2型糖尿病患者の臨床背景別の食事自己管理行動の実施状況における特徴 [in Japanese] Dietary Self-management Behavior and Actual Energy Intake Analyzed from Individual Type 2 Diabetic Patient Clinical Indices [in Japanese]
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【目的】2型糖尿病患者の臨床背景に応じた具体的な療養行動支援を行うために，男女別に臨床背景（年齢，HbA<sub>1</sub>c, BMI, 腹囲）の違いによる，食事自己管理行動の実施状況と食事摂取量，およびその関連を明らかにすることを目的とした．【方法】男性99名，女性77名を対象に，食事自己管理行動（著者らの開発した調査票）と，食事摂取量（半定量食物頻度調査）を調査した．対象者は年齢60歳，HbA<sub>1</sub>c 7.0%, BMI 25, 腹囲（男性85 cm, 女性90 cm）を境界値として2群に分けた．解析にはt検定およびピアソンの相関係数を用いた．【結果】男性では，60歳未満群が，「食の満足感を高める」，「調味量のカロリーを減らす」工夫の実施率が低く，またBMI 25以上群と腹囲85 cm以上群が，「摂取量を決めて食べる」「食の満足感を高める」「バランスよく美味しく食べる」工夫の実施率が低く，摂取量の増加に関連していた．女性ではHbA<sub>1</sub>c 7.0%未満群が，「塩分制限の工夫」の実施率が高く，食事摂取量の減少に強い相関が見られた．また，60歳未満群，BMI 25以上群，腹囲90 cm以上群が，「他の価値観を優先して食べる」という一時的逸脱行動の実施率が高く，摂取量の増加に関連していた．【考察】今回明らかになった臨床背景別の特徴は，2型糖尿病患者への自己管理行動支援に活用できる．
We studied the relationship between dietary self-management behavior and actual energy intake by Type 2 diabetic individuals based on clinical backgrounds and profiles of gender, age, HbA<sub>1</sub>c, body mass index (BMI), and waist size. Subjects were 99 men and 77 women. Using data from the dietary self-management behavior questionnaire (DSBQ) and semiquantitative food frequency questionnaire, which lists 122 dishes, we initially divided clinical profiles into two groups. We then assessed the rank correlation coefficient between DSBQ factors and dietary intake using Student's t-test and Spearman's technique. We noted three trends: (1) Men aged <60 showed a noticeably low frequency of behavior such as "Device to enhance satisfaction during meals," "Device to reduce the use of high-calorie seasoning," and "Device to eat tasty food while maintaining nutritional balance," Similarly, those with a BMI of >25 and a waist of >85 cm demonstrated a noticeably low frequency of behavior such as "Device to avoid excessive food intake," "Device to enhance satisfaction during meals," and "Device to eat tasty food while maintaining nutritional balance," consequently reflected in increased dietary intake. (2) Women with HbA<sub>1</sub>c <7.0% showed a noticeably high frequency of behavior such as "Device to reduce the amount of cooking salt," consequently reflected in decreased dietary intake. Women with a BMI of >25 and a waist of >90 cm showed a high frequency of "Behavior that each allows one's own value system to take priority even if it means eating inappropriate food" in behavior to cope with factors interfering with dietary regimens, consequently reflected in increased dietary intake. Results suggest that it is important for the sake of good care to point out each own characteristics of self-management behavior using the DSBQ.
- Journal of the Japan Diabetes Society
Journal of the Japan Diabetes Society 51(2), 125-138, 2008-02-29
THE JAPAN DIABETES SOCIETY