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研究生:游瓊瑤
研究生(外文):Chiung-Yao Yu
論文名稱:充血性心臟衰竭病患疲憊相關因素之探討
論文名稱(外文):Fatigue and its related factors on patients with congestive heart failure
指導教授:唐婉如唐婉如引用關係
指導教授(外文):Woung-Ru Tang
學位類別:碩士
校院名稱:長庚大學
系所名稱:護理學研究所
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:2005
畢業學年度:93
語文別:中文
論文頁數:85
中文關鍵詞:充血性心臟衰竭疲憊
外文關鍵詞:congestive heart failureFatigue
相關次數:
  • 被引用被引用:10
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  • 下載下載:212
  • 收藏至我的研究室書目清單書目收藏:11
本研究目的主要探討心臟衰竭病患之疲憊感及其相關因素。為描述性相關性設計,採立意取樣,以北部某醫學中心心臟內科病房的心臟衰竭病患107位為研究對象,進行結構式問卷訪談,所收集的資料,包括基本人口學、心臟射出分率(EF)、血紅素(Hb)、收縮性血壓(SBp)、舒張性血壓(DBp)、身體活動功能狀態、疼痛強度、及憂鬱。
在疲憊的測量上,由於疲憊是本研究最主要的結果變項,故除了使用知名的Lee’s疲憊量表(VAS-F)之外,亦使用一份新發展的唐氏疲憊量表(TFRS)來增加對此概念的了解。資料分析結果顯示:
(1)心臟衰竭病患之疲憊感傾向中等程度。
(2) 女性病患疲憊程度高於男性。
(3)有服用β阻斷劑的病患疲憊程度顯著高於沒有使用者。
(4) NYHA、憂鬱與疲憊呈顯著正相關。
(5) EF值、Hb值、身體活動功能與疲憊感呈顯著負相關。
(6)研究結果顯示TFRS具有良好的信、效度。
以TFRS為依變項,憂鬱、NYHA、EF值為自變項,進行複迴歸分析,共可解釋73%變異量,其中憂鬱、EF、NYHA為預測疲憊重要的因子。
本研究證實了心臟衰竭病患的EF值低、NYHA分級愈高及憂鬱程度愈高會加重心臟衰竭病患之疲憊感,醫護人員應運用合宜的疲憊量表評估病患之疲憊程度,即時提供介入措施來提升心臟衰竭病患之照護品質。
The purpose of this study is to discuss the fatigue experienced by patients with heart failure. This study adopted descriptive and relational design, as well as purposeful sampling, and studied 107 patients with heart failure in a cardiology ward of a medical center in Northern Taiwan by structural interview. The data were collected on demography, physiological data (EF, Hb, SBp, DBp), physical performance states, intensity of pain, depression, and fatigue. Since fatigue is the most important outcome variable in this study, aside from Lee’s Fatigue Visual Analog Scale (VAS-F), this study adopted a newly developed fatigue scale —Tang Fatigue Rating Scale (TFRS), to gain a better understanding on the symptom. The data analysis showed that:
1.The fatigue experienced by heart failure patients is medium.
2.Female CHF patients have more fatigue than male CHF patients.
3.The fatigue experienced by heart failure patients taking β blocker is higher than others not taking β blocker.
4.NYHA and depression are positively correlated with fatigue.
5.EF, Hb, and physical performance states are negatively correlated with fatigue.
6.TFRS has good reliability and validity to measure fatigue.
Using TFRS as the dependent variable and depression, EF, and NYHA as the independent variables for multiple regression analysis, 73% of variance was explained by the independent variables. Depression, EF, and NYHA are significant predictors of fatigue.
This study showed that low EF, higher NYHA, and higher depression would intensify the fatigue experienced by patients with heart failure. The results could be provided as a guideline to medical staff when caring for patients with heart failure.
目 錄
指導教授推薦書......................................................................
論文口試委員會審定書..............................................................
國科會授權書.............................................................................. iii
國家圖書館授權書...................................................................... iv
長庚大學授權書.......................................................................... v
誌謝.............................................................................................. vi
中文摘要.................................................................................................... vii
英文摘要...................................................................................... viii
目錄.............................................................................................. ix
附錄目錄...................................................................................... xi
圖表目錄...................................................................................... xi
第一章 緒 論............................................................................ 1
第一節 研究背景及重要性…………………………………...... 1
第二節 研究目的及研究問題.....……………………………... 3
第三節 名詞界定.................................................................. 3
第二章 文獻查證...................................................................... 4
第一節 心臟衰竭病患的身心反應...................................... 4
第二節 疲憊的概念.............................................................. 9
第三章 研究方法...................................................................... 25
第一節 研究架構.................................................................. 25
第二節 研究設計與研究對象.............................................. 26
第三節 研究工具.................................................................. 26
第四節 資料收集方法.......................................................... 32
第五節 資料分析方法.......................................................... 34
第四章 研究結果...................................................................... 39
第一節 研究對象之基本屬性............................................. 39
第二節 各量表之得分......................................................... 41
第三節 各量表之信度分析................................................. 44
第四節 各變項與疲憊感之推論性統計分析.................... 44
第五節 心臟衰竭病患疲憊的預測因子............................. 48
第五章 討論.............................................................................. 50
第一節 心臟衰竭病患的疲憊程度..................................... 50
第二節 心臟衰竭病患疲憊感與人口學變項...................... 51
第三節 心臟衰竭病患疲憊感與生理特性之相關............. 52
第四節 心臟衰竭病患疲憊感與心理特性之相關............. 55
第五節 心臟衰竭病患疲憊感的重要預測因素.................. 55
第六章 結論與建議................................................................. 57
第一節 結論.......................................................................... 57
第二節 護理上的應用.......................................................... 58
第三節 研究的限制.............................................................. 60
參考文獻...................................................................................... 61
中文部份.................................................................................. 61
英文部份.................................................................................. 62
附錄.............................................................................................. 76
附錄目錄
附錄一 病患基本資料表………………………………….. 78
附錄二 Lee’s 疲憊量表.....……………………………….. 79
附錄三 唐氏疲憊量表…………………………………...... 81
附錄四 APS-POQ疼痛次量表............................................ 82
附錄五 身體活動狀況量表(ECOG-PSR)............................ 83
附錄六 研究同意書............................... 84
圖表目錄
圖一 研究架構....................................................................... 25
圖二 資料收集流程................................................................ 33
表一 美國紐約心臟學會心臟功能分級................................ 7
表二 疲憊量表之統整............................................................ 18
表三 描述性統計分析方法.................................................... 35
表四 推論性統計分析方法.................................................... 36
表五 複回歸模式.................................................................... 38
表六 心臟衰竭病患基本資料................................................ 40
表七 心臟衰竭病患理學檢查數據分佈................................ 41
表八 各量表及次量表之得分情形........................................ 43
表九 各量表之內在一致性信度............................................ 44
表十 人口學資料與疲憊感之推論性統計分析.................... 46
表十一 各變項與疲憊之相關性................................................ 47
表十二 複回歸分析.................................................................. 49
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