• 한국사회복지학
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• 제60권4호
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• pp.231-251
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• 2008

본 연구는 성인당뇨병 환자들을 대상으로 의료급여수급여부에 따라 건강수준 및 질병관리 장애요인에 차이가 나타나는지를 분석하고 질병관리 장애요인이 건강수준에 미치는 영향을 살펴보았다. 자료수집은 서울의 종합병원 당뇨병클리닉 및 지역사회 복지기관에서 편의표집한 55세이상 성인당뇨병 환자 144명을 대상으로 조사를 실시하였다. 분석결과, 의료급여환자가 건강보험환자에 비하여 건강수준이 더 나쁘다고 인식하고 있었으며, 질병관리 장애요인을 더 많이 경험하고 있는 것으로 나타났다. 건강보험환자와 의료급여환자간 건강수준의 차이는 인구학적 요인 및 질병관련 특성들을 통제한 이후에도 유의하였다.

• 보건교육건강증진학회지
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• 제30권5호
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• pp.79-90
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• 2013

Objectives: This study is based on Public Care Service for Chronic Diseases in Incheon Metropolitan City featuring Health-Point Service. It is objective to evaluate whether the service could improve self-management ability of hypertension and diabetes patients. Methods: The knowledge about diabetes and hypertension, which can be improved by educational intervention, is considered as one of the most important factor for self-management ability. While the education service have been conducted, 194 patients who have been diagnosed as hypertension and diabetes within 3 months were included. They completed questionnaires two times within 4 months period, which give information about the knowledge, service registration and education experiences. For further inspection, 396 patients who had been diagnosed formerly were studied by cross-sectional analysis. Results: Regardless of service registration or educational intervention, there wasn't statistically meaningful difference between the initial and the follow-up assessments on the knowledge. However, when investigating formerly diagnosed patients, educated patients had better knowledge on hypertension compared with non-educated patients and registered patients, educated patients had the better knowledge on diabetes compared with non-registered patients, non-educated patients. Additionally, analyzing each questions, educated patients got higher grades in questions about definition of hypertension, diabetes managements which they can practice in daily lives. Conclusions: It is probable that long-term service registration and education experiences could improve the knowledge and self-management ability.

• 성인간호학회지
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• 제19권2호
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• pp.283-294
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• 2007

Purpose: The purpose of this study was to identify predictors of cardiovascular risk factors of type 2 diabetic patients. Methods: Diabetic patients (N=160) were interviewed from November, 2003 to June, 2004. The 24 hour dietary recall, the International Physical Activity Questionnaire, the Diabetes Management Self-Efficacy Scale for patient with Type 2 diabetes, the Revised Summary of Diabetes Self-Care Activities Measure Scale and Parma Cardiovascular Risk Index were used to measure the predictors. Data were analyzed by descriptive analyses, Pearson correlation coefficients, and stepwise multiple regression using the SPSS WIN 10.0. Results: Mean dietary intakes of the participants were protein(P) of 64.5g, carbohydrate(C) of 280.74g, fat(F) of 30g, and calcium of 511.45mg. The ratio of CPF was 75:17:8. About 45% of the participants didn't exercise on a regular basis. The levels of self-efficacy, self-care, and cardiovascular risk factors of the participants were moderate. Self-efficacy was the most important predictor of cardiovascular risk factors along with self-care, exercising for more than 6 months, carbohydrate intakes and levels of physical activities. Conclusion: The findings of the study suggest that intervention programs increasing self-efficacy on diabetic management would be more beneficial than the fractional approach focusing only on diet or physical activities.

