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研究生:曾麗華
研究生(外文):Tseng, Li-Hua
論文名稱:代謝症候群於冠狀動脈繞道手術後病患其飲食習慣與生活品質之探討
論文名稱(外文):Association between diet preference and quality of life amongpost coronary artery bypass graft patients with metabolic syndrome
指導教授:童恒新童恒新引用關係
指導教授(外文):Tung, Heng-Hsin
學位類別:碩士
校院名稱:國立台北護理學院
系所名稱:護理研究所
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:2010
畢業學年度:98
語文別:中文
論文頁數:112
中文關鍵詞:代謝症候群冠狀動脈繞道手術飲食頻率生活品質
外文關鍵詞:metabolic syndromeCABGdiet preferencequality of life
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目的 為探討代謝症候群於冠狀動脈繞道術後病患其飲食習慣和生活品質及相關性之探討。
背景 台灣近年來隨著經濟的發展、人口老化與生活習慣的改變,生活飲食習慣趨向西方化,使得代謝性症候群與冠狀動脈心臟疾病的人數逐年增加,對國人健康的影響趨於嚴重。冠狀動脈繞道手術是冠狀動脈心臟病的重要治療方式之一,針對一群具有代謝症候群並罹患冠狀動脈心臟病患者,手術後能改善生活品質則是更重要的研究問題;健康的生活型態是預防冠狀動脈再阻塞所不可或缺的方式,而飲食習慣可能是個重要因子。目前證實飲食營養策略可以預防及降低冠狀動脈心臟病及相關的心血管疾病之風險。而現階段少有針對代謝症候群於冠狀動脈繞道術後病患其飲食習慣和生活品質之研究,故執行本研究,希望藉由了解其手術後之飲食型態與生活品質,以期提供術後衛教更多的資訊。
方法 本研究採橫斷式研究方法,以立意取樣,於台灣北部區域醫院,採問卷調查方式收集資料,共104人參與研究。研究工具包括個人基本資料問卷、飲食頻率問卷與SF-36臺灣版生活品質問卷。研究資料以SPSS 17.0電腦軟體建檔,統計分析包括百分比、平均值、標準差、相關係數和逐步迴歸分析。
結果 本研究結果發現研究對象於手術後所攝取的蔬菜類之頻率較低,油炸類食品較多,烹調油使用頻率偏高;性別、年齡、手術後時間、婚姻狀態、教育程度、飲酒習慣與生活品質有顯著差異。家畜瘦肉類、半肥肉、水果類、茶類與生活品質層面呈正相關;油炸食品與黃豆類製品呈負相關。典型相關分析顯示,油炸類食品之攝取頻率主要負面影響身體健康層面生活品質,水果類攝取頻率正向影響身體健康層面生活品質。以逐步迴歸分析發現年齡與攝取黃豆類製品可解釋身體健康層面生活品質27.4%之變異量;晚餐主食、年齡層、攝取黃豆類製品頻率及舒張壓可解釋心理健康層面生活品質26.8%之變異量。
結論 本研究結果可了解代謝症候群於冠狀動脈繞道手術後患者其飲食習慣之現況,以及在部分飲食頻率之攝取亦會影響生活品質。研究對象飲食型態仍應增加蔬菜之攝取,在烹調油及油炸食物的食用頻率應減少,亟需改善飲食型態的攝取種類,改善代謝症候群之相關生理指標,讓個案能獲得較佳之生活品質。研究對象之準備三餐者有半數為配偶,故指導飲食衛教時,更需著重在準備三餐者的飲食觀念與烹調方式;此結果期望可提供醫護人員在術後飲食衛教的參考,讓病患與家人有健康飲食攝取的觀念及落實。
Aim: The purpose of this study is to investigate the relationship between the diet preference and quality of life in post coronary artery bypass graft patients with metabolic syndrome.
