| Summary: | 碩士 === 國立臺灣大學 === 護理學研究所 === 91 === Abstract
With the prosperity of economy, improvement of living standards, enrichment of life style, diabetes has become one of the major chronic diseases in 21st century Taiwan. Diabetic patients may suffer the threat of multiple complications. The purpose of this study is to explore the psychosocial adjustment of middle age diabetic patients, so the result can be used as reference for tending the related diabetic patients in future. The survey was conducted between March and April 2003, 280 patients were selected by purposive sampling from Endocrinology / Metabolic outpatient department of a medical center in northern Taiwan. The instruments used in the survey are structured questionnaires. 3 types of structured questionnaires were used in this survey: psychosocial adjustment to illness scale (PAIS), social support scale, demographic data and characteristic of illness. The data was analyzed by mean, standard deviation, percentage, one-way ANOVA, post Scheff’s examination, Pearson product-moment correlation, multiple regression, and logistic regression. The result can be summarized as followed:
1.Among the survey subjects whose degree of psychosocial adjustment between mild disturbance to none , ‘extended family relationship’ was the best item in psychosocial adjustment aspects . This is followed by item ‘adjustment to domestic environment ’, ‘sex life adjustment ’ was the worst item in psychosocial adjustment aspects.
2.Among the survey subjects whose social support was at moderate-inferior degree, the informational support was the best , but tangible support was the worst. The family and relatives were the major providers in social network.
3.Among survey subjects'' demographic data related to characteristics of illness and social support , survey subject whose educational level is at least college graduate, married , monthly financial income at least NT$60000 has better social support than others. In addition, survey subject who had diabetes between 5-15 years has better social support than those who had diabetes more than 15 years. Furthermore, survey subject who has no diabetic complication has better social support than those who has one diabetic complication.
4.Among survey subjects'' psychosocial adjustment related to social support, social support and whole psychosocial adjustment ( health care, domestic environment, sexual relation, extended family, social environment, psychological distress) were positively correlated. In another word, subjects with more social support had better whole psychosocial adjustment.
5.Multiple Regression analysis showed that the following factors account for 30% variance of whole psychosocial adjustments: living with spouse, years of contracting diabetes, diabetic complications, social support. Among survey subject who is currently living with spouse, having fewer years of contracting diabetes, having no diabetic complication and having high social support tend to have better whole psychosocial adjustment. Social support and diabetic complications are two of the most influential factors to the subscales of psychosocial adjustment. Social support factor tends to be a predictor to all psychosocial adjustment subscales, higher the social support, better the adjustment. Diabetic complication factor also is predictor to most of the psychosocial adjustment subscales except healthcare adjustment and adjustment to domestic environment.
This research brings forth some suggestions for the reference in the respects of study design, nursing practice, nursing education, nursing administration and nursing research.
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