인슐린 치료중인 제2형 당뇨병 환자의 심리적 인슐린저항성이 자가관리에 미치는 영향

Abstract

This study was performed to identify the level of insulin-related nowledge, psychological insulin resistance, and self-care activities and to evaluate the factors affecting self-care activities in patients with type 2 diabetes mellitus undergoing insulin therapy in order to provide basic data for the development of educational programs. Data were collected from August 29 to October 20, 2017 from the patients with type 2 diabetes mellitus visiting the Diabetes Mellitus Center at H—General Hospital in J—region. The subjects were 168 patients who had been being treated via self-injection for at least 3 months after the start of insulin therapy. Data were collected through the interviews using a structured questionnaire. Data analyses were conducted using stepwise multiple regression, Pearson's correlation coefficients, t-test, and ANOVA using the SAS WIN 9.2 program. The results of this study were as follows: 1) The mean score of insulin-related knowledge was 11.71±1.86 (Range 6∼15). Insulin-related knowledge was significantly different by hypoglycemia (t=1.98, p=.049). 2) The mean score of psychological insulin resistance was 61.25 (Range 29∼37). Psychological insulin resistance was significantly different by frequency of self monitoring blood glucose (t=8.01, p<.001), hypoglycemia (t=5.64,p<.001). 3) The mean score of self-care activities was 53.19 (Range 27∼85). Self-care activities were significantly different by gender (t=-2.94, p=.004), perceived health status (t=7.00, p<.001), and hypoglycemia (t=-2.47, p=.015). 4) Negative correlation was observed between psychological insulin resistance and self-care activities (r=-.33, p<.001). 5) Self-care activities were significantly predicted by psychological insulin resistance (11.1%), 'unhealthy' status, gender, 'moderate' health status, and hypoglycemia, and 19.3% of the variance in self-care activities was explained (F=9.01, p<.001). Psychological insulin resistance in patients undergoing insulin therapy and its effects on self-care activities identified in this study will be useful in starting and maintaining insulin therapy in the future.