Background: Due to the economical development, old age population, life habit alteration and western eating style in Taiwan, the amount of people having metabolic syndrome and coronary artery disease has been increasing dramatically. Coronary artery bypass graft (CABG) is an important method of treatment for coronary artery disease. For patients with metabolic syndrome and coronary artery disease, it is important to investigate how surgery may change their quality of life. Having a healthy life pattern is inevitable to prevent the re-obstruction of coronary arteries, and diet preference may be the most important factor. Recently, evidence showed that diet strategy can prevent and reduce the tendency of having coronary artery disease and related risk for heart disease. Lately, not much study has been seen in the relationship between diet preference and the quality of life in post CABG patients with metabolic syndrome.
Method: A cross-sectional study was used designed and purposively sampling was conducted in a district hospital located in the north of Taiwan. Data was collected by three questionnaires, which included demographic questionnaire, Chinese food frequency questionnaire and short form 36 for quality of life questionnaire.There were 104 samples recreated in this study. The data were managed and analyzed by using SPSS 17.0 computer software for percentage, average, standard deviation, correlation coefficient and stepwise regression.
Results: The results showed that: the patients had less preference for vegetables and eggs post operation, while they had a higher preference for fried food and used cooking oil more often; their quality of life were significantly related to sex, age, time after operation, marital status, education level and alcohol use; positively related to lean meat, half fat meat, fruits and tea; and negatively related to fried food, soybean products and smoky or grilled food. Typical correlation analysis revealed that the frequency of the preference for fried food had the main negative effect on the healthy aspect of the quality of life, and the frequency of the preference for fruits had the main positive effect on the healthy aspect of the quality of life. By stepwise regression, it showed that age and the preference for soybean products may explain the 27.4 % variance in the physical aspect of the quality of life. While other types of food as the main meal for dinner showed that age and the frequency of the preference for soybean products and diastolic pressure may explain the 26.8 % variance in the psychological aspect of the quality of life.
Conclusion: Through this study we can have a better understanding of the diet preference and quality of life for post CABG patients with metabolic syndrome. This conclusion may provide a reference for nurses when teaching instructions are given on diet for these patients.
中文摘要 i
英文摘要 iii
目次 v
表次 viii
圖次 ix
第一章 緒論 1
第二章 文獻探討 3
第一節 冠心症與冠狀動脈繞道手術 3
第二節 代謝性症候群與冠狀動脈心臟病 4
第三節 飲食習慣與代謝症候群 5
第四節 生活品質 7
第五節 飲食習慣與生活品質 8
第三章 研究方法 9
第一節 研究概念架構 9
第二節 研究問題 9
第三節 名詞界定 10
第四節 研究設計 12
第五節 研究步驟 14
第六節 倫理考量 14
第七節 研究工具 15
第八節 研究工具信度 18
第九節 研究工具效度 18
第十節 統計分析 19
第四章 研究結果 20
第一節 代謝症候群於冠狀動脈繞道術後病患之基本屬性 21
第二節 代謝症候群於冠狀動脈繞道術後病患之血液生理指標情形 與飲食頻率之描述 23
第三節 代謝症候群於冠狀動脈繞道術後病患基本屬性、生理指標、 飲食頻率之關係 29
第四節 代謝症候群於冠狀動脈繞道術後病患之生活品質 44
第五節 代謝症候群於冠狀動脈繞道術後病患之基本屬性、生理指
標、飲食習慣與生活品質之關係 46
第六節 代謝症候群於冠狀動脈繞道術後病患飲食頻率與生活品質
之典型關係 60
第七節 代謝症候群於冠狀動脈繞道術後病患基本屬性、血液生理 指標、飲食頻率與生活品質之逐步迴歸分析 64
第五章 討論 70
第一節 代謝症候群於冠狀動脈繞道術後病患基本屬性、生理指標 與飲食頻率 70
第二節 代謝症候群於冠狀動脈繞道術後病患之生活品質 74
第三節 代謝症候群於冠狀動脈繞道術後病患基本屬性、生理指標、 飲食習慣與生活品質之相關性探討 75
第四節 代謝症候群於冠狀動脈繞道術後病患飲食頻率與生活品質 之相關性探討 81
第五節 代謝症候群於冠狀動脈繞道手術後病患之生活品質的預測 82
第六章 結論 84
第七章 限制與建議 86
第一節 研究限制 86
第二節 研究建議 87
參考文獻 88
中文部分 88
外文部分 92
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