臺灣博碩士論文加值系統

背景：子宮內膜異位症雖不是致命的疾病，但所伴隨的月經不適或其他腸胃症狀對於女性的生理、心理、生活及經濟等帶來極大的影響及困擾，因此也唯有實際了解子宮內膜異位症婦女日常生活中的自我照顧行為，方能提供婦女個別化護理計劃基礎，建立與子宮內膜異位症共存的新健康生活方式，以提昇婦女的生活品質及身、心與社會各層面最佳狀態
目的：(一)瞭解子宮內膜異位症婦女的症狀困擾、自我照顧行為與健康生活品質概況﹔(二)探討子宮內膜異位症婦女的人口學屬性、疾病特性與健康生活品質的相關性﹔(三)探討子宮內膜異位症婦女的症狀困擾、自我照顧行為與健康生活品質的相關性﹔(四)探討子宮內膜異位症婦女人口學屬性、症狀困擾、自我照顧行為對健康生活品質之預測性。
方法：本研究採取描述性、橫斷式相關性研究設計，研究對象為經婦科醫師臨床上診斷為子宮內膜異位症患者，共收案216人，以方便取樣方式，採用結構式問卷「子宮內膜異位症症狀困擾」、「自我照顧行為」及「健康生活品質量表EHP-5」，進行面對面訪談調查，以 SPSS 20.0 for windows進行t檢定或ANOVA檢定、皮爾森積差相關檢定及多元(複)迴歸分析。
結果：(一)、子宮內膜異位症健康生活品質、症狀困擾、自我照顧行為的狀況：
子宮內膜異位症對整體健康生活品質的影響約在中等程度，平均得分為40.5分，在影響五大層面生活品質上的程度，以情緒安適層面最高(46.75分)，其次依序的影響層面為控制與無力感(44.5分)、疼痛層面(41.25分)、以社會支持(37.50分)與自我形象(32.50分)的影響最低。子宮內膜異位症最常見的症狀困擾為經痛、月經量、疲勞、腹痛及鬱悶的心情，研究得知最常使用的自我照顧行為有避免吃冰冷食物、多休息、避免做激烈的運動、喝溫開水及依照醫師指示來服用藥物緩解疼痛等自我照顧行為策略。(二)、子宮內膜異位症婦女健康生活品質的相關因素婚姻、教育程度、月經天數、月經週期與自覺經血量與健康生活品質各層面有顯著差異，初經年齡與健康生活品質各層面呈負相關。症狀困擾愈嚴重健康生活品質愈差，自我照顧行為愈好健康生活品質愈佳。(三)、重要的健康生活品質預測因子本研究結果顯示子宮內膜異位症之症狀困擾及教育程度及初經年齡、月經週期、月經天數及自覺經血量與自我照顧行為可預測其健康生活品質解釋變異量為65%。
結論與建議：提供疾病症狀自我照顧相關策略，以增加婦女對自我照顧策略的了解，協助婦女減輕壓力及尋求病友間的支持，互相交流，提供臨床醫護人員在職教育之參考，在護理教育方面應加入症狀困擾、自我照顧行為與影響健康生活品質的層面，提升醫護人員對於子宮內膜異位症婦女身心問題照護及處理，提供更適切的照護。

Background: Endometriosis is not a deadly disease; however menstruation brings discomfort or gastrointestinal symptoms which have great impact and bring distress to women's physical, psychological, and economic lifestyle. Therefore the daily self-care routines in women with endometriosis should be understood for several reasons. First, this information is needed in order to provide a basis for women's individualized nursing care programs. Secondly, this establishes new healthy lifestyles that coexist with endometriosis. Finally, it will improve women's quality of life and offer the best condition for physical, mental, and social status.

Purpose: 1) To understand symptoms of distress, self-care behaviors, and health-related information regarding the quality of life among women with endometriosis, 2) To explore the correlation of demographics, disease characteristics, and health-related quality of life among women with endometriosis, 3) To explore the correlation of symptoms of distress, self-care behaviors, and health-related quality of life among women with endometriosis, and 4) To study predictors of health-related quality of life.

