Wu Fei-Ling, Wu En-Chang, Chang Yue-Cune, Hu Wen-Yu, Juang Jyuhn-Huarng, Yeh Mei Chang
PhD, RN, Assistant Professor, Department of Nursing, Chang Gung University of Science and Technology.
PhD, Emeritus Professor, Department of Psychology, National Taiwan University.
J Nurs Res. 2018 Feb;26(1):44-51. doi: 10.1097/JNR.0000000000000198.
Hypoglycemia is recognized as a limiting factor in diabetes management. Fear of experiencing hypoglycemia may lead to lower quality of life, impaired glycemic control, and emotional distress, all of which impair the ability of patients to self-manage their diabetes effectively. Problem solving is central to diabetes self-management and may help patients achieve effective self-care of their disease.
The aim of this study was to investigate the ability of people with diabetes to avoid hypoglycemia and to explore associated factors.
A cross-sectional, descriptive design was used for the study. Data were collected using a demographic and disease characteristics datasheet, the Hypoglycemic Problem Solving Scale, and the Disease-Associated Negative Mood Scale.
Three hundred thirteen participants were recruited, with a mean age of 55.49 years. The average item score for the questions on hypoglycemic problem-solving ability was 2.43 (SD = 0.75). In comparing Hypoglycemic Problem Solving Scale subscales, participants scored highest on the problem orientation subscales and lowest on the problem-solving skills subscales. Multiple regression analysis revealed that being younger and unmarried and having a higher level of education, a diagnosis of Type 1 diabetes, and a lower negative mood score were each significantly associated with greater problem-solving ability as regards hypoglycemic events.
CONCLUSIONS/IMPLICATIONS FOR PRACTICE: We suggest that patients with diabetes, especially those who are older or with lower levels of education, receive disease-related psychological interventions and that healthcare professionals teach problem-solving abilities in conjunction with hypoglycemia management.
低血糖被认为是糖尿病管理中的一个限制因素。对低血糖发作的恐惧可能导致生活质量下降、血糖控制受损以及情绪困扰，所有这些都会削弱患者有效自我管理糖尿病的能力。解决问题是糖尿病自我管理的核心，可能有助于患者实现对疾病的有效自我护理。
本研究旨在调查糖尿病患者避免低血糖的能力，并探索相关因素。
本研究采用横断面描述性设计。使用人口统计学和疾病特征数据表、低血糖问题解决量表以及疾病相关负面情绪量表收集数据。
共招募了313名参与者，平均年龄为55.49岁。关于低血糖问题解决能力问题的平均项目得分为2.43（标准差=0.75）。在比较低血糖问题解决量表的子量表时，参与者在问题导向子量表上得分最高，在问题解决技能子量表上得分最低。多元回归分析显示，年龄较小、未婚、教育水平较高、1型糖尿病诊断以及较低的负面情绪得分，均与低血糖事件的更大问题解决能力显著相关。
结论/对实践的启示：我们建议糖尿病患者，尤其是年龄较大或教育水平较低的患者，接受与疾病相关的心理干预，并且医疗保健专业人员在进行低血糖管理的同时教授问题解决能力。
