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研究生:李珮甄
研究生(外文):Pei-JhenLee
論文名稱:探討台灣慢性腎臟病患生活品質
論文名稱(外文):Health-Related Quality of Life among Patients Diagnosed with Chronic Kidney Disease
指導教授:顏妙芬顏妙芬引用關係
指導教授(外文):Miaofen, 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
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:2014
畢業學年度:102
語文別:中文
論文頁數:102
中文關鍵詞:慢性腎臟病生活品質腎臟疾病生活品質量表
外文關鍵詞:Health- related quality of life (HRQOL)Chronic kidney disease (CKD)Kidney Disease Quality of Life Short Form 36 (KDQOL- 36)
相關次數:
  • 被引用被引用:5
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  • 下載下載:182
  • 收藏至我的研究室書目清單書目收藏:1
慢性腎臟病患的生活品質變化能評估醫療照護品質與預測醫療支出,現今探討慢性腎臟病患生活品質的研究,多使用一般性生活品質量表,或僅探討症狀較明顯的期別;除了易造成研究結果偏差,也無法真正瞭解其生活品質全貌。本研究目的為探討慢性腎臟病患生活品質及影響因素,採次級資料庫分析,資料來源為「世界衛生組織生活品質量表與腎臟疾病生活品質量表於慢性腎臟病患者使用之比較」研究案;原始資料來源採立意及分層取樣方式,納入南部某醫學中心、區域醫院、血液透析診所一到五期慢性腎臟病患;並以線性迴歸呈現研究結果。
研究結果顯示,腎臟疾病對每日生活影響分數最高,分數越高代表生活品質越好;高教育程度、無罹患心血管疾病為生理層面影響因子(p 〈 .005);男性、高腎絲球過濾率為心理層面影響因子(p 〈 .005);男性、未婚或無伴侶、高血清白蛋白、高腎絲球過濾率為症狀/問題層面影響因子(p 〈 .005);男性、未婚或無伴侶、高血清白蛋白、高腎絲球過濾率為腎臟疾病負擔層面影響因子(p 〈 .005);高腎絲球過濾率為腎臟疾病對每日生活影響層面的影響因子(p 〈 .005)。
女性、低教育程度、已婚、罹患心血管疾病、低腎絲球過濾率、低血清白蛋白者,為腎臟疾病生活品質受損的高危險群,建議針對高危險群施行介入措施、著重於腎臟疾病負擔層面評估。本研究結果呈現出影響腎臟病患生活品質的因素及其生活品質;有助於制定健康照護政策之參考。
The Health- related quality of life (HRQOL) of patients who have been diagnosed with chronic kidney disease (CKD) was investigated in this study. Most previous studies have not included patients representing all five stages of CKD in analyses and have used only generic instrument. Bias might occur when researchers infer results regarding HRQOL based on only some of the stages of CKD.
The cross- sectional study was conducted with purposive and stratified samplings. Patients diagnosed with CKD stage 1 to 5 were selected from medical center, local hospitals and hemodialysis clinic in Southern Taiwan. Linear regression was used. The results indicated that the Effect of kidney disease (EKD) component received the higher score among KDQOL- 36TM components, in which a higher score indicated a higher HRQOL.
And the results of linear regression analysis revealed that higher education, absence cardiovascular disease positively influence physical component summary (PCS); male gender, higher glomerular filtration rate (GFR) positively influence mentle component summary (MCS); male gender, an unmarried status, higher albumin level, higher GFR positively influence symptom/ problem related to kidney diease component (SP) and burden of kidney disease (BKD); only higher GFR influence effect of kidney disease on daily life component.
There were multiple high- risk factor of low health- related quality of life occurrence with female, low level of education, married status, cardiovascular disease, low albumin level, and low GFR level. The strongly evidence in this study indicator that health provider not only apply health promotion program to high- risk group, but also evaluation on their BKD component is more important than others.
目錄
中文摘要 I
Abstract II
致謝 V
目錄 VI
表目錄 VIII
圖目錄 X
第一章 緒論 1
第一節 研究動機與背景 1
第二節 研究目的 4
第三節 研究問題 4
第二章 文獻查證 4
第一節 健康相關生活品質定義 5
第二節 健康相關生活品質量表 6
第三節 慢性腎臟病患者生活品質現況與影響因素 7
第四節 文獻查證總結 27
第三章 研究方法與過程 29
第一節 名詞界定 29
第二節 研究設計 30
第三節 研究架構 30
第四節 研究對象 32
第五節 研究工具 34
第六節 資料收集過程 39
第七節 倫理考量 39
第八節 資料分析 39
第四章 研究結果 41
第一節 慢性腎臟病患特質分佈 41
第二節 慢性腎臟病患生活品質分數分佈 45
第三節 慢性腎臟病患生活品質與變項分佈 46
第四節 小結 56
第五章 討論 56
第一節 慢性腎臟病患基本人口學分析 56
第二節 慢性腎臟病患健康相關生活品質分數分析 58
第三節 影響變項與健康相關生活品質分析 70
第六章 結論與建議 78
第一節 結論 78
第二節 研究建議 78
第三節 研究限制 81
參考文獻 83
中文部分 83
英文部分 86
附錄 103
附錄一 腎臟疾病生活品質量表 103
附錄二 人體試驗委員會人體實驗同意書 104

表目錄
表2- 3- 1健康相關生活品質影響因素 - 人口學特質 17
表2- 3- 2健康相關生活品質影響因素 - 人口學特質 18
表2- 3- 3健康相關生活品質影響因素 - 人口學特質 19
表2- 3- 4健康相關生活品質影響因素 – 營養狀態 20
表2- 3- 5健康相關生活品質影響因素 – 營養狀態 21
表2- 3- 6健康相關生活品質影響因素 – 腎臟功能 22
表2- 3- 7健康相關生活品質影響因素 – 合併症 23
表2- 3- 8健康相關生活品質影響因素 – 合併症 24
表2- 3- 9健康相關生活品質影響因素 – 合併症 25
表2- 3- 10健康相關生活品質影響因素 – 合併症 26
表3- 5查爾森共病指標 38
表4- 1- 1慢性腎臟病患人口學變項分析 43
表4- 1- 2 慢性腎臟病患人口學變項分析 44
表4- 1- 3 慢性腎臟病患人口學變項分析 45
表4-2 慢性腎臟病患生活品質分數分佈…………………………………………45
表4- 3- 1 人口學特質、營養狀態、腎臟功能、合併症與腎臟疾病生活品質量表各層面相關性 47
表4- 3- 2 人口學特質、營養狀態、腎臟功能、合併症與腎臟疾病生活品質量表各層面單變量相關性 48
表4- 3- 3 人口學特質、營養狀態、腎臟功能與合併症對生理層面線性迴歸分析 51
表4- 3- 4 人口學特質、營養狀態、腎臟功能與合併症對心理層面線性迴歸分析 52
表4- 3- 5 人口學特質、營養狀態、腎臟功能與合併症對症狀/問題層面線性迴歸分析 53
表4- 3- 6 人口學特質、營養狀態、腎臟功能與合併症對腎臟疾病負擔層面線性迴歸分析 54
表4- 3- 7 人口學特質、營養狀態、腎臟功能與合併症對腎臟疾病對生活影響層面線性迴歸分析 55
表5- 2- 1 有參加與未參加慢性腎臟病照護計畫之人口學屬性分析…………….60
表5- 2- 2本研究與國內外腎臟疾病生活品質分數之概況 61

圖目錄
圖3- 1 研究架構圖 31
圖3- 4 原始資料收案流程 33
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