臺灣博碩士論文加值系統

本研究目的主要探討影響慢性腎臟疾病患者選擇腹膜透析模式之相關因素。採橫斷式之研究設計，以立意取樣，在台北市四家醫院腎臟科門診、血液及腹膜透析中心選取慢性腎臟疾病患者為研究對象，共計收案 130名。研究工具為結構式問卷，內容包括「病患基本資料表｣、「個人因素影響量表｣、「透析模式知識量表｣、「治療因素影響量表｣、「家庭支持量表｣等五部分。資料分析包括描述性統計分析及t-test、卡方檢定(Chi-square test)、邏輯斯迴歸分析法（Logistic regression）等推論性統計以檢定出影響選擇腹膜透析模式的主要影響因子。
從邏輯斯迴歸單因子分析方法，研究結果發現：「年齡」、「教育程度」、「職業狀況」、「疾病特性」、「醫護人員的決定」、「自我照顧能力｣及「透析模式知識｣等變項達統計學上顯著意義(P< .05)。但從邏輯斯迴歸多重因子分析，結果發現，經控制其他因素的影響效應後，「自我照顧能力｣及「透析模式知識｣二項為慢性腎臟疾病患者腹膜透析模式選擇之主要影響因子。藉由本研究結果，可以提供臨床醫護人員在慢性腎臟疾病患者選擇腹膜透析模式及照護措施上一重要參考依據，期望未來的研究由瞭解相關因素影響，進而採取適當介入措施，以提昇慢性腎臟疾病患者之照護品質。

The purpose of this study was to explore the factors influencing of peritoneal dialysis modality selection in the chronic kidney disease patients. This study was a cross-sectional design with 130 chronic kidney disease patients recruited from four hospitals in Taipei. A structured questionnaire with five components was used that included: 1) Demography;2) Scale of personal factor;3) Scale of knowledge for dialysis;4) Scale of medical factor;and 5) Scale of family support.
The data were analyzed by descriptive statistical analysis, t-tests, Chi-square test. By means of univariate and multivariate logistic regression analyzed that indicated the significant predictors for peritoneal dialysis modality selection in the CKD patients.
The results of this study indicated that the significant predictors of factors influencing for peritoneal dialysis modality selection in the CKD patients by univariate logistic regression analysis were: age, educational level, occupational status, medical status, decision by nephrologists, self-care agency, and knowledge for dialysis(P< .05). The significant predictors of factors influencing for peritoneal dialysis modality selection in the CKD patients were “self-care agency” and “knowledge for dialysis” by multivariate logistic regression analysis.
The resulted of the study highlighted the important influencing factors of
peritoneal dialysis modality selection in the CKD patients. It provides important reference for CKD patients care planning, and furthermore through interventions that enhances the quality of nursing care in CKD patients.

致 謝..................................................І
中文摘要..................................................Ш
英文摘要..................................................V
目 錄................................................VІІ
圖表目次..................................................X
第一章 緒論
第一節 研究動機及重要性...................................1
第二節 研究目的...........................................3
第二章 文獻查證
第一節 慢性腎臟疾病.......................................4
第二節 透析模式...........................................8
第三節 影響選擇腹膜透析模式之因素........................14
第三章 研究方法
第一節 研究架構..........................................21
第二節 研究假設..........................................23
第三節 研究對象與場所....................................24
第四節 研究工具量表與信效度..............................25
第五節 倫理考量..........................................31
第六節 資料收集過程......................................32
第七節 資料分析方法......................................34
第四章 分析與結果
第一節 慢性腎臟疾病患者之個人因素........................36
第二節 慢性腎臟疾病患者透析模式知識之程度................45
第三節 慢性腎臟疾病患者治療因素之考量....................49
第四節 慢性腎臟疾病患者之家庭支持因素....................53
第五節 影響選擇腹膜透析模式因素之分析....................57
第五章 討論
第一節 個人因素與腹膜透析模式選擇......................68
第二節 透析模式知識與腹膜透析模式選擇..................74
第三節 治療因素與腹膜透析模式選擇......................76
第六章 結論與建議
第一節 結論 .............................................78
第二節 研究限制..........................................80
第三節 建議..............................................81
參考資料
中文部份.................................................83英文部份.................................................86
附錄
附錄一 專家效度..........................................93
附錄二 研究同意書........................................94
附錄三 病患基本資料表....................................95
附錄四 個人因素影響量表..................................98
附錄五 透析模式知識量表.................................100
附錄六 治療因素影響量表.................................102
附錄七 家庭支持量表.....................................104
圖表目次
圖一 研究架構圖..........................................22
表一 血液透析與腹膜透析之比較............................12
表二 量表信度測試結果....................................29
表三 專家內容效度評定結果................................30
表四 統計分析方法........................................35
表五 研究對象個人因素之基本屬性、疾病特性................41
表五 研究對象個人因素之基本屬性、疾病特性(續)............42
表六 研究對象個人因素之生活型態改變考慮情形..............43
表六 研究對象個人因素之自我照顧能力考慮情形(續)..........44
表七 選擇血液透析模式之透析模式知識得分情形..............47
表七 選擇腹膜透析模式之透析模式知識得分情形(續)..........48
表八 選擇血液透析模式之治療因素考慮情形..................51
表八 選擇腹膜透析模式之治療因素考慮情形(續)..............52
表九 選擇血液透析模式之家庭支持因素情形情形..............55
表九 選擇腹膜透析模式之家庭支持因素情形情形(續)..........56
表十 個人因素與腹膜透析模式選擇之影響....................59
表十一 透析模式知識與腹膜透析模式選擇之影響..............61
表十二 治療因素與腹膜透析模式選擇之影響..................63
表十三 家庭支持因素與腹膜透析模式選擇之影響..............65
表十四 經控制其他因素後影響因素與腹膜透析模式選擇之影響..67

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