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研究生:邱淑芬
研究生(外文):Shu Fen Chiu
論文名稱:巴金森病病患靈性安適及生活品質相關性之探討
論文名稱(外文):The associations of spiritual well-being and quality of life for patients with Parkinson's disease
指導教授:邱逸榛邱逸榛引用關係
指導教授(外文):Yi Chen Chiu
學位類別:碩士
校院名稱:長庚大學
系所名稱:護理學系
學門:醫藥衛生學門
學類:護理學類
論文種類:學術論文
論文出版年:2017
畢業學年度:105
語文別:中文
論文頁數:156
中文關鍵詞:巴金森病靈性安適生活品質
外文關鍵詞:Parkinson’s diseasespiritual well-beingQoL
相關次數:
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  • 收藏至我的研究室書目清單書目收藏:0
巴金森病是中樞神經退化性疾病,症狀為動作緩慢、僵硬、顫抖及姿態不穩,典型的慢性退化性疾病,造成不可逆的身體功能障礙,漫長的罹病期間承受多重的不適與壓力,造成醫療資源及社會家庭的負擔,生活品質下降。故本研究目的在探討巴金森病病人之人口學屬性、疾病特性變項、靈性安適狀態與生活品質之相關性,研究假設:靈性安適是巴金森病病人生活品質的預測因子。本研究採取橫斷性相關性研究法,以方便取樣法於北台灣某醫學中心之腦神經內科門診收案110位巴金森病患者。研究工具包括:「病人人口學屬性」、「簡易智能狀態量表(MMSE)」、「巴金森氏症統一評估量表(UPDRS)」、「中文版靈性安適量表(SIWB)」和「巴金森氏症生活品質量表(PDQ-39)」。顯著信賴水準α值定為0.05,樣本數是依據過去研究流失率(10%)及階層迴歸分析而定。研究結果發現:有工作者生活品質較無業者高;靈性安適量表與其次量表(生命意義與自我效能)和生活品質顯著負相關。整體生活品質預測因子,包含「職業」、「疾病嚴重度」及「靈性安適之自我效能」,整體可解釋變異量為66.8%(調整後R2:65.8%),顯示有工作的患者整體生活品質顯著優於目前無業者、巴金森病症狀干擾越嚴重,整體生活品質品質越差;當病人面對壓力和困境時,覺得自己無足夠的能力去處理及克服時,生活品質感受越差。本研究結果可以幫助健康相關照護者瞭解巴金森病病患生活品質的相關因素,並作為擬定相關照護計畫的參考,設計促進靈性安適及生活品質的護理措施,以達到促進全人健康的照護目標。
Parkinson's disease (PD) is a chronic and degenerative disorder of the central
nervous system, which manifests itself as slowness of movements, rigidity, tremor
and posture instability, causing irreversible motor dysfunction. The long-term
duration of this disease is associated with a significant discomfort and multiple stress,
medical and social cost, and decreased quality of life (QoL) for persons with
Parkinson’s disease (PWPDs). Therefore, the purpose of this study was to explore the
relationships among demographic variables, disease characteristics, and spiritual
well-being and QoL in PWPDs. We hypothesized that spiritual well-being impacted
QoL in PWPD. The study was a cross-sectional design with a convenient sampling
method. We recruited 110 PWPDs from a neurological clinic of a teaching hospital in
northern Taiwan. The test battery includes: Mini-Mental State Examination
(MMSE), Unified Parkinson's Disease Rating Scale (UPDRS), Spirituality Index of
Well-Being (SIWB) and 39-item Parkison's disease Quality of Life Questionnaire
(PDQ-39). Significant value of α level was set at 0.05. The sample size was estimated
to be 110 according to the previous attrition rate (10%) and the multiple regression
analysis.
The results were as follows: there were significant differences in quality of life
between having a job and unemployment; the total scores of the Spirituality Index of
Well-Being and its two sub-scores (Life Scheme and Self Efficacy) were negatively
correlated with quality of life; UPDRS total score and quality of life was positively
correlated. Finally, occupation, disease severity and self efficacy were the significant
predictors of quality of life for PWPD, explaining 66.8% of the variance (adjust
R2:65.8%). The results can help health care professionals to develop appropriate
intervention for enhancing quality of life for Parkinson’s disease patients.
