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研究生:許華雲
研究生(外文):Hwa-yun Sheu
論文名稱:帕金森氏病患者疲憊感及生活品質之相關探討
論文名稱(外文):Factors Related to Fatigue and Quality of Life in Parkinson’s disease Patient
指導教授:黃子庭黃子庭引用關係
指導教授(外文):Tzu-ting Huang
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:2007
畢業學年度:95
語文別:中文
論文頁數:198
中文關鍵詞:帕金森氏病疲憊感生活品質
外文關鍵詞:Parkinson’s diseasefatiguequality of life
相關次數:
  • 被引用被引用:4
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  • 下載下載:0
  • 收藏至我的研究室書目清單書目收藏:6
中 文 摘 要
帕金森氏病是典型的慢性退化性疾病,造成身體功能障礙是不
可恢復的,漫長的罹病期間需承受許多生理、心理、社會等多重層面
的不適與壓力,本研究目的主要暸解帕金森氏病患者之疲憊感與
生活品質,及分析人口學特性、罹病期間、疾病特性、憂鬱、睡眠品
質、社會支持與疲憊感及生活品質間的關係,並找出疲憊感與生活品
質的預測因子。本研究為橫斷性、相關性之研究設計,採方便取樣,
以結構式問卷收集資料。以北部一所醫學中心神經科病房的原發性帕
金森氏病患者為研究對象,有效樣本100位,研究工具有:個人基本
資料表、帕金森氏病統一評估量表、疲憊嚴重程度量表、疼痛視覺類
比量表、台灣人憂鬱量表、社會支持量表、匹茲堡睡眠品質量表、帕
金森氏病生活品質問卷;本研究所得資料使用SPSS for Window 10.0
中文版套裝軟體,以描述性統計、獨立樣本t檢定、單因子變異數
分析、皮爾森積差相關、及複迴歸進行資料分析。
研究結果發現:
1.疲憊感:(1)帕金森氏病患者疲憊感平均得分為3.75 分 (SD =
1.89),其中46.0%(n = 46)有明顯的疲憊感(FSS ≥ 4);(2)
帕金森氏病的症狀、病程分級、每日服用L-dopa劑量(mg)、疼
痛、憂鬱、及睡眠品質與疲憊感呈顯著正相關,但日常生活功能
與疲憊感呈顯著負相關;(3)憂鬱程度高者是唯一預測疲憊感的
重要因子,可解釋45.0%的變異量。
2.生活品質:(1)帕金森氏病患者生活品質標準化平均得分為32.38
分(SD = 22.69);(2)帕金森氏病的教育程度、婚姻狀態、目前
工作狀況與生活品質有顯著差異,罹病期間、帕金森氏病的症狀、
病程分級、每日服用L-dopa劑量(mg)、疼痛、憂鬱、睡眠品質、
及疲憊感與生活品質呈顯著正相關,但日常生活功能與生活品質呈
顯著負相關;(3)影響生活品質預測的重要因子,包含:日常生
活功能佳、憂鬱程度低、疲憊感輕、每日服用L-dopa劑量(mg)
小,共可解釋80.0%變異量。此研究結果將可提供臨床醫護人員,
在提昇帕金森氏病患者照護品質之參考。
Abstract
Parkinson’s disease is a chronic and progressive neurodegenerative disease. Duration of disease is associated with a significant burden of physical, psychological, and psychosocial. The purpose of this study were to investigate the fatigue and quality of life in patients with Parkinson’s disease, to examine the correlates among personal attributes, duration of disease, disease characteristics, depression inclination, quality of sleep,
social support, fatigue and quality of life, and to explore the predictable factors that affect fatigue and quality of life. The study is a cross-sectional design, one hundred subjects of purposive samples were collected from a medical center in northern Taiwan. Instruments were structured questionnaire including: personal demographic data, Unified Parkinson,s Disease Rating Scale (UPDRS), Hoehen and Yahr stage, Schwab and England Score, Visual Analogue Scale (VAS), Taiwanese Depression Questionnaire (TDQ), Social Support Scale, Pittsburgh Sleep Quality Index (PSQI), Fatigue Severity Scale (FSS), Parkinson’s Disease Quality of Life Questionnaire (PDQ-39). The collected data was analyzed
by descriptive statistics, independent t-test, one-way ANOVA, Pearson product-moment correlation, and multiple regression with using the SPSS for Window 10.0. The results as follows :
1. fatigue (1) The average FSS of total subjects was 3.75 (SD = 1.89),About 46% of the Parkinson’s disease patient had fatigue inclination.
(2) UPDRS total score, Hoehen and Yahr stage, daily L-dopa dose
(mg), pain, depression inclination, quality of sleep and fatigue was positively correlated; Schwab and England score and fatigue was
negatively correlated. (3) Depression inclination explain 45.0% of the variance of fatigue among subjects.
2. Quality of life: (1) The standardized score of PDQ-39 average of total subjects was 32.38 (SD = 22.69), (2) There were significant differences in education, marital status, occupation in quality of life. Duration of disease, UPDRS total score, Hoehen and Yahr stage, daily L-dopa dose (mg), pain, depression inclination, quality of sleep, fatigue and quality of life was positively correlated; Schwab and England Score and quality of life was negatively correlated. (3) Schwab and England Score, depression inclination, fatigue, and daily L-dopa dose (mg),explain 80.0% of the variance of quality of life among subjects. We may apply these results to promote health care quality for Parkinson’s disease patient.
目錄
指導教授推薦書
口試委員會審定書
頁數
受權書………………………………………………………………….iii
誌謝……………………………………………………….…………….iv
中文摘要…………………………………………….………….……….v
英文摘要……………………………………………………………….vii
目錄……………………………………………………….…………….ix
本文目錄………………………………………………………..……….x
圖表目錄…………………………………………………………….…xii
附錄目錄……………………………………………………….……….xv

