成人糖尿病患者之健康知能與其健康狀態之相關性研究
A Study on the Association between the Health Literacy and Health Status among Adult Diabetic patients
中文摘要 背景及目的：
在醫療照護市場同時具有很多有別於其他產業的特性，其中資訊不對等的特性即 常為人們所討論。因為醫療之高度專業性，而醫療照護市場的資訊並未完全公開 流通，故病人常受限於資訊獲得之有限，故無論是有醫師之建議或在家自我照護 的情形下，往往無法在擁有充分資訊的情況下作出其最適當之選擇決策。因此，
健康資訊及健康知能的提昇即成為民眾健康狀況提昇的一個選項，本研究之最主 要研究目的即為想要了解健康知能與整體健康狀態之關係。
研究方法：
在眾多之疾病種類之中，糖尿病患之自我照護之好壞對於其自身的病情發展是非 常重要的因素，是故，本研究以自行研發之特定疾病中文化健康知能評估問卷及 SF12 健康狀態快速測量問卷為研究工具，分別選擇來自北中南東立意選取七家 醫院之門診糖尿病患者為研究對象，並以問卷填答之結果為基礎進行民眾訪談，
希望能探討在不同的個人能力及社會條件之屬性下，其健康知能與其健康情況之 影響模式關係、並據之以了解相關單位應如何提昇民眾健康知能之程度及檢討醫 療機構是否要加強病患對相關衛教醫療資訊之浸潤程度以提出個人之建議。本研 究共回收 690 份問卷，經篩選後之有效問卷 519 份，問卷有效率為 75%。本研究 透過敍述性統計將樣本組成特性做整理，並透過統計上之雙變項分析、因素分 析、複迴歸分析、SEM 分析及路徑分析來對本研究之研究假設做驗證。
研究結論：
(1).對於罹患糖尿病的民眾而言，健康知能之高低會直接影響到其整體心理之健 康狀態，但若透過醫囑遵從性之中介變項，則對整體生理健康會呈現顯著差異。
(2).不同地區民眾習慣接收的健康資訊來源不同，都會區之民眾健康資訊之來源 較為多元，故醫療院所應廣為設置如網路多媒體等方式之健康資訊宣傳管道來健 康資訊之宣導，而非都會區之民眾則較偏重於醫療人員對於民眾之直接衛教宣 導。
(3).健康知能之相關構面中，民眾之計算能力為較弱的一環。
(4).根據本研究之適配模式可以了解，本研究所定義的健康知能構面對於整體健 康狀態都會產生直接的影響力，疾病常識及日常照護能力會產生正向的關係，但 由於醫囑遵從性會是影響健康最大的顯著因素，故想要透過提昇健康知能來提昇 醫囑遵從性，則透過日常自我照護能力及數值計算能力來達到正向的影響力，因 此，無論是直接影響力或間接影響力，日常照護能力之都可以產生影響力，故本 研究認為要提昇民眾之健康狀態，若要透過提昇健康知能的方式，其中，首要必
須提昇的能力，即為民眾之日常自我照護能力。
英文摘要
Title of Thesis: A Study on the Association between the Health Literacy and Health Status among Adult Diabetic patients
Author: Lo Chia-Lun
Thesis advised by: Chiu Chiung-Hsuan, PhD Objectives：
Medical care industry with information asymmetry characteristics make patients constrained by health information, and ultimately not able to make appropriate decisions for their best interests. Enhancement of health knowledge and health
literacy is the possible solution to better health status. This study mainly discusses the relationship between health literacy and health status, especially for the adult diabetic patients.
Methods：
Diabet is one of the most demanding self care diseases. This study develops a Chinese version Disease-Specific instrument and utilizes Chinese version SF12 health
outcome. The sample was selected from patients visiting diabetic specialty outpatient department at seven hospitals. This study collected 690 questionnaires, and 519 valid questionnaires. Response rate is 75%. Data analysis utilizes confirmatory and
exploratory factor analysis, hierarchical regression, path analysis to test the model validity.
Results：
(1).The healthy literacy associates mental health outcome. If we set compliance variable as moderator, health literacy impacts significantly to physiology health.
(2). The different region people are used to the different healthy information source.
The source of health information at the metropolitan area is quite diverse. Medical institution should explore the variety of health education and channels.
(3).In the constructs of health literacy, calculating is the weakest ability among all.
(4).According to the LISREL test, the healthy literacy factor defined by this research will generate direct influence for whole healthy statuses. Compliance behavior is the most notable factor to health status. The compliance behavior could enhance the capability of self-care and calculating ability. Compliance behavior moderated the relationship between self-care ability and health outcome. Therefore, enhancement of health literacy, especially the self care capability, could positively associate health outcome among diabetic population.
