摘 要
本研究之目的在探討糖尿病患者心理社會適應、因應方式與衛教需求之間的相關。以自擬之結構式與非結構式問卷，對台北市某醫學中心新陳代謝科門診的第二型糖尿病患者訪談，共得有效問卷215份，重要結果如下：
一、糖尿病患者心理社會適應以健康照顧適應最好，性的適應最差。
二、糖尿病患者使用正向因應方式比負向之因應方式多，最常使用樂觀因應，最少使用情緒化因應方式。
三、使用正向因應方式，心理社會各層面的適應皆較好，也較能肯定研究中之衛教需求，是有益的因應方式。
四、糖尿病患者自覺衛教需求達中度需求，最不需要的衛教項目是「工作壓力調適」，最想了解個人現存糖尿病之慢性合併症情況及嚴重合併症之預防。
五、糖尿病患者自覺衛教需求因年齡、教育程度、職業、罹病期間而有不同；衛教需求之顯著預測變項有社經地位、性適應、正向因應與負向因應方式，總共解釋了21.5%的變異量。
六、「社經地位」及「心理社會適應」對衛教需求有間接的正向關係；「因應方式」對衛教需求的影響是直接正向關係，而「罹病期間」對衛教需求的影響是直接負向關係。
依研究結果建議未來評估患者衛教需求之同時，應評估患者之
因應方式，作為衛生教育及行為改變計畫之參考；罹病期短、低社
經地位者之衛生教育應予重視，糖尿病患者性適應問題應予關注。
關鍵詞：糖尿病、心理社會、因應、衛生教育需求

A Study of Diabetic Patients’ Psychosocial adjustment, Coping styles and the Needs for Diabetes Education at a Medical Center
A Master Thesis
By
Yan-Shin Hor
ABSTRACT
The purpose of this study is to investigate diabetic patients’ psychosocial adjustment to illness, their coping styles, and their needs for diabetic education. Data were collected in the metabolic outpatient department at a medical center in Taipei through the use of both structured and unstructured questionnaires. A total of 215 valid questionnaires were completed in this study.
The main findings of the study are as follows:
1. The results show that the subjects display the best psychosocial adjustment in the area of health care aspect, and the poorest in sexual relationships.
2. The subjects use more positive coping styles than negative ones. The most frequently used coping style is optimistic one while the least frequently used is emotional one.
3. The results reveal that the subjects benefit notably from the use of positive coping styles. The more the subjects use positive coping styles, the better they develop their psychosocial adjustment to illness, and the more they value the diabetic education needs in this study.
4. The subjects evaluate their needs for diabetes education is scored as moderate, expressing the most needs in “chronic complication and prevention”, and the least in “vocational stress adjustment.”
5. The needs for diabetes education as evaluated by the patients vary significantly with age, educational levels, vocations, and duration of diabetes. Significant predictors to the needs for diabetes education include socioeconomic status, sexual relationship adjustment, as well as positive and negative coping styles, accounting for 21.5% of total variance.
6. Subjects with higher socioeconomic status, better psychosocial adjustment, more use of positive coping styles, and shorter duration of being a diabetic to have more diabetes education needs.
According to the findings, the researcher would like to suggest synchronize the evaluation of education needs with those of coping styles so as to generate more references for educational programs and behavior changing plans. Meanwhile, special care must be given to provide health education for those with shorter duration of diabetes and lower socioeconomic status. In addition, more concerns should be given to the diabetic with poor sexual relationships.
Key word：Diabetes、Psychosocial、Coping、Education needs

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