臺灣博碩士論文加值系統

本研究目的係探討以個別化諮詢對全身性紅斑狼瘡青少年的焦慮、憂鬱及生活品質之成效，研究設計屬類實驗性研究，以北部某醫學中心之兒童過敏免疫風濕科門診為收案地點，參與研究之個案共45人，實驗組有22人、控制組有23人。
實驗組於門診後二週、四週及六週，以電訪或面對面方式提供10±5分鐘的個別諮詢，包括：主動關懷、傾聽及支持，並依需求而提供相關的訊息及資源服務，及依據衛教手冊與病童討論居家自我照護的行為，例如：疾病治療、飲食、預防感染、日常生活等；對照組則仍接受門診常規衛教。
以全身性紅斑狼瘡疾病活動性評估量表、兒童焦慮量表、青少年憂鬱量表及生活品質量表等結構式問卷調查方式，採用卡方檢定（Chi-square test）、獨立T檢定（Independent T-test）及成對T檢定（Pair T-test）檢測與比較實驗組及控制組在介入措施前後的焦慮及憂鬱程度、生活品質之差異。
研究結果發現：個別化諮詢有助於降低全身性紅斑狼瘡青少年的焦慮狀況之發生頻率，並提升在「因身體生理問題角色受限」及「心理健康狀況」面向之生活品質，故本研究結果期使兒科護理人員能再加強臨床照護之心理層面的諮詢，並擴展門診護理角色功能及業務範圍，進而提升整體護理的照護成效與價值，及提供相關研究之實證基礎。

The purpose of this study was to investigate the effectiveness of individual counseling on improving the adaptation among adolescents with Systemic Lupus Erythematosus (SLE). The study was a quasi-experimental design. Forty-five adolescents were conducted from a pediatric outpatient department at one medical center in Northern Taiwan. Twenty-two adolescents were randomly assigned to experimental group and twenty-three adolescents were randomly assigned to control group.
The experimental group received 5 to 15 minutes of individual counseling by telephone or face-to-face at second, fourth, and sixth week after clinical visit baseline assessment. The counseling contents protocol included active caring, listening, mental support, information providing and discussing self-care behaviors, such as treatment regiment, diet, infection & prevention, and daily activities. Subjects in control group were received routine health education care.
The research tools were Systemic Lupus Erythematosus Disease Activity Index (SLEDAI), State-Trait Anxiety Inventory for Children (STAIC), Adolescent Depression Inventory and SF-36 Taiwan version. Chi-square test, Independent T-test, and Pair T-test were used to analysis the effectiveness of individual counseling.
The research results were that individual counseling could decrease the anxiety frequency level in adolescents with SLE, could improve the quality of life in role limitation due to physical problems and mental health. The research results reminded clinical nurses should strength psychological counseling. Therefore, nurses could expend professional roles, improve the effectiveness of holistic nursing, and provide evidence base to further researches.

第一章 緒論 1
1.1 研究動機與重要性 1
1.2 研究目的 4
第二章 文獻查證 5
2.1 全身性紅斑狼瘡疾病的相關概念 5
2.2 全身性紅斑狼瘡對青少年的影響 11
2.3 個別化諮詢介入措施之重要性 17
第三章 研究方法 21
3.1 研究架構及方法 21
3.2 研究假說 24
3.3 解釋名詞 25
3.4 研究設計與研究對象 27
3.5 研究工具 29
3.6 資料收集步驟 36
3.7 資料分析方法 38
第四章 研究結果 39
4.1 研究對象之基本資料及前測比較結果 39
4.2 焦慮程度結果分析及前後測之比較 44
4.3 憂鬱程度結果分析及前後測之比較 46
4.4 生活品質結果分析及前後測之比較 48
第五章 討論 56
5.1 個別化諮詢對降低全身性紅斑狼瘡青少年焦慮及憂鬱之成效 56
5.2 個別化諮詢對提升全身性紅斑狼瘡青少年生活品質之成效 59
第六章 結論及建議 61
6.1 研究結論 61
6.2 護理領域的應用 63
6.3 研究限制與建議 64
參考文獻 66
附錄一 基本資料表 75
附錄二 全身性紅斑狼瘡疾病活動性評估量表 77
附錄三 兒童焦慮量表 78
附錄四 青少年憂鬱量表 80
附錄五 台灣版生活品質量表 81
附錄六 個別化諮詢標準化操作程序 85
附錄七 個別化諮詢記錄表 86
附錄八 受試者同意書 87
圖表目錄
圖3-1 個別化諮詢對全身性紅斑狼瘡青少年的調適之研究架構 21
圖3-2 資料收集步驟 37
表3-1 研究設計 27
表4-1 研究對象之基本屬性 42
表4-2 研究對象之家庭基本資料 43
表4-3 實驗組與控制組焦慮程度結果之前測比較及信度 45
表4-4 實驗組與控制組之焦慮程度結果及前後測的差異 45
表4-5 實驗組與控制組憂鬱程度結果之前測比較及信度 47
表4-6 實驗組與控制組之憂鬱程度結果及前後測的差異 47
表4-7 實驗組與控制組生活品質之前測比較及信度 53
表4-8 實驗組與控制組之生活品質結果及前後測的差異 53

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