Exploring the related factors of diabetic patients' insulin pen needle disposal knowledge, attitude and behavior.

[[abstract]]糖尿病患者使用胰島素筆型注射器治療是逐年增加的趨勢，糖尿病患者需返家後自行使用針頭注射藥物，糖尿病患者若無先把針頭放在堅固容器的原則下，隨意丟棄的過程中有可能導致患者本身、家人和其他人遭受不必要的針扎風險，也可能增加社區感染的疑慮。 本研究之目的有五點，第一調查糖尿病患者因針頭棄置之針扎盛行率；第二瞭解糖尿病患者之針頭棄置的知識、態度與行為；第三分析糖尿病患者之不同人口學變項對針頭棄置的知識、態度與行為之關係；第四探討糖尿病患者之針頭棄置的知識與態度與行為的相關性；第五分析影響針頭棄置行為的主要因素。 本研究為橫斷式研究，非隨機立意取樣方式，採用自編問卷，問卷內容經專家效度分析，再經預試後，進行項目分析、因素分析以確立效度。知識量表Cronbach Alpha值0.66、態度量表Cronbach Alpha值0.81、行為量表Cronbach Alpha值0.79。問卷分成兩個部分，第一為人口學變項；第二為針頭棄置之知識、態度與行為量表。共有220位受試者在台中市澄清醫院中港院區收案完成，是以20歲（含）以上之糖尿病患者，且筆針頭注射胰島素超過一年（含）以上為收案條件。所有資料編碼與建檔於統計軟體 SPSS 25.0，進行t test、ANOVA、積差相關、線性複迴歸檢定針頭棄置之知識、態度及行為及其相關因素之分析。 研究結果顯示糖尿病患者針扎之盛行率為35.9%；在針頭棄置之知識、態度與行為有顯著差異的人口學變項為：是否刺傷他人、教育程度、醫療人員說明針頭棄置衛教、一個針頭使用次數、是否刺傷自己；而針頭棄置之知識、態度與行為均呈顯著正相關；一個針頭使用次數、醫療人員說明棄置的衛教、知識總分、態度總分為影響針頭棄置之行為的主要四個因素。 本研究發現患者的知識與態度會導致不正確的針頭棄置行為，進而發生針扎。因此，建議藉由各種衛教輔助宣導方式以提高患者對針頭棄置的認知及提供堅固的罐子以提高患者的積極態度，促進正確針頭棄置的行為。[[abstract]]Insulin pen therapy for diabetic patients is the increasing trend year by year. Diabetic patients need to use pen needles to inject insulin drugs by themselves at home. The process from the installation of the needle to the injection to the disposal of the needle, if there is a little error in the process, needle sticks and exposure to blood-borne pathogens may occur. In the classification of medical wastes of the Environmental Protection Administration of the Executive Yuan, the random disposal process may cause the patient himself, his family, and other people such as street cleaners and Garbage cleaning members, unnecessarily suffer the risk of needle sticks and the possible causes of the community infection, if diabetic patients do not put pen needles in a solid container first. The research objectives are following:1. Investigate the prevalence of needle sticks caused by needle disposal in diabetic patients.2. Understand the knowledge, attitude and behavior of pen needle disposal in diabetic patients.3. Analyze the relationship between the knowledge, attitude and behavior of needle disposal by different demographic variables of diabetic patients.4. Explore the correlation between knowledge, attitude and behavior of needle disposal in diabetic patients.5. Analyze the main factors influencing needle disposal behavior. This study is a cross-sectional study and using a non-random purposive sampling method. It is adopted by a self-made questionnaires survey. Experts analyzed the content of the questionnaire and conducted the item analysis and factor analysis after the pre-test for the validity. The knowledge scale Cronbach alpha is 0.66, the attitude scale Cronbach alpha is 0.81, and the behavior scale Cronbach alpha is 0.79. The content of the questionnaire is divided into two parts, which are demographic variables and the investigation scale of the needle disposal knowledge, attitude, and behavior of the diabetic patients. A total of 220 cases were completed in the Cheng Ching Hospital Chung Kang Branch in Taichung City. The acceptance conditions are diabetic patients over 20 years old (inclusive) and used pen needles injecting insulin for more than one year (inclusive). All data of the questionnaire would be encoded and archived by SPSS 25.0 with t-test, ANOVA, the Product-moment correlation, multiple regression analysis. This investigation verifies the related factors between the scores of the analysis above for the needle disposal knowledge, attitude, and behavior of diabetic patients. The results show the prevalence rate of needlestick injury in diabetic patients is 35.9%. The demographic variables with significant differences in needle disposal knowledge, attitudes, and behaviors are following: whether the needle stabbed people (others or yourself) or not, education level of diabetic patients, whether medical personnel explained the needle disposal health education or not, and how many times for a needle to use. The knowledge, attitude, and behavior of needle disposal are significantly positively correlated. The four main factors that influence the behavior of needle disposal are the following: the medical personnel explained the needle disposal health education, the number of usage times for a needle, the knowledge scores, and the behavior scores. This study finds that the patients’ knowledge and attitude would lead to incorrect needle disposal behavior, which occurs needle stick injuries. It recommends health education by a variety of propaganda ways to enhance needle disposal awareness of patients, and to provide a solid container to increase the positive attitude of patients and attain correct the behavior of needle disposal