成人糖尿病患者の食事管理に影響する要因と自己効力感

The Factors Giving Influence on Dietary Self-Management of Adult Patients with Diabetes Mellitus and Perceived Self-Efficacy of the Patients

　本研究は，20～70歳の糖尿病患者を対象に，食事管理に影響する要因を明らかにし，さらに自己効力感の影響力について調べることを目的としている．分析対象は141例，回収率は69.1％で，男性が60％，平均年齢55.5歳であった．調査方法は自記式の質問紙調査で，分析の枠組みは，（1）属性に関する要因，（2）前提要因，（3）実現要因，（4）強化要因を設定した．分析は，重回帰分析およびパス解析を行った．その結果，食事自己管理行動のよさに直接的に最も影響を与えているのは，自己効力感が強いことで，次いで就労していないこと，糖尿病について自己学習したこと，食事療法の成功達成感であった．自己効力感を媒介に間接的に影響しているのは成功達成感であった．自己効力感は，自己管理を行うために重要であることが明らかになった．

　The purpose of the present study was to evaluate the factors which exert influence on dietary self-management behavior of the patients with diabetes mellitus of 20-70 years old and to assess perceived self-efficacy of the patients. The study was performed on 141 patients, and the answer collecting ratio was 69.1％. Among them, male subjects accounted for 60％, and average age was 55.5 years old. The study was carried out by disseminating self-entering questionnaire. The frame of the analysis included: (1) demographic factors, (2) predisposing factors, (3) enabling factors, and (4) reinforcing factors. For the analysis, multiple regression analysis and path analysis were used. As a result, it was found that the factors directly exerting the strongest influence on the dietary self-management of the patients were perceived self-efficacy of the patients. Next followed: non-engagement of the patient in specific work, self-learning about diabetes mellitus, and the patients enactive attainment in dietary therapy. The factor giving indirect influence via self-efficacy was the patients' enactive attainment. These results suggest that perceived self-efficacy of the patients have an important role in their behavior of self-management.