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題名:糖尿病患接受冠狀動脈繞道手術後治療遵從行為之探討
書刊名:護理暨健康照護研究
作者:連如玉陳強儀施俊哲童恒新
作者(外文):Lien, Ru-yuChen, Chiang-yiShih, Chun-cheTung, Heng-hsin
出版日期:2015
卷期:11:2
頁次:頁137-147
主題關鍵詞:冠狀動脈繞道手術糖尿病治療遵從行為Coronary artery bypass graftDiabetes mellitusTreatment compliance behavior
原始連結:連回原系統網址new window
相關次數:
  • 被引用次數被引用次數:期刊(1) 博士論文(0) 專書(0) 專書論文(0)
  • 排除自我引用排除自我引用:1
  • 共同引用共同引用:5
  • 點閱點閱:134
背 景:冠狀動脈繞道術後有10-20%復發率,造成再次手術原因多為無持續追蹤治療或未能改變不健康生活型態,不但生活品質無法真正提升,更可能耗費大量醫療成本。目 的:探討糖尿病合併冠狀動脈繞道手術後病患的治療遵從行為,了解病人治療遵從行為的解釋因子,以利醫護人員協助強化病人的醫療遵從性。方 法:採橫斷性調查立意取樣方式,以北部三家教學醫院之門診糖尿病患接受冠狀動脈繞道手術患者為對象,共166位。研究工具為自擬式基本資料問卷及心血管糖尿病治療遵從性量表問卷,資料收集後以SPSS 21.0進行統計分析。結 果:研究對象出現不遵從治療行為者有34.9%,於術後1-3年最多。遵從行為以飲食控制最佳,其次為藥物遵從,改變生活型態最差。能自我照顧者治療遵從性較佳,遵從性較佳者越能執行規則運動,冠狀動脈繞道手術後時間越久治療遵從性越佳,出現藥物副作用者遵從性較差。病患個人對目前生活環境的滿意程度、手術後時間以及是否出現藥物副作用,為治療遵從性行為的重要解釋因子,達統計上顯著意義(F=4.039, p=.046)。實務應用:醫療人員應提供返家後飲食控制之相關資訊,協助整個家庭的飲食行為的改變,促使病人藉由飲食控制建立健康的生活模式,另應讓病患瞭解與配合疾病控制必需的藥物應定時服用,建議病患改變生活型態方式,取代非必要的藥物治療,共同訂定可達成的運動計畫,以提升生活環境的滿意度,進而幫助病患自我強化治療遵從行為。
Background: Coronary artery bypass surgery has an average recurrence rate of 10 to 20%, which generally results in the need for a reoperation and keeping close track of treatments and unhealthy lifestyle indicators. This situation negatively impacts the quality of life of patients and increases the costs of medical care. Purpose: This paper explores the factors related to the compliance behavior of post‐coronary‐bypass diabetes patients and develops a model to improve the healthcare and medical compliance of this population. Methods: This cross‐sectional study used convenience sampling to recruit diabetes patients who had received coronary artery bypass surgery at one of the largest medical hospitals in northern Taiwan. The 166 participants were asked to fill out a questionnaire that included questions on basic demographics, type of diabetes treatment, cardiovascular health status, and treatment compliance behavior. Results: A total of 34.9% of participants were identified with poor compliance behavior. Most non‐compliance behavior began to appear at 1 to 3 years post‐surgery. Patients with the best compliance behavior performed the best in the category of diet control followed by medication compliance. Lifestyle change was identified as the least important behavior. The results show that the longer the duration since CABG surgery treatment, the better that treatment compliance behaviors were. The findings also indicate that satisfaction with living environment, length of time since surgery, and the side effects of medication explained the variance in treatment compliance behaviors in participants (F=4.039, p=.046). Implications for Practice: Healthcare workers should teach family dietary changes and control. Patients should receive education on regular medication and healthy habits. Furthermore, programs that improve living conditions may help patients comply with appropriate behavior therapy.