• 한국컴퓨터정보학회논문지
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• 제26권4호
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• pp.169-179
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• 2021

본 연구의 목적은 당뇨병 문제를 관리하는데 있어서 개인이 어떻게 행동과정에 대해 결정을 내리는지를 설명하는 자기조절의 인식유형과 특성을 탐색하고, 이를 근거로 당뇨병 환자의 관리방법을 제시하고자 시도되었다. 총 40개의 Q-표본과 38명의 P-표본이 본 연구에 사용되었으며 응답자의 반응은 Q방법론에 기초한 요인분석을 통해 5개의 유형이 도출되었다. 각 유형의 특성은 근거기반 순응형(evidence-based compliance), 위기대응 거부반응(crisis responding denial reaction), 정보기반 관계지향형(information-based orientation to relationship), 독립적 실천형(independent practice), 의지결핍 충동반응형(willingness deficit impulse reaction)으로 명명되었다. 5개 유형으로 분류된 응답자의 특성을 자기조절 속성에 따라 포지셔닝 시킴으로써 당뇨병 관리의 전략적 함의를 도출하였다.

• 한국농촌간호학회지
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• 제19권1호
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• pp.35-43
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• 2024

Purpose: This study aimed to explore the influence of knowledge, problem-solving processes, and self-efficacy on the clinical competency of nursing students in the home health nursing management of diabetes mellitus (DM). Methods: The subjects of this study were 136 nursing students. Data were collected from April 18 to April 29, 2022, and analyzed using the SPSS 23.0 program. Results: The total mean scores of nursing students' knowledge, problem-solving process, self-efficacy, and clinical competency in DM home health nursing management were 71.24, 3.92, 7.47, and 4.09, respectively. Clinical competency was significantly and positively correlated with the problem-solving process (r=.60, p<.001) and self-efficacy (r=.48, p<.001) but not with knowledge (r=.09, p=.311). The problem-solving process was also positively correlated with self-efficacy (r=.41, p<.001). Regression analysis revealed a 41.4% variance in the nursing student's clinical competency with problem-solving process (β=.47, p<.001) and self-efficacy (β=.28, p<.001). Conclusion: The results of this study provide valuable evidence for the development of educational interventions aimed at enhancing the clinical competency of nursing students in relation to home-visit healthcare services for DM management.

• Journal of Yeungnam Medical Science
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• 제40권2호
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• pp.218-222
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• 2023

A holistic approach to diabetes considers patient preferences, emotional health, living conditions, and other contextual factors, in addition to medication selection. Human and social factors influence treatment adherence and clinical outcomes. Social issues, cost of care, out-of-pocket expenses, pill burden (number and frequency), and injectable drugs such as insulin, can affect adherence. Clinicians can ask about these contextual factors when discussing treatment options with patients. Patients' emotional health can also affect diabetes self-care. Social stressors such as family issues may impair self-care behaviors. Diabetes can also lead to emotional stress. Diabetes distress correlates with worse glycemic control and lower overall well-being. Patient-centered communication can build the foundation of a trusting relationship with the clinician. Respect for patient preferences and fears can build trust. Relevant communication skills include asking open-ended questions, expressing empathy, active listening, and exploring the patient's perspective. Glycemic goals must be personalized based on frailty, the risk of hypoglycemia, and healthy life expectancy. Lifestyle counseling requires a nonjudgmental approach and tactfulness. The art of diabetes care rests on clinicians perceiving a patient's emotional state. Tailoring the level of advice and diabetes targets based on a patient's personal and contextual factors requires mindfulness by clinicians.

• 대한간호학회지
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• 제39권5호
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• pp.720-730
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• 2009

Purpose: The purpose of this study was to test the effects of tailored diabetic education on blood glucose control and self-care for patients with type 2 diabetes on insulin therapy. Methods: The participants were 60 patients (experimental group: 30, control group: 30) with type 2 diabetes on insulin therapy. The patients were being seen at a university hospital in Seoul, Korea. Group diabetic education and tailored diabetic education were given to the experiment group while group diabetic education only was given to the control group. Data were collected before and three months after the education. $X^2$ test, t-test, and ANCOVA were used to analyze the data. Results: No significant differences in postprandial (PP2hrs) glucose and HbA1c levels were found between the two groups. Participants in the experiment group showed statistically significant differences in the area of self-glucose test, management of insulin injection, and life style change compared to those in the control group. Conclusion: The results indicate that tailored education for patients with diabetes on insulin therapy improve self-glucose test, management of insulin injection, and life style. Therefore it is suggested that tailored education can be applied in diabetic education to improve self-care.

