本研究為回溯性描述研究，運用Currie、Amos及Hunt（1991）發展之行為動態改變模式作為理論架構，探討第二型糖尿病患者轉換胰島素注射治療過程中之前置因素、誘發因素、促進因素、阻礙因素及相關行為改變情形。以立意取樣於台南市某教學醫院，選取24位持續胰島素注射一個月至十二個月之第二型糖尿病患者參與研究，經由面對面訪談收集資料，量性資料進行描述性統計，質性資料將採用內容分析法（content analysis）進行分析與歸納。
　　結果顯示，大部分患者皆有延遲轉換胰島素注射治療之現象，轉換胰島素注射過程是動態的，是個人內在與環境外在相互影響的決定過程，此過程中的前置因素包括血糖控制重要性的體認、對醫療專業的信任及順命的疾病觀。誘發因素包括自決、他決及合併兩者等三種類型，自決可能源自於遵從醫師的專業建議、血糖過高、自覺高血糖症狀，他決又分為重要他人的堅持及專業人員的介入兩類型。阻礙因素包括有認知、態度、能力、心理/社會障礙及其他慢性病症狀干擾。促進因素有注射必要性的自覺、注射執行無礙及信任的醫病關係。於轉換注射的過程會帶動包括社交、飲食、運動、血糖自我監測等相關行為的改變。
　　在引導患者轉換胰島素注射治療時，醫護人員應掌握個案對胰島素注射治療之「理性」與「感性」層面的瞭解與預備，去除個人阻礙因素並連結周邊社會資源以營造注射無礙之狀態。同時必須持續追蹤上述狀況之改變，才能確保胰島素注射治療之成功進行。

　　Based on Currie, Amos & Hunt’s (1991) dynamic model, the purpose of this is to explore the predisposing factors, triggers, facilitating factors and inhibiting factors in the process of type 2 diabetes patients switching to insulin injection. The design of this research is retrospective study. Using purposive sampling method, 24 subjects receiving insulin injection 1 to 12 months from one of the teaching hospital at Tainan were recruited. We used semi-structure questionnaires and face-to-face interview to collect quantitative data that were analyzed by the descriptive statistics. Moreover, qualitative data was analyzed by content analysis.
　　The result shows that most of the patients hesitated in switching to insulin injection. Switching to insulin injection is a dynamic decision making process that may be influenced by the internal and external environment of the individual continuously. The predisposing factors include understanding the importance of blood sugar control, trust in professionalism and, acceptance of fate. Triggers include three styles, self-determinant, others-determinant and combined with both. Self-determinant may be induced by accepting professional suggestions, excessive high blood sugar, and perception of the symptoms of hyperglycemia. Others-determinants that may come from the insistence of the patients’ significant others and the intervention of professionals. Inhibiting factors include the barriers in cognition, attitude, operating ability, psychosocial and the interference of other chronic diseases. Facilitating factors include self-awareness of the necessity of injection, without any difficulty in injection and doctor-patient trust relationship. In the process of switching to insulin injection, several relative behaviors also changed that include social activity, diet, physical exercise, and self-monitoring of blood sugar.
　　To help the patients in switching to insulin injection, primary health care providers should assess both their cognitive reasoning and emotional sensation of the injection treatment. By removing all the obstacles inside and outside of the patients and reorganizing of the supporting resources, a friendly environment with no little obstacles in injection must be arranged. Finally, switching to injection is not a one time job, constantly evaluation of all the relative situations mentioned above is necessary to ensure the success of insulin injection.

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