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研究生:王俞蓉
研究生(外文):Yu-Rung Wang
論文名稱:探討生活型態對早期慢性腎臟病患之影響-病例對照研究
論文名稱(外文):Lifestyle Related Factors on the Risk of Early-stage Chronic Kidney Disease - A Case-control Study
指導教授:顏妙芬顏妙芬引用關係
指導教授(外文):Miao-fen Yen
學位類別:碩士
校院名稱:國立成功大學
系所名稱:護理學系碩博士班
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:2008
畢業學年度:96
語文別:中文
論文頁數:102
中文關鍵詞:慢性腎臟疾病病例對照研究生活型態
外文關鍵詞:chronic kidney diseaselifestylecase-control study
相關次數:
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台灣地區慢性腎臟病患逐年增加,近年來透析發生率更高居全球之冠。早期慢性腎臟病可能是由於不健康的生活型態,以及對疾病的低察覺度等原因,造成其迅速惡化至末期腎臟病。因此,本研究將探討可能造成早期慢性腎臟病惡化的原因,包括慢性人口學變項、危險因子,以及生活型態等因素,並經由與無慢性腎臟病者比較,進而找出影響慢性腎臟疾病的最重要因素。
本研究為病例對照研究,並使用次級資料分析,分析2006年國科會計劃「早期慢性腎疾病患者生活型態相關因素探討」三年計畫中第一與二年計畫資料。該資料以南部四家教學醫院慢性腎臟病患與鄰近社區居民為研究對象,經由區域、年齡與性別配對後,選取病例組為慢性腎臟病患,以及對照組為無慢性腎臟病者,各92份資料。本研究以「健康促進生活型態量表」與「每週身體活動評估量表」進行施測。資料採用獨立 t-檢定、卡方檢定與邏輯式回歸等方法進行統計分析。
研究結果顯示:(1)在危險因子方面,高血壓、糖尿病與身體質量指數較高者,罹患慢性腎臟病的機率較高;(2) 在生活型態方面,「健康責任」與「身體活動」頻率較低者,與身體活動量不足者,得到慢性腎臟病的機率將會增加。根據本研究結果,建議預防慢性腎臟病發生,應宣導慢性腎臟病患了解疾病對健康的威脅,主動尋求醫療照護,並教導其健康的生活型態。另外,對於已經罹患慢性疾病與身體質量指數過高患者,應進一步檢查並留意腎臟功能,以避免可能導致慢性腎臟病。
The number of chronic kidney disease patients has been increased gradually. In Taiwan, the use of hemodialysis therapies for end-stage renal failure patients is on the top list from a worldwide survey. Abnormal lifestyles and low awareness are considered as possible factors underlying the progression of chronic kidney disease to end-stage renal failure. The purpose of this study was to identify the risk factors, including demographic and lifestyle, for early stage chronic kidney disease. By comparing with the non-chronic kidney disease population, the major risk factors for renal failure were evaluated.
This was a case-control study with secondary data analysis. The original data is from the research project entitled “Investigating the Lifestyle and Its Related Factors among Patients with Chronic Kidney Disease in the Early Stages.” This study represents the first 2 years’ work of a 3-year project funded by the National Science Council, 2006. Some of the samples were collected from patients with chronic kidney disease at 4 hospitals in southern Taiwan; other samples were obtained from people living in the local neighborhood of the hospitals. These samples were categorized as chronic kidney disease (n = 92) and the non-chronic kidney disease population (n = 92); both sample categories were sub-grouped by area, age, and gender. Each individual enrolled in the study was tested using the “Health Promotion Lifestyle Profile-II” (HPLP-II) and the “Typical Week Physical Activity Survey” (TWPAS). Independent t-test, chi-square and logistic regression were applied for statistical analysis.
The results of this study indicated the following: (1) diseases including hypertension and diabetes, and a high body mass index (BMI) were positively correlated with chronic kidney disease; and (2) in terms of lifestyles, inattention to physical activity, external problems disease management, personal health management and insufficient amounts of physical activity might increase the possibility of renal disease. The result of this study suggested that it is crucial to educate patients for better understanding of health threats of the disease, and to suggestion them actively seeking medical care, in order to postpond the deterioration of renal function. In addition, for those patients with chronic disease and overweight particular attention should be paid to regularly examining them renal function in order to prevent the potential development of chronic kidney disease.
中文摘要 I
英文摘要 II
致 謝 IV
第一章 緒論 1
第一節 研究重要性及動機 1
第二節 研究目的與問題 3
第二章 文獻查證 4
第一節 生活型態之定義 4
第二節 生活型態量表發展與相關之研究 8
生活型態量表發展 8
生活型態量表相關之研究 10
第三節 早期慢性腎臟病之定義與照護 13
第四節 生活型態對慢性腎臟病之影響相關研究 16
人口學變項與慢性腎臟病相關之研究 16
危險因子與慢性腎臟病相關之研究 19
中草藥認知與慢性腎臟病之相關研究 25
身體活動量與慢性腎臟病之相關研究 27
第三章 研究方法與過程 29
第一節 研究架構 30
第二節 名詞解釋 31
第三節 研究假設 34
第四節 研究樣本 35
第六節 研究過程 40
第七節 倫理考量 41
第八節 資料分析 42
第四章 研究結果 44
第一節 慢性腎臟病患與無腎臟病者之人口學變項分佈與分析 44
第二節 慢性腎臟病患與無腎臟病者之危險因子變項分析 47
第三節 慢性腎臟病患與無腎臟病者之生活型態變項分析 49
第四節 人口學變項、危險因子、生活型態對影響慢性腎臟病之預測 52
第五節 生活型態量表顯著次量表分析 57
第五章 討論 60
第一節 早期慢性腎臟病患之人口學變項、危險因子、生活型態的現況 60
早期慢性腎臟病患之人口學變項 60
早期慢性腎臟病患之危險因子 62
早期慢性腎臟病患生活型態 63
第二節 人口學變項、危險因子、生活型態對影響慢性腎臟病之因素 66
人口學變項影響有無慢性腎臟病的重要因素 66
危險因子影響有無慢性腎臟病的重要因素 67
生活型態影響有無慢性腎臟病的重要因素 68
第六章 結論與建議 71
第一節 結論 71
第二節 研究結果應用與建議 72
第三節 研究限制 74
參考文獻 75
圖 目 錄
圖3-1 探討早期慢性腎臟病患之生活型態研究架構圖 30
圖3-2 資料收集之流程圖 40
表 目 錄
表3-1 描述性統計與推論性統計 43
表4-1 研究樣本人口學變項分布-類別變項 46
表4-2 研究樣本危險因子分布-類別變項 48
表4-3 研究樣本危險因子分布-連續變項 48
表4-4 研究樣本生活型態分佈-連續變項 51
表4-5 研究樣本生活型態分佈-類別變項 51
表4-6 人口學變項、危險因子與生活型態對有無腎臟病的預測模式 54
表4-7 控制顯著人口學變項、危險因子與生活型態對有無腎臟病的預測模式 56
表4-8 健康責任與身體活動於有無慢性腎臟病患之差異 59
附 錄
附錄一、人體試驗委員會同意臨床試驗證明書 91
附錄二、慢性腎臟病患基本資料問卷 92
附錄三、社區民眾基本資料問卷 94
附錄四、生活型態問卷 96
附錄五、每週身體活動評估量表 99
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