第二型糖尿病患身體活動、睡眠品質與血糖控制之關聯性研究

Abstract

本研究目的為針對宜蘭縣教學醫院第二型糖尿病患者，探討其身體活動、睡眠品質與血糖控制之關聯性。本研究共發出201份問卷，得有效樣本數為181份，回收率為90％。研究工具為中文版之匹茲堡睡眠品質量表及國際身體活動表短版。資料以SPSS 23.0進行描述性和推論性統計，並以卡方及邏輯斯迴歸分析各變項之關聯性，結果如下：一、研究對象年齡平均為63.47歲，以大於65 歲最多，大多睡眠品質良好（56.9％）且身體活動足夠（65.2％），其中血糖控制良好占多數（50.3％）。 二、針對個人背景因素與睡眠品質部分：運用卡方檢定進行分析探討發現個人背景因素之「職業狀況」、「慢性併發症」、「飲食控制」與睡眠品質有顯著關聯，本研究顯示「有工作」、「無慢性併發症」、「有飲食控制」之第二型糖尿病患者有較佳的睡眠品質。 三、針對個人背景因素與身體活動部分：運用卡方檢定進行分析探討發現個人背景因素之「年齡」、「教育程度」與身體活動有顯著關聯，本研究「小於65 歲」、「國高中」之第二型糖尿病患者更容易達到身體活動建議量。 四、針對睡眠品質與血糖控制部分：運用邏輯斯回歸檢定進行多變項分析探討出睡眠品質與血糖控制有達統計上顯著關聯，「睡眠品質良好」之患者有2.1倍達成較佳的血糖控制 (勝算比= 2.1)。 五、針對身體活動與血糖控制部分：運用邏輯斯回歸檢定進行多變項分析探討出身體活動與血糖控制於統計上無顯著關聯。 根據本研究之結果，於未來衛教教育上，建議將睡眠品質納入糖尿病衛教教育知識中，也可個別針對「無工作」及「有慢性併發症」之患者，深入關心患者睡眠品質部分，並加強宣導睡眠品質教育，若必要可協助患者轉介相關睡眠中心，了解及解決患者之睡眠問題，進而改善睡眠品質之狀況，以減少睡眠品質偏差對血糖之影響。針對身體活動部分，建議可針對「65歲以上」之患者進行身體活動之衛教宣導，在未來糖尿病衛教上可提供更多身體活動之衛教影片或是由專業人員教導第二型糖尿病患者於居家生活中可執行身體活動方法，以提倡身體活動，進而改善血糖控制狀況。關鍵字：第二型糖尿病、身體活動、睡眠品質、血糖控制The objective of this study was to explore the association of physical activity and sleep quality with blood glucose control in patients with type 2 diabetes mellitus in Yilan County Teaching Hospital.A total of 201 questionnaires were issued in this study, and the effective sample size was 181, with a recovery rate of 90%. The research tools were the Chinese version of the Pittsburgh Sleep Quality Index and the short version of the International Physical Activity Questionnaire. The data were analyzed by chi-square and logistic regression using SPSS 23.0, and the results were as follows: 1.The average age of the study subjects was 63.47 years old, with the most than 65 years old, most of them had good sleep quality (56.9%) and sufficient physical activity (65.2%), of which good blood glucose control accounted for the majority (50.3%).2.In view of the significant association between personal background factors and sleep quality:"occupational status", "chronic complications", "diet control" and sleep quality, this study showed that patients with type 2 diabetes who had "work", "no chronic complications" and "dietary control" had better sleep quality. 3.In view of the significant association between personal background factors and physical activity: "age", "education level" and physical activity, the recommended amount of physical activity was more likely to be achieved in this study for type 2 diabetics who were "less than 65 years old" and "national high school". 4.For the sleep quality and blood glucose control part: detection using logistic regression that sleep quality and blood glucose control were statistically significantly correlated, and patients with "good sleep quality" achieved better blood glucose control by 2.1 times (odds ratio = 2.1). 5. For the physical activity and glycemic control section: detection using logistic regression that physical activity and glycemic control were not statistically significantly associated

According to the results of this study, it is recommended that sleep quality be included of diabetes health education in the future , and that diabetes patients with "no job" and "chronic complications" can be individually cared , and sleep quality education can be strengthened ,if necessary, can referred diabetes patients to relevant sleep centers to understand the patient's sleep problems, to reduce the impact of sleep quality deviation on blood sugar. For the physical activity part, it is recommended that the health education of physical activity be included of diabetes health education in the future ,and that diabetes patients of over 65 years old, suggest more physical activity health education ,example physical activity video or professionals can teach type 2 diabetics patients to perform physical activity methods at home , to increase the impact of physical activity deviation on blood sugar.Keywords: Type 2 diabetes, physical activity, sleep quality, blood sugar control