臺灣博碩士論文加值系統

本研究為描述性之量性研究，採橫斷式研究設計，以方便取樣方式，在台灣北部某醫學中心、區域教學醫院及地區教學醫院過敏免疫風濕科門診進行結構式問卷訪談，以類風濕性關節炎患者為研究對象，抽取血液檢體並測量其憂鬱程度、日常活動狀況與生活品質，探討病患憂鬱與日常活動狀況對生活品質之影響。門診病患經專科醫師診斷為類風濕性關節炎且意識清楚、能用語言或文字表達溝通、無精神疾患者選取221位為研究對象。研究工具包括病患疾病活動性(DAS-28)評估、健康評估(HAQ)問卷、貝氏憂鬱量表(BDI)、台灣簡明版生活品質量表，資料採SPSS 10.0軟體進行數據建檔並進行描述性、相關性及複迴歸統計分析。研究發現類風濕性關節炎患者之憂鬱程度對生活品質中生理範疇、心理範疇、社會關係範疇、環境範疇、自覺健康滿意度與自覺整體生活品質有顯著負相關 (r=-0.583、-0.658、-0.438 、-0.543、-0.573 & -0.485，p<0.01); 日常活動狀況對生活品質中生理範疇、心理範疇、社會關係範疇、環境範疇、自覺健康滿意度與自覺整體生活品質有顯著負相關 (r=-0.508、-0.455、-0.413 、-0.409、-0.474 & -0.360，p<0.01)。運用複迴歸分析，憂鬱與活動狀況為預測類風濕性關節炎患者生活品質變化之重要因子。研究結果可提供醫療及護理人員發展介入措施，改善類風濕性關節炎患者憂鬱狀況，協助增進日常活動功能以提昇生活品質。

The purpose of this study is to examine the interrelationships among depression, activities of daily living, the livel of quality of life in Rheumatoid Arthritis patient. A cross-sectional correlation design was used to examine the effects of demographic variables, disease attribute variables, depression and activities of daily living on quality of life. Data were collected from a purposive sample of 221 Rheumatoid Arthritis patients who following by outpatient department in three tacching hospitals and were interviewed by the investigator directly.
The data collected were analysed using correlation and multiple regression. The finding indicated that depression is negatively correlated with physical health, psychological state, social relations, environments, perceived health status and perceived the livel of quality of life status ( r = -0.583、-0.658、-0.438 、-0.543、-0.573 & -0.485, p<0.01 ). In addition, the activities of daily living is negatively correlated with physical health, psychological state, social relations, environments, perceived health status and perceived the livel of quality of life status ( r = -0.508、-0.455、-0.413 、-0.409、-0.474 & -0.360, p<0.01 ). Moreover, a hierarchical regression was performed to partial out the influence of demographic and disease attribute variables on the relationship between independent variables (depression and activities of daily living) and (quality of life). As expected, The independ variables (depression and activities of daily living) have direct negative effect on quality of life.
Thus, this study suggested that nursing intervention should improve depression condition and activities of daily living among Rheumatoid Arthritis patient.

目 錄 頁數
致謝˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙Ⅰ
中文摘要˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙Ⅱ
英文摘要˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙Ⅲ
目錄˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙Ⅳ
圖表目次˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙Ⅵ
第一章 緒論
第一節 研究動機˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙2
第二節 研究目的˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙3
第二章 文獻查證
第一節 類風濕性關節炎˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙5
第二節 日常活動˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙8
第三節 慢性病與憂鬱˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙10
第四節 生活品質˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙12
第三章 研究方法
第一節 研究假設˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙15
第二節 研究架構˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙15
第三節 名詞解釋˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙16
第四節 研究設計˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙19
第五節 研究場所及對象˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙20
第六節 研究工具˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙20
第七節 研究工具信效度檢定˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙25
第八節 研究步驟˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙26
第九節 資料處理˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙27
第四章 研究結果
第一節 類風濕性關節炎病患人口學屬性、疾病屬性與研究變項之描述性統˙28
第二節 憂鬱程度、日常活動狀況、生活品質之相關性分析˙˙˙˙˙˙˙˙38
第三節 影響類風濕性關節炎病患生活品質預測因子之探討˙˙˙˙˙˙˙˙41
第五章 討論
第一節 類風濕性關節炎病患人口學屬性、疾病屬性、憂鬱程度、日常活
動狀況與生活品質之現況˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙47
第二節 類風濕性關節炎病患憂鬱程度、日常活動狀況與生活品質之相
關性˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙48
第三節 影響類風濕性關節炎病患生活品質之重要因子˙˙˙˙˙˙˙˙˙˙49
第六章 結論與建議
第一節 結論˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙50
第二節 研究限制與建議˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙52
第三節 護理上的應用˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙52
參考資料
中文部份˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙53
英文部份˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙55
附錄
附錄一 參與研究同意書˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙61
附錄二 研究問卷內容˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙62
附錄三 專家問卷效度檢定說˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙72
附錄四 問卷使用同意書˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙74

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