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系統識別號 U0026-1108201713564400
論文名稱(中文) 印尼第二型糖尿病人之神經病變疼痛和功能性表徵及生活品質之關係
論文名稱(英文) Painful Diabetic Neuropathy, Functional Performance and Quality of Life among Type II Diabetes Mellitus Patients in Indonesia
校院名稱 成功大學
系所名稱(中) 護理學系
系所名稱(英) Department of Nursing
學年度 105
學期 2
出版年 106
研究生(中文) 馬昕儀
研究生(英文) Roza Marlinda
學號 T26047093
學位類別 碩士
語文別 英文
論文頁數 100頁
口試委員 指導教授-許玉雲
口試委員-方素瓔
口試委員-林宙晴
中文關鍵字 none 
英文關鍵字 Type 2 diabetes mellitus  painful diabetic neuropathy  functional performance  and quality of life 
學科別分類
中文摘要 none
英文摘要 Background: Type 2 Diabetes mellitus (T2DM) patients may experience painful diabetic neuropathy, one of the symptoms of distal symmetric polyneuropathy (DSPN). While pain is a highly unpleasant symptom affecting and disrupting people’s life, Painful Diabetic Neuropathy (PDN) is overlooked, which may impact patient’s functional performance and quality of life. There is limited information regarding the relationships of PDN, functional performance and quality of life among patients with T2DM in Indonesia.
Purpose: The purpose of the study was to investigate the relationships among demographic factors, health characteristics, painful diabetic neuropathy, functional performance and quality of life among patients with T2DM in Indonesia.
Method: This study uses a cross-sectional design. The participants were T2DM patients with an abnormal monofilament test and able to communicate using the Indonesian language. Self-reported Leeds Assessment of Neuropathic Signs and Symptoms (s-LANSS) was used to assess neuropathic pain. Short-Form 36-Item Health Survey (SF-36) was used to measure functional performance and quality of life. Algorithm software was used to calculate the scoring of functional performance and index of quality of life separately.
Results: A total of 200 patients with T2DM participated in this study. The mean age of the participants was 59.77 (SD=8.45) years old, ranging from 40 to 79 years old, 53% were male, 73.5 % had high school or higher education level, 91% were employed, and 59.5% had low-income status. The mean score of Body Mass Index (BMI) was 23.60 (SD=2.68). The mean duration diagnosed with Diabetes Mellitus (DM) was 6.68 (SD=4.56), and the median was six years (ranging from 4 months - 25 years). Eighty-two percent of the participants took oral medicine treatment, only 11.5% got insulin treatment, and 16% got the combination of oral and insulin treatment. There were 40% of the participants a smoker. Three-quarters of the subjects experienced pain above the ankle, and 79% had painful discomfort. Hierarchical multiple regressions revealed age, occupation, DM duration, the area of worst pain, and painful neuropathic discomfort were predictors of functional performance, with R2=0.26. Also, occupation, income level, BMI, treatment regimens and area of worst pain were predictors of quality of life, with R2=0.23.
Conclusions: Neuropathic pain is related to functional performance and quality of life among T2DM patients. Therefore, performing early screening to detect painful diabetic neuropathy and its impact on functional performance and quality of life is needed.
Keywords: Type 2 diabetes mellitus, painful diabetic neuropathy, functional performance, and quality of life.
論文目次 ABSTRACT ii
ACKNOWLEDGEMENT iii
TABLE OF CONTENTS iv
LIST OF TABLES v
LIST OF FIGURES vi
CHAPTER I INTRODUCTION 1
1.1. Research Background 1
1.2. Research Purpose 2
CHAPTER II LITERATURE REVIEW 5
2.1. Diabetes Mellitus 5
2.1.1. Diabetic Neuropathy in Type II Diabetic Mellitus 8
2.1.2. Painful Diabetic Neuropathy 11
2.2. Functional Performance and Quality of Life 16
CHAPTER III RESEARCH METHOD 20
3.1. Research Design and Sampling 20
3.1.1. Design 20
3.1.2. Sampling 20
3.2. Research Framework 21
3.3. Instruments 22
3.3.1. Demographic Data and Health Characteristic 22
3.3.2. Monofilament Test 23
3.3.3. Painful Diabetic Neuropathy 24
3.3.3.a. s-LANSS 24
3.3.4. 36-Item Short-Form Health Survey (SF-36) 26
3.4. Ethical Consideration 27
3.5. Data Collection Procedures 37
3.6. Data Analysis 29
CHAPTER IV RESEARCH RESULTS 30
4.1. Sample Characteristics 30
4.2. Painful Diabetic Neuropathy 32
4.3. Functional Performance 32
4.4. Relationship among demographic Factors, Health Characteristics Functional Performance and Quality of Life 33
4.5. Relationship among Painful Diabetic Neuropathy and Functional Performance and Quality of Life 35
4.6. Demographic Factors, Health Characteristics and Painful Diabetic Neuropathy on Functional Performance 37
4.7. Demographic Factors, Health Characteristics and Painful Diabetic Neuropathy on Quality of Life 40
CHAPTER V DISCUSSION 42
5.1 Discussion 42
5.1.1 Factors associated with Functional Performance and Quality of Life 44
5.1.2 Predictors of Functional Performance 45
5.1.3 Predictors of Quality of Life 46
5.2 Limitation 47
5.3. Clinical Implication 48
5.4 Conclusion 49
REFERENCES 50
APENDICES 62
Appendix 1: Informed Consent (English Version) 62
Appendix 2: Informed Consent (Bahasa Indonesia Version) 64
Appendix 3: Research Instrument (English Version) 66
1. Demographic Factors and Health Characteristics Questionnaire 66
2. Self-reported Leeds Assessment of Neuropathic Symptoms and Signs Questionnaire 69
3. Short-Form 36-item Health Survey Questionnaire 72
Appendix 4: Research Instrument (English Version) 79
1. Kuesioner Demografi 79
2. Self-reported Leeds Assessment of Neuropathic Symptoms and Signs Questionnaire Indonesian Version 82
3. Kuesioner Kesehatan dan Kesejahteraan 85
Appendix 5: IRB Approval 91
Appendix 6: Hospital Permit 92
Appendix 7: s-LANSS & SF-36 Questionnaire Permission 93


LIST OF TABLES

Table 1. Classification of Diabetic Neuropathy 9
Table 2. Demographic Characteristic of the Study Sample 31
Table 3. Description of s-LANSS for Painful Diabetic Neuropathy 32
Table 4. Functional Performance and Utility Index of Quality of Life 33
Table 5. Correlation among Demographic Factors, Health Characteristic, and Functional performance and Quality of Life 34
Table 6. Association among Demographic Factors, Health Characteristic, and Functional performance and Quality of Life 35
Table 7. Correlation among Neuropathic Painful Discomfort and Functional performance and Quality of Life 37
Table 8. Association among Neuropathic Painful Discomfort and Functional Performance and Quality of Life 37
Table 9. Demographic Factors, Health Characteristic, and Neuropathic Pain on Functional Performance 39
Table 10. Demographic Factors, Health Characteristic, and Neuropathic Pain on Quality of Life 41 
LIST OF FIGURES

Figure 1. Research Framework 22
Figure 2. Monofilament Testing 23
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