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研究生:陳佩盈
研究生(外文):Pei-Ying Chen
論文名稱:運動衛生教育介入對於慢性腎衰竭透析前期病患之成效研究
論文名稱(外文):The Effects of Exercise and Health Education Intervention for Chronic Renal Failure Predialysis patients
指導教授:高毓秀高毓秀引用關係
指導教授(外文):Yu-Hsiu Kao, Ph.D.
學位類別:碩士
校院名稱:國立台北護理學院
系所名稱:醫護教育研究所
學門:教育學門
學類:專業科目教育學類
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:130
中文關鍵詞:慢性腎衰竭透析前期疲憊憂鬱運動行為
外文關鍵詞:The chronic renal failure predialysisfatiguedepressionexercise behavior
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研究主要目的在探討慢性腎衰竭透析前期病患之運動衛教介入對實驗組研究對象之血液生化值、憂鬱、疲憊及運對行為的成效。採用實驗設計法,實驗組、對照組前後測方式進行。實驗處理是實驗組接受運動衛教,而對照組則不接受任何的實驗處理。於北部某一家醫學中心腎臟科門診篩選診斷為慢性腎衰竭尚未接受透析治療的病患為研究對象,並隨機分派至實驗組與對照組,研究期間因故流失,最後實際收案,實驗組45人,對照組49人。研究工具包括個人基本資料、運動行為量表、憂鬱評量表、疲憊評量表及血液生化值記錄表。運動衛教介入的內容包括疾病與運動、腎臟病患者的運動建議及腎臟病患者的運動計畫等。所得資料以卡方檢定、t檢定、配對t檢定、Bowker,s test of symmetry及共變數分析(analysis of covariance, ANCOVA)等方法進行分析。結果顯示運動衛教介入能顯著降低病患血中的膽固醇數值,改善憂鬱及疲憊情形,並增加運動人數與每週運動量,而在紅血球、血色素、血比容及血糖數值則無顯著差異。本研究結果可以提供慢性腎病患者運動衛教之參考,並且將運動實際融入慢性腎病患者整體照護計畫中,以提升照護之品質。
The main purpose of this study was to investigate the effects of health education on exercise as an intervention upon the predialytic phase of chronic renal failure, i the areas of blood biochemistry, depression, fatigue and exercise behavior. Experimental design and a pre-test/post-test comparison group design between a study group and control group were used in this study. The study group received health education in exercise and the control group didn't. Patients with chronic renal failure without undergoing hemodialysis were selected as the study subjects in the nephrology clinics of a medical center in northern Taiwan. Subjects were randomly distributed into the study group or control group. The total number of valid sample was 94; 45 persons in the study group and 49 in the control group. The study tool included questionnaires on personal information, exercise behavior scale, depression rating scale and fatigue rating scale and blood biochemistry test record. The content of health education on exercise included the relation between disease and exercise, suggestion of exercise and exercise program for patients with renal diseases. The data were analyzed using chi-square test, t-test, paired t-test, Bowker’s test of symmetry, and analysis of covariance (ANCOVA). Results of the study showed that exercise and health education intervention reduced fasting plasma total cholesterol level, improved depression and fatigue, and increased exercise population and amount of exercise per week. However, no significant differences were found for red blood cell(RBC), hemoglobin(Hb), hematocrit (Hct) and blood sugar. The results of this research can provide information for health education intervention on exercise in patients with chronic renal diseases. Adopting exercise as an integral part of a care program for patients with chronic renal diseases can improve the quality of care.
致 謝................................................Ⅱ
中文摘要..............................................III
英文摘要...............................................IV
目 錄................................................V
圖表目次...............................................Ⅷ

目錄
第一章 緒論
第一節 研究動機及重要性.................................1
第二節 研究目的........................................4
第三節 研究問題........................................5
第四節 研究假設........................................5
第五節 名詞界定........................................6
第六節 研究限制........................................8
第二章 文獻查證
第一節 慢性腎衰竭概述...................................9
第二節 延緩照護策略....................................11
第三節 運動對血液生化值的效應...........................15
第四節 運動對憂鬱的效應................................17
第五節 運動對疲憊的效應................................20
第六節 運動介入的成效..................................25
第三章 研究設計與方法
第一節 研究設計.......................................35
第二節 研究架構.......................................37
第三節 研究對象.......................................38
第四節 研究工具及信效度檢定............................39
第五節 資料收集過程...................................42
第六節 資料分析與處理.................................44
第七節 研究對象權益維護...............................44
第四章 研究結果
第一節 研究對象之背景資料分析..........................46
第二節 運動衛教介入前,研究對象之血液生化值、憂鬱、疲憊及運動行為的分佈情形
............................................51
第三節 運動衛教介入前後之差異.........................54
第四節 運動衛教介入之成效.............................61
第五章 討論
第一節 研究對象之背景資料.............................65
第二節 研究對象之血液生化值、憂鬱、疲憊及運動行為........66
第三節 運動衛教介入之效果.............................68
第六章 結論與建議
第一節 結論..........................................70
第二節 建議..........................................71
參考文獻
中文部分.............................................75
英文部分.............................................81
附 錄
附錄一 慢性腎衰竭透析前期病患之運動衛教成效調查問卷........93
附錄二 血液生化記錄表.................................100
附錄三 慢性腎病患者運動衛教手冊........................101
附錄四 參與研究同意書.................................114
附錄五 「貝氏憂鬱量表第二版」研究工具使用申請函...........115
附錄六 「疲憊評量表」研究工具使用同意函..................116
附錄七 「過去一年運動習慣量表」研究工具使用同意函.........117
附錄八 「運動階段量表」研究工具使用同意函................118
附錄九 研究工具內容效度之專家名單......................119
附錄十 慢性腎病患者運動衛教手冊內容效度之專家名單........120
附錄十一 人體試驗委員會同意書............................121
附錄十二 同意臨床試驗證明書..............................122

圖表目次
圖3-2-1 研究架構……………………………………………………………37
圖3-5-1 資料收集流程圖..…………………………………………………42
表2-1-1慢性腎臟疾病的分期及盛行率………………………………………9
表2-2-1 生活型態修正建議表 ……………………………………………15
表2-3-1 跨理論模式的建構~以運動為例 …………………………………32
表2-3-2 跨理論模式應用於運動衛生教育…………………………………34
表3-1-1 研究設計……………………………………………………………35
表3-4-1 Canada Fitness Surver(1983)MET換算值………………41
表3-6-1 研究目的、研究假設與統計方法…………………………………45
表4-1-1 研究對象之基本資料與卡方檢定…………………………………49
表4-2-1 前測血液生化值與兩組t檢定 ……………………………………51
表4-2-2 前測心理層面與兩組t檢 定………………………………………52
表4-2-3 前測運動階段的分佈與兩組卡方檢定……………………………53
表4-2-4 前測過去三個月運動習慣與兩組t檢定 …………………………53
表4-3-1 兩組於血液生化值前後測比較……………………………………55
表4-3-2 兩組於心理層面前後測比較………………………………………56
表4-3-3 實驗組於各運動階段前後測之比較………………………………57
表4-3-4 實驗組於各運動階段前後測之改變………………………………57
表4-3-5 對照組於各運動階段前後測之比較………………………………58
表4-3-6 對照組於各運動階段前後測之改變………………………………59
表4-3-7 兩組於過去三個月運動習慣前後測比較…………………………60
表4-4-1 各變項之組內迴歸係數同質性檢定………………………………62
表4-4-2 以兩組前測為共變項之後測共變數分析及調節後之平均值……63
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