本研究主要目的在於探討胰島素依賴型糖尿病病患之自我照顧情形，及其對糖尿病控制的影響。以中華民國糖尿病學會組織的「台北市胰島素依賴型糖尿病調查小組」所登綠的個案及「康泰幼年型糖尿病聯誼會」會員中曾接受體檢並完成自我照顧調查之個案為主，採敘述性與相關性調查研究法。 本研究工具之項目包括：(1)自我照顧調查表(2)家人態度量表(3)心理適應量表(4)糖尿病知識評估表(5)體檢所得血糖值及糖化血色素值。結果顯示在130病例中，年齡以7歲～12歲所佔比率最多（43人，33.1%），有63%（82人）病患發病在12歲以下。82.2%（106人）病例於最近一個月內有檢查血糖；91.5%（118人）每天能按時規則注射胰島素；但只有33.3%（43人）的患者常按照營養師所設計食譜進食。 130位病患中有73位參予體檢。經由推論統計分析相關值，發現自我照顧較好者其糖化血色素值較低，有關糖尿病知識愈多者，其糖化血色素值則愈低。複迴歸統計進一步分析發現，自我照顧行為可以解釋35%的HbA(下标 1C)之變異量，自我照顧行為及知識可以解釋47%的HbA(下标 1C)之變異量。本研究證實自我照顧與知識對糖尿病控制的重要性。

This study was conducted with a descriptive and correlational design to investigate the self-management of patients with insulin-dependent diabetes (IDDM), and to analyze its influence on diabetic control. The subjects were recruited from the enrolled list of a survey project of Taipei IDDM Registry and from the list of the Kang-Tai IDDM association. One hundred and thirty subjects either completed the questionnaires by themselves or being interviewed by well trained nurses. Seventy-three subjects participated the annual physical examination which was supported by the Department of Health, Executive Yuan, the diabetic association and the Kang-Tai IDDM association of this country. The questionnaires included: (1) the self-management assessment based on self-monitoring of blood sugar, diet, insulin injection, exercise, safety procedure, foot care, etc., (2) the IDDM knowledge assessment, (3) the psycho-social assessment, (4) the diabetic family behavior checklist, (5) the blood sugar value and HbA(subscript ID) value simultaneously done at the physical examination. These assessments were approved with the content validity and the adequacy reliability in this study. Results indicated: the most IDDM patients were at the ages from 7 to 12 years old (33.1%); The majority of patients developed diabetes before the age of 12 (63.0%); 82.2% of patients did the blood sugar test within recent one month; and 91.5% of patients had regular insulin injections; however, only 33.3% of patients followed the diet instructed by dietician; The self-management negatively associated with the HbA(subscript ID). The better the self- management was, the lower the value of HbA(subscript 1D) would be. The negative association also existed between diabetic knowledge and HbA(subscript 1D). Using a stepwise multiple regression, self- management was found to explain 35% variance of HbA(subscript ID) level, and combining with knowledge which could explain 47% variance of HbA(subscript ID) level. This study confirmed the importance of self-management and knowledge relevant to the diabetic control.

胰島素依賴型糖尿病 ； 自我照顧 ； 糖尿病控制

Insulin-Dependent Diabetes Mellitus, Self-Management, Diabetic Control