期刊論文
1.林憶珊、楊南屏、周碧瑟(200903)。第二型糖尿病患口服藥物服藥順應性相關因子之探討。臺灣家庭醫學雜誌,19(1),24-35。  延伸查詢new window
2.Topinkova, E.、Fialova, D.、Carpenter, G. I.(2006)。Cross-national comparison of drug compliance and non-compliance associated factors in the elderly with polypharmacotherapy。Časopis Lékařů Českých,145(9),726-732。  new window
3.Mourot, L.、Boussuges, A.、Campo, P.、Maunier, S.、Debussche, X.、Blanc, P.(2009)。Cardiovascular rehabilitation increase arterial compliance in type 2 diabetic patients with coronary artery disease。Diabetes Research and Clinical Practice,84(2),138-144。  new window
4.Pang, M. Y.、Eng, J. J.、Lin, K. H.、Tang, P. F.、Hung, C.、Wang, Y. H.(2009)。Association of depression and paininterference with disease-management self-efficacy in community-dwelling individuals with spinal cord injury。Journal of Rehabilitation Medicine,41(13),1068-1073。  new window
5.Sudchada, P.、Khom-ar-wut, C.、Eaimsongchram, A.、Katemut, S.、Kunmaturos, P.、Deoisares, R.(2012)。Diabetes and cardiovascular risk factor controls in Thai type 2 diabetes with no history of cardiovascular complications; situation and compliance to diabetes management guideline in Thailand。Journal of Diabetes and Its Complications,26(2),102-106。  new window
6.Mellbin, L. G.、Anselmino, M.、Ryden, L.(2010)。Diabetes, prediabetes and cardiovascular risk。European Journal of Cardiovascular Prevention & Rehabilitation,17(S1),9-14。  new window
7.Long, Q.、Little, R. J.、Lin, X.(2010)。Estimating causal effects in trials involving multi-treatment arms subject to non-compliance: A Bayesian framework。Journal of the Royal Statistical Society: Series C (Applied Statistics),59(3),513-531。  new window
8.Kostapanos, M. S.、Elisaf, M. S.、Mikhailidis, D. P.(2012)。Targeting cardiovascular risk: The impact of age, gender and compliance to treatment。Current Medical Research and Opinion,28(9),1415-1419。  new window
9.Huffman, M. H.(2009)。HEALTH COACHING: A Fresh, New Approach to Improve Quality Outcomes and Compliance for Patients with Chronic Conditions。Home Healthcare Nurse,27(8),496-498。  new window
10.Gutiérrez-Angulo, M. L.、Lopetegi-Uranga, P.、Sánchez-Martín, I.、Garaigordobil-Landazabal, M.(2012)。Therapeutic compliance in patients with arterial hypertension and type 2 diabetes mellitus。Revista de Calidad Asistencial: Organo de la Sociedad Espanola de Calidad Asistencial,27(2),72-77。  new window
11.Goering, E. M.、Matthias, M. S.(2010)。Coping with chronic illness: Information use and treatment adherence among people with diabetes。Communication & Medicine,7(2),107-118。  new window
12.Fast, Y. J.、Steinke, E. E.、Wright, D. W.(2009)。Effects of attending phase II cardiac rehabilitation on patient versus spouse (proxy) quality-of-life perceptions。Journal of Cardiopulmonary Rehabilitation and Prevention,29(2),115-120。  new window
13.Bayer, F. J.、Galusha, D.、Slade, M.、Chu, I. M.、Taiwo, O.、Cullen, M. R.(2014)。Process of care compliance is associated with fewer diabetes complications。The American Journal of Managed Care,20(1),41-52。  new window
14.Bhattacharyya, N.、Das, M. K.、Chatterjee, P. S.、Biswas, R.(2010)。An intervention study on compliance of diabetes mellitus patients。Journal of the Indian Medical Association,108(2),88-90。  new window
15.Brod, M.、Rousculp, M.、Cameron, A.(2008)。Understanding compliance issues for daily self-injectable treatment in ambulatory care settings。Patient Preference and Adherence,2,129-136。  new window
16.陳淑美、林佩萱(20140600)。臺灣老人居住安排與生活滿意度關係之區域差異分析。建築與規劃學報,15(1),61-82。new window  延伸查詢new window
17.Dongbo, F.、Ding, Y.、McGowan, P.、Fu, H.(2006)。Qualitative evaluation of Chronic Disease Self Management Program (CDSMP) in Shanghai。Patient Education and Counseling,61(3),389-396。  new window
18.Albert, N. M.(2008)。Improving medication adherence in chronic cardiovascular disease。Critical Care Nurse,28(5),54-65。  new window
19.Cameron, C.(2008)。Patient compliance: Recognition of factors involved and suggestions for promoting compliance with therapeutic regimens。Journal of Advanced Nursing,24(2),244-250。  new window
學位論文
1.張維誠(2009)。糖尿病患者遵醫囑行為對血糖控制及生活品質之影響(碩士論文)。美和技術學院。  延伸查詢new window
2.陳美滿(2008)。多種慢性病老年患者遵從醫囑服藥之障礙(碩士論文)。國立成功大學。  延伸查詢new window
圖書
1.Clinic, Mayo(2006)。The mayo clinic plan: 10 essential stept to a better body & healthier life。New York, NY:Time Home Entertainment Books。  new window
其他
1.衛生福利部國民健康署(2007)。中老年身心社會生活狀況長期追蹤調查系列調查簡介,http://www.hpa.gov.tw/BHPnet/Web/HealthTopic/TopicArticle.aspx?No=200712270017&parentid=200712270002, 2013/06/08。  延伸查詢new window
2.World Health Organization(2015)。Cardiovascular diseases (CVDs),http://www.who.int/cardiovascular_diseases/en/。  new window
3.衛生福利部統計處(2012)。性別統計圖像與分析,http://www.mohw.gov.tw/cht/DOS/Statistic.aspx?f_list_no=312&fod_list_no=2204。  延伸查詢new window
4.衛生福利部統計處(2014)。門、住診合計就診率統計--按性別及年齡別分,http://www.mohw.gov.tw/cht/DOS/Statistic.aspx?f_list_no=312&fod_list_no=4718。  延伸查詢new window
5.衛生福利部統計處(2014)。門、住診主要手術處置統計,http://www.mohw.gov.tw/cht/DOS/Statistic.aspx?f_list_no=312&fod_list_no=4728。  延伸查詢new window
6.American Heart Association(2010)。Heart disease and stroke statistics--2015 update,http://circ.ahajournals.org/content/early/2014/12/18/CIR.0000000000000152.full.pdf。  new window
7.(2014)。十大死因第四糖尿病服用藥物遵從率低,http://healthnews.com.tw/readnews.php?id=13694。  延伸查詢new window
圖書論文
1.Haynes, R. B.(1979)。Strategies to improve compliance with referrals, appointment, and prescribed regimen。Compliance in health care。Baltimore, ML:Johns Hopkins University Press。  new window
 
 
 
 
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