets regarding prediabetes. Interventions lasted a total of six weeks. Research tools included the Diabetes Prevention Knowledge Scale, the Diabetes Health Behavior Scale and Physiological parameters such as Fasting Plasma Glucose, Height, Weight, Waist circumference and Hip circumference. In addition to descriptive statistics, data analysis was conducted using inferential statistics, including Independent Samples t Test, Wilcoxon Signed Ranks Test, Mann-Whitney U Test, and multiple regression analysis.
Results: This study found that social network health care interventions achieved effective results in improving the knowledge, health behaviors and fasting plasma glucose of prediabetic employees, but found no significant difference in waist circumference, hip circumference and waist-hip ratio. The research results after social network health care intervention were implemented are as follows :
(1) The prediabetic employees in the experimental group scored significantly higher (b=3.48, p=0.001) than those in the control group (b=3.48, p =0.001) in terms of the Diabetes Prevention Knowledge Scale, and their posttest score for the Diabetes Prevention Knowledge Scale (M=10.67, SD = 1.85) is significantly higher than their pretest score (M=4.47, SD= 2.03) (p<0.001);
(2) The prediabetic employees in the experimental group scored significantly higher (b = 29.18, p=0.001) than those in the control group in terms of the Diabetes Health Behavior Scale, and their posttest score for the Diabetes Health Behavior Scale (M=107.00, SD=4.98) is significantly higher than their pretest score (M=70.87, SD=15.67) (p<0.001);
(3) The average posttest fasting plasma glucose of the pre-diabetic employees in the experimental group was 103.27 mg/dL (SD = 9.49), which was lower than that of the control group, i.e., 106 mg/dL (SD = 7.26). Although such difference did not achieve statistical significance (b=-2.45, p= 0.49), the posttest fasting plasma glucose mean of the pre-diabetic employees in the experimental group (M=107.00, SD=4.98) is lower than the pretest mean (M=109.03, SD=7.57), showing significant differences (p= 0.02);
(4) The waist circumference, hip circumference and waist-hip ratio of prediabetic employees in the experimental and control groups did not show significant difference. In addition, the pretest and posttest means of waist circumference, hip circumference and waist-hip ratio in both groups showed no significant difference, either.
Conclusion: The results of this study show that social network health care interventions can effectively improve the knowledge, health behaviors and fasting plasma glucose levels among prediabetic employees, while enhancing their motivation for lifestyle changes. Therefore, this research may serve as a reference for clinical practices, health education units and workplaces to include the promotion of social network health care interventions in addition to existing diabetes prevention and control programs.

中文摘要 I
ABSTRACTIII
目錄VI
表目錄VIII
圖目錄IX
第一章 緒論1
第一節 研究背景與動機1
第二節 研究目的4
第三節 研究問題5
第四節 研究假設6
第五節 名詞解釋7
第二章 文獻查證10
第一節 糖尿病前期10
第二節 糖尿病前期的知識、健康行為的關係16
第三節 社群網路健康照護介入對糖尿病前期之影響25
第三章 研究方法29
第一節 研究架構29
第二節 研究設計30
第三節 研究對象及場所31
第四節 介入措施32
第五節 研究工具40
第六節 測量工具41
第七節 研究步驟42
第八節 倫理考量45
第九節 資料處理與分析46
第四章 研究結果47
第一節 員工之社會人口學資料、糖尿病前期之知識、健康行為及生理指標現況47
第二節 社群網路健康照護介入對於員工在糖尿病前期知識的成效54
第三節 社群網路健康照護介入對員工在健康行為的成效58
第四節 社群網路健康照護介入對員工在生理指標的成效60
第五章 討論68
第一節 社群網路健康照護介入對糖尿病前期知識之成效68
第二節 社群網路健康照護介入對健康行為之成效 69
第三節 社群網路健康照護介入對生理指標之成效 71
第六章 結論與建議73
第一節 結論73
第二節 建議75
第三節 未來研究建議77
第四節 研究限制78
參考資料 79
中文部分 79
西文部分 82
附錄97
附錄一 人體試驗倫理委員會臨床試驗同意證明書 97
附錄二 糖尿病預防知識量表授權同意書98
附錄三 糖尿病健康促進自我照顧行為量表授權書 99
附錄四 職場員工糖尿病前期知識、健康行為問卷調查表100
表目錄
表2-1糖尿病前期的分類11
表2-2台灣糖尿病風險評估公式12
表2-3台灣成人糖尿病篩檢建議12
表2-4預防糖尿病的生活型態15
表2-5以wang et al. (2012)之健康行為量表相關研究18
表2-6健康行為介入糖尿病前期相關研究 21
表2-7社群網路與糖尿病前期相關研究28
表3-1研究設計30
表3-2社群網路介入衛教內容33
表3-3研究時程確認表43
表4-1實驗組與控制組基本資料之同質性檢定(n = 60)48
表4-2實驗組與控制組前測依變項之同質性檢定(n= 60)53
表4-3社群網路健康照護介入對糖尿病預防知識量表得分之多變項線性迴55
表4-4社群網路健康照護介入對糖尿病前期預防知識、糖尿病前期健康行為、空腹血糖(n=60)56
表4-5社群網路健康照護介入對糖尿病健康行為量表得分之多變項線性迴歸分析(n=60)59
表4-6社群網路健康照護介入對空腹血糖之多變項線性迴歸分析(n = 60) 61
表4-7社群網路健康照護介入對腰圍之多變項線性迴歸分析(n = 60)63
表4-8社群網路健康照護介入對臀圍之多變項線性迴歸分析(n = 60)64
表4-9社群網路健康照護介入對腰臀圍比之多變項線性迴歸分析(n = 60) 66
圖目錄
圖3-1研究架構 29
圖3-2研究步驟流程圖44
圖4-1糖尿病前期知識測驗不同時間點平均分數之改變54
圖4-2糖尿病前期健康行為測驗不同時間點平均分數改變58
圖4-3空腹血糖不同時間點平均分數改變 60
圖4-4腰圍不同時間點平均分數改變62
圖4-5臀圍不同時間點平均分數改變64
圖4-6腰臀圍比不同時間點平均分數改變 66

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