護理師正在評估一位病人罹患第二型糖尿病的風險。下列何種發現是可改變的風險因子？
A nurse is assessing a client's risk for developing type 2 diabetes. Which finding is a modifiable risk factor?
- ASedentary lifestyle久坐的生活方式正確答案
- BHistory of gestational diabetes during a previous pregnancy曾於前次懷孕期間罹患妊娠糖尿病
- CFamily history of diabetes糖尿病家族史
- DAge over 45 years年齡超過45歲
- A久坐的生活方式
「可改變（modifiable）」指的是病人能透過行為或治療實際改變的因子。 久坐生活型態（A 為正解）可以靠增加規律身體活動直接改變，是第二型糖尿病最典型的可改變風險因子——增加活動量能改善胰島素敏感性，是糖尿病預防計畫的核心介入之一。 其餘三項都屬不可改變：B 曾有妊娠糖尿病病史是已經發生過的既定事件，雖然它顯著提高日後罹患第二型糖尿病的風險，但這段病史本身無法回頭改變（能改變的是之後的體重與活動量，不是這項病史）。C 家族史屬遺傳背景。D 年齡超過 45 歲隨時間推進而來。 臨床應用：辨識可改變因子的意義在於指出「介入的著力點」——對這位病人，護理指導應聚焦於增加身體活動，而不是花力氣在無法改變的項目上。
- A · 正確答案久坐的生活方式
久坐生活方式可透過增加體能活動來改變。
- B曾於前次懷孕期間罹患妊娠糖尿病
肥胖是可改變的風險因子，但生活方式是更廣泛的類別。
- C糖尿病家族史
家族史是不可改變的風險因子。
- D年齡超過45歲
年齡增長是不可改變的風險因子。
美國強調預防醫學，鼓勵大眾透過生活方式調整降低慢性病風險；台灣對慢性病防治的推廣亦不遺餘力，但資源分配與民眾執行力仍有差異。
English explanation
Option A is correct because a sedentary lifestyle can be changed directly by increasing regular physical activity. Greater activity improves insulin sensitivity, making it a central intervention in programs intended to prevent type 2 diabetes. Modifiable means that the client can alter the factor through behavior or treatment, so nursing guidance should focus on increasing physical activity. Option B is incorrect because a history of gestational diabetes is an established past event that cannot be changed, even though it significantly raises the client's future risk of type 2 diabetes; later weight and activity can change, but the history cannot. Option C is incorrect because family history reflects an inherited background. Option D is incorrect because being older than 45 years results from the passage of time and cannot be modified. Identifying modifiable factors helps direct prevention toward areas where intervention can make a practical difference.
最近修訂：2026-05-17