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研究生:洪麗娥
研究生(外文):Li - Oer Hung
論文名稱:充能激勵對末期腎疾病患者之成效探討
論文名稱(外文):The Efficacy of Empowerment Training 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, Ph.D., R.N.
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:中文
論文頁數:119
中文關鍵詞:末期腎疾病血液透析充能自我照顧自我效能生活品質憂鬱
外文關鍵詞:End-Stage Renal DiseaseHemodialysisEmpowermentself-scare self-efficacyquality of lifedepression
相關次數:
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本研究目的旨在探討利用充能訓練對末期腎疾病患者的充能、自我照顧能力、憂鬱和生活品質之成效。選樣條件包括:(1)經醫師診斷為慢性腎衰竭或尿毒症,需長期血液透析之患者,(2)意識清楚,可與他人溝通;(3)接受血液透析治療三個月以上門診病患;(4)無其他嚴重全身系統性疾病,如癌症轉移、嚴重充血性心衰竭、四肢肢體癱瘓;(5)年滿18歲及以上且經同意參與研究者。本研究採實驗型設計,以方便選樣方式於高雄市區域教學醫院血液透析室,選出50位符合選樣條件之病患,且隨機分派至實驗組與對照組,各25位。實驗組施行充能訓練,而對照組則接受一般單位照護。充能訓練活動每週三次,每次約一小時,共進行十二次為期一個月。研究工具包括:充能量表、自我照顧自我效能量表、生活品質量表、貝氏憂鬱量表。資料蒐集分前測、充能訓練實施後一週內追蹤後測。研究資料以SPSS 10.0套裝軟體進行建檔及統計分析。統計方法包括次數分配、百分比、平均數、標準差、t檢定、 ANCOVA。
研究結果顯示末期腎疾病患者的自我照顧能力屬中等程度,48 ﹪的研究對象有憂鬱情緒和比正常人低落的生活品質。患者的充能與自我照顧能力(r = 3.81, p =.006)和生活品質(r =3.9 , p = .005)有顯著的正相關,而充能與憂鬱則顯示負相關(r = - 2.99 , p = .03)。結果也顯示充能訓練對患者之充能(F = 40.76 , p =.001)、自我照顧自我效能(F =10.812 , p =.002)及生活品質的心理構面(F =5.368 , p =.025)均有顯著的改善,而憂鬱則無顯著的改善(F = 1.836 , p= .096)。
本研究結果提供臨床護理人員照顧末期腎疾病患者之護理模式,期能藉由充能激勵訓練措施提昇患者之自我照顧自我效能及生活品質。
The purpose of this study was to examine the effectiveness of empowerment training in empowerment, self-care self-efficacy, quality of life and depression among patients with end-stage renal disease (ESRD). Sampling criteria included:(1) patients with a diagnosis of chronic renal disease or uremia; (2) clear consciousness and able to communicate; (3) receiving hemodialysis treatment for at least of three months;(4) no other serious illness , such as cancer or heart failure;(5) over 18 years of age. The study was an experimental design. Fifty qualified subjects were recruited from a hemodialysis center of a major hospital located in Kaohsiung. Subjects were randomly assigned into an experiment group or a control group. Patients in the experiment group (n=25) received one hour per section, 3 times per week for one month. Patients in the control group (n=25) only received unit routine care. Instruments included Empowerment Scale, Self-Care Self-Efficacy Scale, MOS SF-36, Beck Depression Inventory. Data were collected at baseline and one week following the empowerment training. Data were coded and analyzed by using the SPSS 10.0 software. Statistical analyses included frequency, percentage, mean, SD, t-test, and ANCOVA.
The descriptive results showed that participants had a moderate level of self-care self-efficacy. Forty-eight percent of subjects have depressed mood. Generally, patients had a lower quality of life than normal population. Empowerment was significantly correlated with self-care self-efficacy (r = 3.81 , p =.006), mental component scores of quality of life(r = 3.9 , p =.005), and was negatively related to depression(r =-2.99 , p =.035).
This study findings provide an interventional model for nurses who are taking care patients with ESRD.
目 錄
誌謝.......................................................Ⅰ
中文摘要...................................................Ⅱ
英文摘要...................................................Ⅴ
目 錄...................................................Ⅵ
圖表目次...................................................Ⅹ
第一章 緒 論...............................................1
第一節 問題重要性..........................................1
第二節 研究動機............................................2
第三節 研究目的............................................3
第二章 文獻查證.............................................4
第一節 末期腎臟病變概述....................................4
第二節 充能理念的探討......................................5
第三節 末期腎臟病患者自我照顧與自我效能之探討..............8
第四節 末期腎臟病患者生活品質之探討.......................12
第五節 末期腎臟病患者憂鬱之探討...........................15
第三章 研究方法............................................17
第一節 研究設計...........................................17
第二節 概念架構...........................................19
第三節 研究假設...........................................20
第四節 名詞解釋...........................................20
第五節 研究對象與場所.....................................22
第六節 研究工具...........................................22
第七節 研究措施之描述.....................................28
第八節 病人人權之保護.....................................29
第九節 研究步驟...........................................29
第十節 資料處理與分析.....................................33
第四章 研究結果...........................................34
第一節 研究對象背景資料...................................34
第二節 血液透析患者之充能、自我照顧自我效能、生活品質及憂鬱
狀態..................... .....................39
第三節 血液透析患者之充能、自我照顧自我效能、生活品質及憂鬱
狀態之相關性分析... ...............................42
第四節 充能激勵訓練對血液透析患者之充能、自我照顧自我效能、
生活品質及憂鬱之成效 ..............................43
第五章 討論...............................................60
第一節 研究對象的社會人口屬性和疾病相關因素等研究變項概述.60
第二節 血液透析患者之充能、自我照顧自我效能、生活品質及憂鬱
狀態...............................................61
第三節 充能激勵課程實施對充能、自我照顧自我效能、生活品質及
憂鬱狀態之相關性分析...............................64
第四節 充能激勵課程實施對充能、自我照顧自我效能、生活品質及
憂鬱狀態之成效探討.................................65
第六章 結論、建議與研究限制...............................69
第一節 結論...............................................69
第二節 護理上的應用.......................................70
第三節 研究限制與建議.....................................72
參考資料...................................................75
中文部分...................................................75
英文部分...................................................78
附錄一、充能量表使用同意函.................................85
附錄二、生活品質量表(SF-36)使用同意函......................86
附錄三、申請SUPPH-29使用同意函.............................87
附錄四、同意使用SUPPH-29之E-MAIL...........................88
附錄五、健康促進策略量表(SUPPH)使用同意函..................89
附錄六、血液透析充能激勵衛教手冊課程表.....................90
附錄七、血液透析充能激勵流程圖.............................91
附錄八、血液透析患者充能激勵衛教手冊內容...................92
附錄九、參與研究同意書....................................106
附錄十、基本資料問卷表....................................107
附錄十一、血液透析自我照顧自我效能問卷量表................108
附錄十二、生活品質問卷量表................................109
附錄十三、憂鬱問卷量表....................................112
附錄十四、充能問卷量表....................................113
附錄十五、充能量表專家效度名單............................115
附錄十六、致充能量表專家效度鑑定函........................116
附錄十七、充能量表專家效度結果............................118
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