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研究生:卓宜靜
研究生(外文):Yi-Ching Cho
論文名稱:穴位指壓對末期腎臟疾病患者之疲憊感、生活品質和憂鬱之成效探討
論文名稱(外文):The effect of acupressure on fatigue, quality of life and depression among end-stage renal disease patients
指導教授:蔡秀鸞蔡秀鸞引用關係
指導教授(外文):Shiow-Luan Tsay
學位類別:碩士
校院名稱:國立台北護理學院
系所名稱:護理研究所
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:2002
畢業學年度:90
語文別:英文
論文頁數:108
中文關鍵詞:穴位指壓疲憊感生活品質憂鬱末期腎臟疾病
外文關鍵詞:AcupressureFatigueQuality of lifeDepressionEnd-stage renal disease
相關次數:
  • 被引用被引用:20
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末期腎臟疾病接受血液透析患者疲憊感是最常見的症狀,此影響患者的情緒和生活品質。本研究的目的在檢視穴位指壓按摩對末期腎臟疾病患者改善其疲憊感、生活品質和憂鬱的成效。本研究為實驗型前測和後測研究設計,研究對象為南部一所區域醫院及醫學中心的洗腎室,洗腎時間超過三個月以上的病患;採方便取樣62位洗腎病患,以分層隨機方式(一、三、五;二、四、六)隨機分配至實驗組及控制組各31位。實驗組患者接受每星期三次及每次15分鐘的按摩及穴位指壓,為期四週;控制組則接受一般洗腎照護。四週前、後以結構式問卷:疲憊感量表、生活品質量表(SF-36台灣版)、貝氏憂鬱量表進行會談,收集實驗組與控制組疲憊感、生活品質及憂鬱的得分。所得資料以描述性統計分析、卡方檢定、配對t檢定、獨立樣本t檢定及共變異數分析(ANCOVA)進行資料分析與檢定。結果顯示:研究對象有中等程度的疲憊感受,有63.8﹪的患者有憂鬱情緒及生活品質比一般人低。在介入實驗處置後,實驗組之疲憊感(F=9.05, p=.004)、憂鬱(F=4.20,p=.045)和生活品質之心理健康構面(F=5.65, p=.02)之改善顯著優於控制組,顯示穴位指壓介入措施,能顯著改善患者的疲憊感、憂鬱及生活品質。研究結果建議可將此減輕疲憊感之穴位指壓方案納入洗腎患者的護理照護中,以提高護理末期腎臟疾病接受血液透析患者的照護品質。
Fatigue is the most significant symptom experienced by patients with end-stage renal disease. The purpose of this study is to examine the effectiveness of acupressure in fatigue, quality of life and depression among patients with end-stage renal disease (ESRD) who were receiving hemodialysis treatment.
The study is an experimental pretest and posttest design. Sixty-two hemodialysis patients participated in the study. Data were collected from two hemodialysis clinics of major hospitals in the southern Taiwan. Subjects were randomly assigned to an acupressure group or a control group. Patients in the acupressure group received acupoints massage for 15 minutes per day, 3 days per week, for a consecutive of 4 weeks. Subjects in the control group only received unit routine care. The measures included the Revised Piper Fatigue Scale, the Beck’s Depression Inventory and the MOS SF-36. Descriptive statistics, c2 tests, t-test and analyses of covariance were used for data analysis. The results indicate that hemodialysis patients experienced a moderate level of fatigue. Nearly 65﹪of hemodialysis patients had a depressed mood. Patients rated their quality of life were lower than the normal population. ANCOVA results indicates that fatigue, depression and quality of life of patients in the acupressure group had a significantly greater improvement(p<0.05)than patients in the control group. Findings of this study provide an interventional model for nurses who are taking care of ESRD patients.
