| Summary: | 博士 === 中華大學 === 科技管理博士學位學程 === 100 === Lifestyle behavior change in type 2 diabetic patients may provide effective glycemic control and reduce the risk of related complications. To date, fewer than one-half of all diabetic patients receive appropriate care and enjoy a good quality of life. Therefore, in this study, from the patient perspectives, used the importance-performance gap analysis (IPGA) to investigate the key factors in and gap between perception and performance of daily blood glucose monitoring, regular exercise, and diet control in individuals with type 2 diabetes and applied the transtheoretical model to investigate the key factors that promote behavior change in diabetic subjects.
Results showed that Perseverance was the key factor affecting blood glucose monitoring and regular exercise in men more than in women. The critical factor in diet control was the desire to eat. Patients’ perceived severity and limited daily activities of diabetes correlated with regular exercise; patients’ compliance correlated with glucose monitoring and perceived health status with diet control. The social support, self-efficacy, and compliance demonstrated differences in stages of behavior change in type 2 diabetic patients. Routine management of diabetes was a key factor in behavior change, which correlated indirectly with HbA1C values through compliance and was positively affected by social support. Compliance and undermining from family or friends were directly associated with HbA1C.
This study may provide more specific management guideline by applying IPGA approach for patient's self-management to clinical practice. The differences in psychological factors at stages of change may provide the references to maintain lasting behavior changes. Establishing a social support system, developing a tailored self-management plan, putting into use a "meaning-centered" rather than a "message-centered" philosophy of communication, and applying the current technology to assist or reminder patients health behavior, which all to improve the patients’ perceived confidence in routine management may be the best way to achieve sustainable behavior change and promote better blood glucose control.
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