Key words:Parkinson’s disease, spiritual well-being, QoL.
目錄
指導教授推薦書
口試委員會審定書
誌謝……………………………………………………………………..ⅲ
中文摘要………………………………………………………………..ⅴ
英文摘要………………………………………………………………..ⅵ
目錄……………………………………………………………………..ⅶ
圖目錄………………………………………………………………….x
表目錄…………………………………………………………………..ⅹi
第一章 緒論……………………………………………………………1
第一節 研究動機……………………………………………………1
第二節 研究重要性…………………………………………………4
第三節 研究目標……………………………………………………5
第四節 研究假設……………………………………………………6
第五節 名詞解釋……………………………………………………6
第二章 文獻查證………………………………………………………8
第一節 巴金森病……………………………………………………8
第二節 巴金森病病患之靈性安適及其相關因素…………………16
第三節 巴金森病病患之生活品質及其相關因素…………………43
第四節 巴金森病病患之靈性安適與生活品質的關係……………57
第三章 研究方法……………………………………………………....59
第一節 研究設計與場所……………………………………………59
第二節 研究對象……………………………………………………59
第三節 研究架構……………………………………………………61
第四節 研究工具及其信效度………………………………………61
第五節 研究進行步驟………………………………………………66
第六節 倫理考量……………………………………………………66
第七節 資料處理與分析……………………………………………67
第四章 研究結果………………………………………………………69
第一節 研究對象之描述性資料及現況分析………………………69
第二節 研究對象之中介變項-靈性安適相關影響因素…………...77
第三節 研究對象生活品質相關影響因素及預測因子……………81
第五章 討論……………………………………………………………93
第一節 研究對象之靈性安適相關影響因素………………………93
第二節 研究對象之生活品質相關影響因素及預測因子…………96
第六章 結論與限制……………………………………………………103
參考文獻…………………………………………………………..........106
附錄…………………………………………………………..........124
附錄一 人口學調查資料表………………………………………….124
附錄二 簡易智能狀態量表(MMSE) ………………………………..126
附錄三 巴金森氏症統一評估量表(UPDRS Total Score)…………..127
Hoehen and Yahr stage & Schwab and England Score
附錄四 中文版靈性安適量表……………………………………….131
附錄五 巴金森氏症生活品質量表………………………………….132
附錄六 研究工具使用同意書……………………………………….134
附錄七 統合分析 1995-2017 年靈性與巴金森病相關系統文獻搜尋歷程記錄…………………………………………………….140


圖目錄
圖次
圖2-1 靈性安適概念架構……………………………………………..42
圖3-1 研究架構圖……………………………………………….........61


表目錄
表次
表1-1 名詞解釋…………………………………………………………. 6
表2-1 Hoehn and Yahr scale……………………………………………10
表2-2 藥物整理………………………………………………………...11
表2-3 靈性概念………………………………………………………….17
表2-4 靈性安適對健康結果有正向影響之研究報告………………….21
表2-5 1995-2017 年靈性與巴金森病相關系統文獻回顧………………24
表2-6 靈性安適測量工具………………………………………….........28
表2-7 生活品質概念……………………………………………….........43
表2-8 生活品質測量工具………………………………………………..52
表3-1 各量表之內在一致性信度分析…………………………………..65
表3-2 資料統計方法……………………………………….....................67
表4-1-1 巴金森病病患人口學屬性…………………………...................71
表4-1-2 巴金森病病患疾病特性………………………….......................73
表4-1-3 靈性安適分佈狀況…………………………...............................74
表4-1-4 生活品質及其各層面之分佈狀況……………………………...76
表4-1-5 生活品質各題得分與排序之分佈狀況………………………...76
表4-2-1 人口學變項與靈性安適的差異分析…………………………...79
表4-2-2 年齡、疾病特性變項與靈性安適的相關分析………………...81
表4-3-1 人口學屬性與生活品質的差異分析…………………………...86
表4-3-2 年齡、疾病特性變項與生活品質的相關分析………………...88
表4-3-3 研究對象之生活品質迴歸分析及各變項之共線性診斷結果…91
表5-2-1 研究對象有參加病友會電訪記錄……………………………...99
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