제2형 당뇨병 환자의 당뇨병지식, 자기효능감, 자기관리행위

Abstract

This study was conducted in order to provide the fundamental knowledge for the development of the effective nursing interventions for diabetic education and continuous management of the disease, by examining the relationship among the diabetic knowledge, self-efficacy, and self-management behaviors. The research subjects were 150 patients after 6 months of being diagnosed as the type 2 diabetic patients at the Y university hospital located in S province from May 1st 2012 to August 31st 2012. For the measurement of diabetic knowledge, the Diabetes Knowledge Test was used. For the self-efficacy, the Diabetes management self-efficacy scale was used, and for self-management behaviors, the Summary of Diabetes Self-Care Activities Questionnaire(SDSCA) was used. The collected data were analyzed by frequency analysis, descriptive statistics, t-test, ANOVA, Pearson's correlation, and the multiple regression analysis using the SPSS WIN 18.0 Program. The results of the study are as follows. 1. The diabetic knowledge of the subjects who do not use the insulin was shown to be 9.28±0.18 and the diabetic knowledge of the subjects who use the insulin was 14.18±0.16. The self-efficacy was shown to be 47.76±1.59, and self-management behaviors was 27.73±5.28. 2. As for the general characteristics of the subjects, the self-efficacy was high in the group where they did not make the payment by themselves(t=-2.308, p=.022), and the self-management behaviors was high in the group(F=4.697, p=.011) where the monthly income was between 2 million won to 4 million won. 3. As for the disease specific characteristics of the subjects, the self-efficacy was high in such case when the diet cure and oral drug therapy were combined(F=2.729, p=.046) among the current therapy methods, and the case when the blood glucose meter was possessed(t=3.718, p=.000). The self-management behaviors was shown to be high in the case when the diet cure and oral drug therapy were combined(F=5.077, p=.022), and the case when the blood glucose meter was possessed(t=4.152, p=.000). 4. The relationship between the self-efficacy and self-management behaviors was also shown to be a positive relationship(r=.484, p<.001), and it was shown that as the self-efficacy increased, the self-management behaviors also increased as well. 5. The self-efficacy of the subjects were shown to be influential for self-management behaviors(β=.488, p<.001), and was shown to be statistically significant(F=26.493, p=.000). In these results, the self-efficacy had important influences on self-management behaviors. In order to enhance self-efficacy, therefore, it is necessary to develop a program makes the patients participate in the disease control and management and derives behavior change. By applying program practically, it is thought to be able to have a positive effect on self-management behaviors.;본 연구는 당뇨병지식, 자기효능감, 자기관리행위간의 관계를 파악함으로써, 당뇨병교육과 지속적인 질병관리를 위한 효과적인 간호중재 개발에 기초자료를 제공하고자 시도되었다. 본 연구의 자료수집기간은 2012년 5월 1일∼2012년 8월 31일 까지 S시에 소재한 3차 의료기관에서 제2형 당뇨병으로 진단을 받은 후 6개월 이상 된 만 20세 이상의 남녀 성인 환자 150명을 대상으로 하였다. 당뇨병지식 측정을 위해 Fitzgerald등이 1998년에 개발한 Diabetes knowledge test 설문지를 사용하였다. 자기효능감 측정을 위해 Diabetes management self-efficacy scale(Van der Bijl, van Poelgeest-Eeltink & Shortridge-Baggett, 1999)을 사용하였으며, 자기관리행위 측정을 위해 Toobert와 Glasgow(1994)가 개발하고 Toobert, Hampson과 Glasgow(2000)이 수정한 Summary of Diabetes Self-Care Activities Questionnaire(SDSCA)를 사용하였다. 자료는 SPSS WIN 18.0을 이용하여 빈도분석과 기술통계, t-test, ANOVA, Pearson's correlation, multiple regression analysis로 분석하였다. 본 연구의 결과는 다음과 같다. 1. 인슐린 비사용자의 당뇨병지식 평균평점은 9.28±0.18점이며, 인슐린 사용자의 당뇨병지식은 14.18±0.16점으로 나타났다. 자기효능감은 47.76±1.59점, 자기관리행위는 27.73±5.28점으로 나타났다. 2. 대상자의 일반적 특성에서는 본인이 치료비 부담(t=-2.308, p=.022)을 하지 않는 경우에 자기효능감이 높았으며, 월수입 200-400만원 미만인 집단(F=4.697, p=.011)에서 자기관리행위가 높은 것으로 나타났다. 3. 대상자의 질병관련 특성에서는 치료방법 중 식사요법과 경구약물요법을 함께 병행하는 경우(F=2.729, p=.046), 혈당측정기를 소유하고 있는 경우(t=3.718, p=.000)에 자기효능감이 높았다. 식사요법과 경구약물요법을 함께 병행하고 있으며(F=5.077, p=.022), 혈당측정기를 소유하고 있는 경우(t=4.152, p=.000)에 자기관리행위가 높게 나타났다. 4. 자기효능감과 자기관리행위는 양의 상관관계(r=.528, p=.000)를 보여 자기효능감이 높을수록 자기관리행위가 높은 것으로 나타났다. 5. 대상자의 자기효능감(β=.538, p<.001)이 자기관리행위에 영향을 미치는 것으로 나타났고 이는 30.1%의 설명력을 가지며 통계적으로 유의하게 나타났다(F=26.493, p=.000). 이상의 연구결과를 통해 자기효능감이 자기관리행위에 영향을 미친다는 것을 확인하였다. 따라서 행위변화를 유도하는 자기효능감을 증대시키기 위한 프로그램 개발 및 실무적용이 필요하며 이를 통하여 자기관리행위를 증진시킬 수 있을 것으로 생각된다.