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研究生:林愛真
研究生(外文):Lin, Ai - Chen
論文名稱:因應訓練對末期腎疾病患者之成效探討
論文名稱(外文):The effectivenss of coping skill training in patient with end - stage renal disease
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:中文
論文頁數:86
中文關鍵詞:末期腎疾病壓力因應策略生活品質憂鬱
外文關鍵詞:ESRDstresscoping strategiesquality of lifedepression
相關次數:
  • 被引用被引用:11
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本研究旨在探討實施「因應訓練」對末期腎疾病接受血液透析治療的病人在壓力、因應行為、生活品質及憂鬱的影響成效。本研究採實驗型研究設計,以台北某一醫學中心血液透析單位共48位病人為對象,隨機分派到實驗組及對照組,實驗組接受8週的因應訓練活動,對照組接受一般透析單位之照護。在因應訓練實施前後,二組皆接受前後測,測量工具包括「血液透析壓力源量表」、「因應方法量表」、「生活品質量表」、「貝氏憂鬱量表」來評價因應訓練之成效。研究資料以SPSS 10.0視窗版套裝軟體進行資料之分析,描述性統計以次數分佈、百分率、平均值、標準差等分析;推論性統計以卡方檢定、獨立性t檢定、皮爾遜積差、成對t檢定及共變異數分析等進行相關考驗。
本研究的主要發現:末期腎疾病洗腎病患呈現低等程度的壓力感受,比一般健康民眾低的生活品質及近六成患者有憂鬱情緒狀態;病患主要是運用問題導向因應行為來調適疾病相關之壓力。病患之壓力與生活品質有正相關性(γ = .37,p = .01),與憂鬱有負相關性(γ = .35,p = .01);因應行為與壓力、生活品質及憂鬱均無相關性(p>.05)。實施因應訓練後結果發現,實驗組比控制組病患有顯著降低憂鬱情緒(t = 3.47,p=.001)及提昇身體構面生活品質(t = 2.81,p = .01)之成效;但對壓力感受及因應行為,兩組間則無顯著之差異。
本研究結果可提供給血液透析單位及照護人員之因應訓練模式參考,以協助洗腎病人面對長期治療之調適。
The purpose of this study was to evaluate the effectiveness of coping skills training in coping, perception of stress, depression and quality of life of end-stage renal disease (ESRD) patients who were receiving hemodialysis treatment. The study was a pretest-posttest experimental design, 48 qualified patients from a medical center in the Northern Taiwan were included in the study. Subjects were randomized into experiment or control groups. Measures include the Hemodialysis Stressors Scale, the Ways of Coping Checklist, the Beck Depression Inventory, and the MOS SF- 36. Subjects in the experimental group received weekly section of coping skills training for eight weeks, whereas subjects in the control group only received unit routine care. Data were collected at baseline and a week following the coping skills training. Data were analyzed by using the SPSS 10.0 for Windows software. Data analyses included descriptive statistics, t-test, Pearson’s correlation, Paired t-test and analysis of covariance.
Results of descriptive statistic indicated that ESRD patients had a low level of stress and demonstrated a below normal level of life quality. Nearly 60% of subjects showed a depressed mood. Subjects have mainly used problem-focused coping strategies to deal with illness-related stress. The findings in this study showed that patients who were receiving skills coping training scored significant lower in depression (t = 3.47,p = .001) and significantly improved in physical component score of the quality of life (t = 2.81,p = .01) than patients in the control group. However, there were no significant differences in the perception of stress and coping strategies that were used between groups.
This study provided an interventional model for health care providers who are taking care of hemodialysis patients.
目 錄 頁 數
中文摘要……………………………………………………………Ι
英文摘要……………………………………………………………Ⅲ
目 錄……………………………………………………………Ⅴ
圖表目錄……………………………………………………………Ⅶ
第一章 緒論…………………………………………………………1
第一節 研究研究動機與重要性…………………………………1
第二節 研究目的…………………………………………………3
第二章 文獻查證……………………………………………………4
第一節 末期腎疾病………………………………………………4
第二節 末期腎疾病病人的壓力探討……………………………5
第三節 末期腎疾病病人的因應行為探討………………………8
第四節 末期腎疾病病人的生活品質探討 ……………………15
第五節 末期腎疾病病人的憂鬱探討 …………………………18
第六節 結論 ……………………………………………………21
第三章 研究方法與步驟……………………………………………22
第一節 研究架構 ………………………………………………22
第二節 名詞界定 ………………………………………………23
第三節 研究假設 ………………………………………………24
第四節 研究設計 ………………………………………………25
第五節 研究場所與對象 ………………………………………26
第六節 研究工具 ………………………………………………27
第七節 研究步驟 ………………………………………………35
第八節 資料處理與分析 ………………………………………36
第四章 研究結果……………………………………………………38
第一節 研究對象基本資料的分析 ……………………………38
第二節 ESRD患者各變項前、後測之得分狀態 ………………42
第三節 ESRD患者各變項之相關性分析 ………………………53
第四節 ESRD因應技能訓練介入後之成效 ……………………54
第五節 因應訓練活動之評值與成效 …………………………59
第五章 討論……………………………………………………………62
第一節 研究對象的基本資料及疾病相關特質特性 …………62
第二節 ESRD患者等變項間之相關性 …………………………63
第三節 ESRD患者等變項於因應訓練活動實施後之影響成效 64
第六章 結論與建議……………………………………………………72
第一節 結論………………………………………………………72
第二節 建議………………………………………………………73
參考資料
中文部分 …………………………………………………………76
英文部分 …………………………………………………………79
附錄目次
附錄一 研究同意書………………………………………………87
附錄二 專家效度名單……………………………………………89
附錄三 「MOS SF-36」允用同意書 ……………………………90
附錄四 研究全份問卷……………………………………………91
附錄五-1因應訓練活動進度表…………………………………131
附錄五-2因應訓練活動教案……………………………………132
附錄五-3因應訓練手冊「腎友成長團體」……………………141
圖表目次
Figure 3-1 Conceptual Framework for this study………22
Figure 2 Pretest and posttest score of studied variables between groups……………………………………48
Table 3-1 Research Design for This Study………………26
Table 3-2 Cronbach’s Alpha of Measures Tools ………34
Table 4-1 Comparison of Demographic and
Disease-Related Variables Between Groups(N=48)…41
Table 4-2 Comparison of Demographic and
Disease-Related Variables Between Groups(N=48)…42
Table 4-3 Comparison of Pretest and
posttest Means Between Groups……………………………49
Table 4-4 Stressors for Hemodialysis Patients(N=48)…51
Table 4-5 Category of Depression
for hemodialysis patients(N=48)……………………52
Table 4-6 Correlation of Stress, Coping, SF-36
and Depression Between Groups (N=48) ……………53
Table 4-7 Comparison Paired t-test
Between Groups(N=48) …………………………………58
Table 4-8 Comparison Independent t-test
Between Groups(N=48) …………………………………58
Table 4-9 Evaluation for coping skills
training(N=20) …………………………………………61
Table 4-10 Evaluation for coping skills
training(N=20) …………………………………………61
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