• 지역사회간호학회지
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• 제8권2호
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• pp.304-313
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• 1997

This study was designed to identify the degree of perceived self-efficacy and self-esteem in non - insulin dependent diabetes mellitus. The 278 Diabetic patients participating in this study were selected from a diabetic clinic. The period of data collection was September 2 to September 10, 1996. Collected data were analyzed by means of Frequency, Mean, SD, t - test, Pearson correlation, ANOVA using SPSS/PC+. The result are summarized as follows: 1. The mean score of perceived self-efficacy were 3.52 in total, 3.91 for medication, 3.40 for exercise, 3.60 for diet control, 3.18 for glucose test, 3.53 for general management. And the mean score of self-esteem were 3.51 2. Perceived self-efficacy and self-esteem had statistically significant positive correlations (r=.3125, p=.001). 3. The results of testing for the degree of perceived self -efficacy, according to the subject's demographic variables, showed that there were significant differences in sex (t=4.14, p<0.001), the level of education(t=6.24, p<0.01) and diabetic education(t=3.25, p<0.05). These results suggest that perceived self-efficacy and self-esteem is an important variable in the compliance of diabetic patients.

• 지역사회간호학회지
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• 제14권4호
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• pp.559-567
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• 2003

Background: We first launched the case management program for diabetic patients who were registered in NHIC (National Health Insurance Corporation) in Korea and conducted this study to assess the effectiveness of the program. Methods: During the period from October in 2002 to March in 2003, 30 case managers performed the program for 71 diabetic patients. We evaluated the effectiveness of the program based on the results of fasting blood sugar level, two hour post-prandial blood sugar level, knowledge for diabetes, difficulty index in diabetes management, and the health risk factor changes of them. We analyzed results related to these factors through $x^2$ test and paired t-test. Results: The ave rage age of the subjects was 58.9. and the numbers of women and men were 43 and 28 respectively. The fasting blood sugar level and two hour post-prandial blood sugar level decreased from 164.3mg/dl to 146.5mg/dl and from 224.0mg/dl to 203.0mg/dl respectively. The knowledge for diabetes and difficulty index in diabetes management changed from 8.13 to 9.10 and from 3.52 to 2.91 respectively, and these changes were the positive. We observed improvement in self-test of sugar level, foot management, oral hygiene and proper medication but not in self-test of nutritional management. Conclusions: This study revealed that the case management program for diabetic patients who were registered in NHIC is significantly effective. However, the program need to study further to understand its long-term effects.

• 농촌의학ㆍ지역보건
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• 제42권4호
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• pp.234-243
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• 2017

본 연구는 2014년 5월부터 2015년 5월까지 세종특별자치시 고혈압 당뇨병 등록교육센터에서 교육 받은 당뇨병 환자 39명을 대상으로 교육 프로그램의 효과를 평가하고자 실시되었다. 프로그램은 제2형 당뇨병에 대한 질환, 영양, 운동 등에 관한 내용으로 2일 동안 2회의 세션(세션 당 45 분)으로 구성되었다. 교육 전에 당뇨병에 관한 지식, 자기효능감, 자기관리행위 등을 평가하였고, 교육 직후에 지식과 자기효능감 평가, 교육 후 12주째에 자기관리행위를 평가하여 다음과 같은 결과를 얻었다. 당뇨병 지식 점수(10점 만점)는 프로그램 전후 평균 5.72점에서 8.21점으로 유의하게 증가하였고(p<0.001), 자기효능감 점수(10점 만점)는 프로그램 전후 6.88점에서 8.16점으로 유의하게 증가하였다(p<0.001). 자기관리행위 점수는 프로그램 전 5점 만점 중 3.59점이었던 것이 프로그램 종료 12주째에 4.35점으로 유의하게 증가하였다(p<0.001). 본 프로그램은 당뇨병 지식, 자기효능감, 자기관리행위 등의 향상을 통해 등록환자의 효과적인 당뇨병 관리에 기여할 수 있을 것으로 사료된다.