誌 謝 --------------------------------------------------- I
中文摘要 --------------------------------------------------- II
英文摘要 --------------------------------------------------- IV
目 錄 --------------------------------------------------- VI
圖表目次 --------------------------------------------------- IX
第一章 緒論
第一節 研究動機及重要性 ---------------------------------- 1
第二節 研究目的 ------------------------------------------- 2
第二章 文獻查證
第一節 末期腎臟疾病的定義及處置 -------------------------- 3
第二節 疲憊感的定義 -------------------------------------- 3
第三節 有關疲憊感的研究 ---------------------------------- 8
第四節 穴位指壓 ------------------------------------------ 9
第五節 有關穴位指壓的研究 --------------------------------18
第六節 生活品質的定義 ------------------------------------19
第七節 末期腎臟疾病與生活品質的研究 ------------------------22
第八節 憂鬱的定義 ------------------------------------------24
第九節 末期腎臟疾病與憂鬱 ----------------------------------25
第三章 研究架構、假設、名詞界定
第一節 研究架構 ------------------------------------------28
第二節 研究問題與假設 ------------------------------------28
第三節 名詞解釋 ------------------------------------------29
第四章 研究方法
第一節 研究設計 ------------------------------------------31
第二節 研究對象 ------------------------------------------32
第三節 研究工具 ------------------------------------------32
經穴指壓方案 -------------------------------------------32
穴位的選定 --------------------------------------------33
指壓手法的選擇 ----------------------------------------34
介入處置的時間 ----------------------------------------35
經穴指壓之信效度控制 ----------------------------------35
疲憊量表 ----------------------------------------------37
生活品質量表 ------------------------------------------38
貝氏憂鬱量表 ------------------------------------------40
第四節 研究過程 ------------------------------------------41
第五節 資料處理與分析 ------------------------------------43
第五章 研究結果
第一節 研究對象背景資料 ----------------------------------44
第二節 穴位指壓對血液透析患者疲憊感的成效 ----------------51
第三節 穴位指壓對血液透析患者生活品質的成效 ----------------55
第四節 穴位指壓對血液透析患者憂鬱的成效 --------------------60
第五節 研究對象指壓後的主觀感覺 ----------------------------64
第六章 討論
第一節 研究對象基本資料之分佈 ----------------------------65
第二節 血液透析患者之疲憊感、生活品質及憂鬱的狀態 --------66
第三節 穴位指壓對血液透析患者疲憊感、生活品質及憂鬱的成效 68第七章 討論與建議
第一節 結論 ----------------------------------------------71
第二節 研究之限制 ----------------------------------------71
第三節 護理上之應用與建議 --------------------------------72
參考文獻
中文部分 --------------------------------------------------74
英文部分 --------------------------------------------------78
附 錄
附錄一 研究工具使用同意函 ---------------------------------87
附錄二 研究工具使用同意函 ---------------------------------88
附錄三 研究說明書 -----------------------------------------89
附錄四 參與研究同意書 -------------------------------------90
附錄五 穴位點位置圖 ---------------------------------------91
附錄六 實驗組穴位指壓方案 ---------------------------------92
附錄七 實驗組穴位指壓方案之專家評分表 ---------------------93
附錄八 專家效度函 -----------------------------------------94
附錄九 實驗組穴位指壓方案之專家內容檢定 -------------------95
附錄十 穴位指壓方案專家效度名單 ---------------------------96
附錄十一 指壓力量之內在信度測定 -----------------------------97
附錄十二 穴位指壓部位之正確性專家認定表格 -------------------98
附錄十三 問卷 -----------------------------------------------99
圖表目錄
圖3-1 概念性架構 -------------------------------------------28
表3-1 研究模式 ---------------------------------------------31
表5-1 研究對象社會人口學資料 -------------------------------49
表5-2 研究對象疾病相關屬性資料 -----------------------------50
表5-3 兩組研究對象之疲憊感 ---------------------------------53
表5-4 兩組研究對象疲憊感之共變數分析 -----------------------54
表5-5 以成對t檢定兩組研究對象疲憊感、生活品質和憂鬱之前後差 55
表5-6 兩組研究對象之生活品質次量表得分 ---------------------59
表5-7 兩組研究對象生活品質之共變數分析 ---------------------60
表5-8 研究對象之憂鬱程度 -----------------------------------63
表5-9 兩組研究對象憂鬱程度之比較 ---------------------------63
表5-10 兩組研究對象憂鬱之共變數分析 -------------------------63
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