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https://ah.lib.nccu.edu.tw/handle/140.119/59431| 題名: | 預測第二型糖尿病患者之胰島素注射意圖：應用計畫行為理論並探討情緒之影響 The prediction of insulin injection intention among patients with type 2 diabetes: an application of TPB and exploring the impact of emotions |
作者: | 張榮哲 Chang, Jung Che |
貢獻者: | 許文耀 張榮哲 Chang, Jung Che |
關鍵詞: | 第二型糖尿病 心因性胰島素抗拒 計畫行為理論 同時情緒 預期情緒 Type 2 diabetes mellitus Psychological insulin resistance Theory of planned behavior Anticipatory emotion Anticipated emotion |
日期: | 2012 | 上傳時間: | 2-Sep-2013 | 摘要: | 胰島素自我注射是第二型糖尿病的重要治療方法。然而，許多病患的心因性胰島素抗拒（PIR）使他們拒絕胰島素治療，因而導致血糖控制不良。本研究目的即嘗試找出影響第二型糖尿病患者接受胰島素治療與否之可能因素。我們採用計畫行為理論（TPB）為基本架構，此理論主張「態度」、「主觀規範」、「覺知行為控制」三個變項可決定對某行為之意圖，而意圖可預測此行為之發生。此外，我們將情緒變項整合進TPB架構中以提昇預測力，包括「同時情緒」（對行為本身當下之心理或生理反應）與「預期情緒」（預期未來行為之後果成真時的情緒反應）。我們採自陳式問卷，橫斷研究設計，總計457位目前未使用胰島素之第二型糖尿病患者參與研究。階層迴歸分析結果，三個TPB變項（態度、主觀規範、覺知行為控制）均顯著預測胰島素治療之意圖，可解釋39.1%變異量；加入情緒變項後，整體模式解釋力提昇，可解釋43.2%意圖之變異量，「負向同時情緒」及「負向預期情緒」均為顯著預測因子。比較血糖控制較佳（HbA1C < 9%）與血糖控制較差（HbA1C ≧ 9%）兩組受試者，「負向同時情緒」是研究模型中唯一有顯著差異之變項。本研究結果顯示TPB可成功應用於解釋PIR，而情緒變項之影響亦不容小覷。 Insulin injection is an important treatment in the care of type 2 diabetes mellitus. However, psychological insulin resistance (PIR) has long been an obstacle for many patients to achieve optimal glycemic control. The purpose of this research is to identify the influencing factors in decision-making process of type 2 diabetic patients whether or not to undergo insulin therapy. We adopted the theory of planned behavior (TPB) as our theoretical basis, which argues attitude, subjective norm and perceived behavior control (PBC) are determinants of behavioral intention, and intention is the precursor of behavior. Besides, we integrated extra emotion variables into TPB, which were anticipatory emotion (immediate psychological and physical responses toward the behavior itself) and anticipated emotion (affective responses expected to be experienced in the future when behavioral outcomes occur), to expanded the predictive power of research model. A cross-sectional questionnaire study design was employed, and a total of 457 currently not using insulin type 2 diabetic patients participated in this research. The hierarchical regression analysis revealed that all three TPB variables (attitude, subjective norm, PBC) significantly predict intention to use insulin, which account for 39.1% variance of intention. After the addition of emotional variables, the research model explains intention variance up to 43.2%, with negative anticipatory emotion and negative anticipated emotion being significant determinants. In the comparison of better glycemic-control (HbA1C < 9%) and worse glycemic-control (HbA1C ≧ 9%) participants, negative anticipatory emotion is the only variable in our research model significantly differs between both groups. The results of this research indicate not only TPB is a useful framework in realizing PIR, but also the impact of anticipatory and anticipated emotions cannot be overlooked. |
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