| Summary: | 碩士 === 國立成功大學 === 高階管理碩士在職專班 === 96 === Diabetes mellitus has become one of the major chronic diseases in Taiwan. Long-term control of diabetes mellitus largely depends on a comprehensive education program and a regular screening of diabetes related complications in order to achieve optimal metabolic control goals. This research is directed primarily to those outpatients with diabetes from the Division of Endocrinology and Metabolism at Yong-Kang Veteran Hospital who have joined the “diabetes shared care model” case management. We want to study the differences and relationship among the patients�Sbaseline characteristics, first visit metabolic indicators, annual metabolic indicators, the improvement of annual metabolic indicators, and diabetes cognitive behaviors.
We hope to offer research suggestions in accordance with our study analysis result, to afford community primary hospital the disease management model and to share our experience, to increase the application result of combining the disease management style of the community's medical system. We hope to achieve the goals of promoting higher care quality for diabetic patients, reducing the medical utilization rates, increasing patients’ cognition and behavior control, and using for the Yong-Kang Veteran Hospital and other relevant units' reference.
A structured questionnaire about diabetes cognitive behaviors had been used to collect the data. SPSS 12.0 Chinese edition software was used to analyze both the descriptive and inferential statistic data. The study methods we used included reliability analysis, descriptive statistic analysis, Chi-square test, paired t test, independent sample t test, Mann-Whitney U test, analysis of variance (ANOVA), Pearson correlation analysis, and multiple regression analysis, etc.
The study result showed :
1.Part of the patients�S baseline characteristics have significant differences among the 2004 first visit metabolic indicators, 2005 annual metabolic indicators, the improvement of 2005 annual metabolic indicators, and diabetes cognitive behaviors.
2.Part of the 2004 first visit metabolic indicators have significant effects on diabetes cognitive behaviors.
3.Part of the improvement of 2005 annual metabolic indicators have significant effects on diabetes cognitive behaviors.
4.Part of the diabetes cognitive behaviors have significant effects on the improvement of 2007 annual metabolic indicators.
5.Our outpatient diabetes have low emergency and hospitalization utilization rates and they show significant improvement in their diastolic blood pressure, body weight, fasting plasma glucose, A1C level after one year’s comprehensive case management, especially in those patients who have the higher initial A1C level(≧9%), and they still have significant improvement in their mean systolic blood pressure, diastolic blood pressure, body weight, total cholesterol, high-density lipoproteins cholesterol and low-density lipoproteins cholesterol level after three years’ comprehensive case management.
So we can prove that the “diabetes shared care model” case management system is a system that is worth popularizing, and it should be offered to patients as close to the time of diagnosis as possible, and it should be directed towards diabetic patients with a low level of education and high initial A1C, high initial systolic blood pressure, high initial total cholesterol, high initial TG, high initial GPT levels , to strengthen and improve diabetic knowledge and self-care attitudes, in order to promote diabetic behavior control, and encourage the family to join the education together and family support, which can be helpful to the diabetic patient's condition obviously.
We will continue to promote diabetic education work, and go on by way of different defending teaching methods at the same time, enable to maintain and improve the life quality and to reduce the severity of the prognosis of diabetic patients.
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