通院中の糖尿病患者の自己管理へのやる気に家族による支援，動機づけ要因，自己管理行動への主観的な総体的評価が与える影響

The Effects of Family Support, Motivation Factors and Patient's Subjective General Evaluations in Self-Management Behavior on Motivation to Self-Manage in Outpatients with Diabetes

要旨

目的：家族から支援のある通院中の糖尿病患者の自己管理へのやる気に，家族による支援，動機づけ要因（満足，自己効力感），糖尿病自己管理行動への患者による主観的な総体的評価が与える影響を検討した．

方法：通院中の糖尿病患者208名に無記名自己式質問紙調査を行った．

結果：家族から支援のある患者数は，55名（26.4％）であった．患者の平均年齢は59.8歳，HbA1c値の中央値は6.4％（JDS）であった．パス解析の結果，家族からの支援に対する満足から，自己管理へのやる気へのパスは有意（p＜.05）であった．糖尿病自己効力感との間に有意（p＜.01）なパスを示した糖尿病自己管理行動に対する主観的な総体的評価から，自己管理へのやる気へのパスは有意（p＜.05）であった．

結論：通院中の糖尿病患者の自己管理へのやる気に，家族からの支援に対する満足と糖尿病自己効力感と関係のある糖尿病自己管理行動に対する主観的な総体的評価が肯定的な影響を与えることが示された．

Aim: This study aimed to investigate the effects of family support, motivation factors (satisfaction, self-efficacy) and patient's subjective general evaluations in diabetes self-management behavior on motivation to manage diabetes on one's own in outpatients with diabetes who have received support from their family.

Methods: A self-administered questionnaire was distributed to two hundred and eight outpatients with diabetes.

Results: Fifty-five outpatients with diabetes (26.4%) have received support from their family. Their average age was 59.8 years old, the median HbA1c% (JDS) was 6.4. Results of path analysis showed a significant path coefficient for links between family support and patient's satisfaction with family support and diabetes self-efficacy (p<.05). The path coefficients for the links from patient's satisfaction with family support to motivations for self-management were significant (p<.01). The path coefficients for motivations for self-management were signiflcant (p<.05) from subjective general evaluations of patients where self-management behaviors showed signiflcant path coefficients while feeling a sense of self-efficacy with diabetes.

Conclusion: The results of this investigation indicated that patient's satisfaction with family support and patients' own subjective general evaluation in diabetes self-management behavior associated with diabetes self-efficacy positively influenced motivation in diabetes self-management in diabetic outpatients.