Methods：This research is a cross-sectional correlation study of 216 women who were classified with endometriosis. The participants answered various questionnaires which included：「symptoms of distress with endometriosis」、「self-care behaviors」、「Endometriosis Health Profile Questionnaire-5 (EHP-5)」. Data was processed by SPSS 20.0 for Windows. The major statistical procedures applied were：descriptive statistics, T test, one way ANOVA, Pearson correlation, and multiple linear regression（MLR）

Results: 1) Endometriosis’ impact on the quality of life is middle-level with an average score of 40.5. In the five categories describing quality of life, the highest is level of emotional well-being (46.75). Next follows the levels of control and powerlessness at 44.5, level of pain at 41.25, and social support at 37.50. The level of self-image is the lowest impact (32.50). The most common symptoms of distress of endometriosis are menstrual pain, menstrual flow, fatigue, abdominal pain, and depressed mood. The study found that the common strategies of self-care behaviors are as follows: to avoid eating cold food, to get more rest, to avoid intense exercise, to drink warm water, and to follow the doctor's prescription to take medicine. 2) There are significant differences in health-related quality of life among women with endometriosis which include marital status, education level, menstrual days, menstrual cycle, and conscious menstrual flow volume. There is a negative correlation between the age when the women first started menstruating and all categories of health-related quality of life. The worse the symptoms of distress are, the worse the health-related quality of life. Conversely, the better the self-care behaviors are implemented, the better quality of life, 3) This study shows that the predictors of health-related quality of life are: symptoms of distress, education level, the starting age of menstruation, menstrual cycle, menstrual days, conscious menstrual blood flow volume, and self-care behaviors. All of these points can predict the quality of life up to 65%.

Conclusion and Suggestion: The findings of this study help provide self-care strategies
for women with endometriosis and enable them to relieve stress, seek support, and exchange information with each other. The symptom of distress of endometriosis, self-care behaviors, and health-related quality of life should be included in on-the-job education for health care providers to improve quality of care.

中文摘要 ………………………………………………………………………… i
英文摘要………………………………………………………………………… ii
目次 ……………………………………………………………………………… iii
表次……………………………………………………………………………… v
圖次……………………………………………………………………………… vi
第一章 緒論
第一節 研究背景與動機 ……………………………………………………..1
第二節 研究目的 …………………………………………………………… 3
第三節 研究問題 …………………………………………………………… 3
第四節 研究假設 …………………………………………………………… 4
第五節 名詞定義 …………………………………………………………… 4
第二章 文獻探討
第一節 子宮內膜異位症致病因及治療…………………………………… 6
第二節 子宮內膜異位症婦女的健康生活品質…………………………… 9
第三節 子宮內膜異位症婦女健康生活品質相關影響因素………………12
第三章 研究方法
第一節 研究設計 ………………………………………………………… 16
第二節 研究架構 ………………………………………………………… 17
第三節 研究對象與場所…………………………………………………..17
第四節 研究工具 ………………………………………………………… 18
第五節 資料處理與分析 ………………………………………………… 21
第六節 研究倫理考量 …………………………………………………… 22
第四章 研究結果
第一節 研究對象的基本人口學分佈情形………………………………… 23
第二節 症狀困擾、自我照顧行為與健康生活品質分佈情形…………… 25
第三節 人口學屬性、症狀困擾、自我照顧行為與健康生活品質之相關性 31
第四節 子宮內膜異位症婦女健康生活品質之預測因子…………………… 36
第五章 討論
第一節 子宮內膜異位症婦女基本人口學流行率分析……………………… 37
第二節 子宮內膜異位症婦女健康生活品質、症狀困擾及自我照顧行為討論……………………………………………………………………38
第三節 子宮內膜異位症婦女健康生活品質之相關因子分析……………… 42
第四節 子宮內膜異位症婦女健康生活品質之預測因子………………….. 46
第六章 結論與建議
第一節 結論…………………………………………………………………… 47
第二節 護理應用……………………………………………………………… 48
第三節 研究限制與建議……………………………………………………… 50
參考文獻
中文部分 ……………………………………………………………………… 51
外文部分 ……………………………………………………………………… 53
附錄
附錄一 量表授權同意書 …………………………………………………… 59
附錄二 原文量表 …………………………………………………………… 62
附錄三 問卷專家效度名單…………………………………………………..64
附錄四 人體試驗委員會同意書書………………………………………… 65
附錄四 問卷內容…………………………………………………………… 67

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