本文目錄
第一章 緒論
第一節 研究重要性………………………………………………1
第二節 研究動機…………………………………………………4
第三節 研究目的............................................................................6
第四節 研究問題…………………………………………………6
第五節 名詞界定…………………………………………………7
第二章 文獻探討
第一節 帕金森氏病………………………………………………12
第二節 疲憊感…………………………………………………….27
第三節 生活品質………………………………………………….47
第三章 研究方法和過程
第一節 研究設計…………………………………………………..64
第二節 研究架構…………………………………………………..64
第三節 研究場所與對象…………………………………………..69
第四節 資料收集過程……………………………………………..70
第五節 研究工具及其信效度……………………………………..71
第六節 資料分析…………………………………………………..83
第七節 人權考量…………………………………………………..85
第三章 研究結果
第一節 研究對象之描述性資料…………………………………….87
第二節 研究對象之疲憊感相關影響因素及預測因子…………...106
第三節 研究對象之生活品質相關影響因素及預測因子………...113
第五章 討論
第一節 疲憊感及其相關影響因素及重要預測因子……………...130
第二節 研究對象之生活品質及其相關影響因素及重要預測
因子………………………………………………………..141
第六章 結論與建議
第一節 研究結論……………………………………………………155
第二節 建議…………………………………………………………157
第三節 研究限制……………………………………………………160
參考文獻………………………………………………………………161
中文部分………………………………………………………………161
英文部分………………………………………………………………167

圖 表 目 錄
圖次
圖2-1 統合疲憊感模式圖…………………………………………..33
圖3-1 研究概念架構圖……………………………………………..65
圖3-2 本研究概念架構與統合疲憊感模式結合圖………………..67
圖3-3 帕金森氏病患者疲憊感及生活品質之相關研究架構圖.….68
圖4-1 帕金森氏病患者疲憊感之標準化殘差值的次數分配直方
圖…………………………………………………………….112
圖4-2 帕金森氏病患者疲憊感之標準化殘差值的常態機率分佈
圖…………………………………………………………….112
圖4-3 帕金森氏病患者疲憊感之預測值與殘差值的散佈圖…….113
圖4-4 帕金森氏病患者整體生活品質之標準化殘差值的次數分配直
方圖…………………………………………………………..123
圖4-5 帕金森氏病患者整體生活品質之標準化殘差值的常態機率分
佈圖…………………………………………………………..123
圖4-6 帕金森氏病患者整體生活品質之預測值與殘差值的散佈
圖………………………………………………………..……124
圖4-7 帕金森氏病患者疲憊感與生活品質之相關因素圖………..126
圖4-8 預測帕金森氏病患者疲憊感與生活品質之相關因素圖…..127
表次
表2-1 常用抗帕金森藥……………………………………………...17
表2-2 與左多巴胺使用相關的運動功能障礙………………………19
表2-3 抗帕金森氏病藥物優缺點……………………………………23
表2-4 影響疲憊感相關因素…………………………………………34
表2-5 帕金森病患疲憊感之相關研究………………………………46
表3-1 睡眠品質表計分方式與意義…………………………………81
表3-2 資料統計分析方法…………………………………………….83
表4-1-1 研究對象之人口學資料………………………………………88
表4-1-2 研究對象之疾病特性、憂鬱、睡眠品質與社會支持……….90
表4-1-3 睡眠困擾各題分佈……………………………………………94
表4-1-4 帕金森氏病患睡眠品質之分佈情形…………………………97
表4-1-5 帕金森氏病患社會支持及各範疇得分………………….....100
表4-1-6 研究對象社會支持提供者分佈情形……………………….100
表4-1-7 疲憊感分佈情形…………………………………………….101
表4-1-8 生活品質及其各層面之分析……………………………….104
表4-1-9 帕金森氏病患生活品質各題得分與排序………………….105
表4-2-1 人口學資料與疲憊感之差異分析………………………….109
表4-2-2 疾病嚴重度、疼痛、憂鬱、睡眠品質、社會支持與疲憊感
之相關分析…………………………………………….……111
表4-2-3 研究對象之疲憊感複迴歸分析及各變項之共線性診斷
表..….…………………………………………….………..113
表4-3-1 人口學基本特性與生活品質之差異分析…..…………….122
表4-3-2 罹病期間、疾病嚴重度、藥物劑量、疼痛、憂鬱、睡眠品質、
社會支持、疲憊感與生活品質之相關分析……………….123
表4-3-3 研究對象之生活品質複迴歸分析及各變項之共線性診斷
表……………………………………………………………126
表5-1-1 研究對象之憂鬱傾向與有、無疲憊感的卡方檢定表……..137
表5-1-2 研究對象之憂鬱傾向與睡眠品質良好、差的卡方檢定表.138


附 錄 目 錄
附錄一 研究正式問卷……………………………………………….179
附錄二 研究工具使用同意書……………………………………….193
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